Habit Reversal Training (HRT)
Habit Reversal Training (HRT) is the evidence-based treatment for behaviors such as Tourette’s syndrome, which is characterized by motor or verbal tics, as well as habit disorders, such as trichotillomania (hair-pulling) and pathological skin picking. HRT is a multi-component behavior treatment implemented in a therapy session with the client who exhibits the habit disorder/ tics.
HRT is composed of five main components:
Awareness training- the person is first taught to describe the behaviors involved in the habit. Then, the person learns to identify when the habit occurs or when it is about to occur.
Competing response training- the person learns a behavior incompatible with the habit behavior. They then practice the competing response when the habit occurs or when they have the urge to engage in the habit. Next, the person imagines and makes a list of when the habit is most likely to occur outside the clinical session to inhibit the habit. Lastly, the person is instructed to use the competing response outside of the clinical session whenever the habit occurs or is about to occur.
Social support training- significant others (i.e., family members, friends) are taught to prompt the person to use the competing response(s) when the habit occurs. They are also taught how to praise the person for engaging in the competing response and not the habit.
Building motivation- person reviews the situations in which their habit causes them inconveniences, embarrassment, and prevents them from accessing their values/ goals. The person also develops a list of goals they hope to accomplish and access when they are no longer engaging in the habit(s).
Generalization of new responses- person is encouraged to use their learned responses in a variety of settings in different contexts other than the mastered environment(s). This purpose is for long-lasting, sustainable change.