People sometimes struggle with bad habits because of certain mental disorders. Habit reversal training is an effective form of therapy that helps manage these behaviors.

Humans have the unique ability to train themselves out of their established habits. Habit reversal training, also known as habit reversal therapy, helps people manage certain actions or conditions that have created a pattern of dysfunction.

What Is Habit Reversal Training?

Its name is straightforward, but exactly what is habit reversal training? How does it work, and what are its components?

Available since the 1970s, habit reversal training (HRT) is a comprehensive, step-based intervention. It allows clients to become more aware of their unconscious habits and trains them to act in alternative ways. A recent surge in clinical evidence for its effectiveness has popularized this intervention, especially in treating impulse control disorders and Tourette syndrome.

How Habit Reversal Therapy Works

Have you have ever experienced a muscle twitch in response to stress, or do you know someone who experiences tic disorders? If so, you have a framework for understanding how habit reversal therapy works. Habit reversal training makes individuals more aware of their unconscious behaviors. After gaining a more conscious awareness of these behaviors, HRT shows clients how to create new behaviors and prevent old ones from returning.

Habit Reversal Training Components

Habit reversal therapy splits the process into five parts. Habit reversal components include:

  1. Awareness training: The goal of this training is to increase the client’s awareness of unconscious behaviors. Using a step-by-step approach, clients are made to be literally self-conscious. For example, they may watch their repetitive actions in a mirror and describe what they see. The therapist acts as an extra set of eyes for monitoring the undesired habit. Together, the therapist and client can look for the earliest warning signs of undesirable behavior. As a client gains self-awareness, they can more easily control undesirable or unhealthy patterns.
  2. Competing response training: Once the habit has been identified, the next step is to replace the old behavior with a new one. In this way, competing response training is similar to using methadone or buprenorphine in medication-assisted therapy. These medications offer a competing response to opioids that are difficult to control.
  3. Relaxation training: If competing response training is similar to medication-assisted therapy, then relaxation training is comparable to a medication taper. By learning relaxation techniques, clients can gradually replace old, dysfunctional patterns with new, beneficial patterns.
  4. Building motivation: To prevent undesirable habits from returning, clients are taught to use both positive and negative reinforcement. For negative reinforcement, clients should make a list of all the ways their behavior has caused harm. For positive reinforcement, friends and family are highly encouraged to praise clients undergoing therapy.
  5. Generalization training: Generalization aims to incorporate the medical setting’s “safe” experience of habit reversal into “real world” settings.

Effectiveness of HRT

HRT is proven to be effective in addressing many mental health disorders. These include addiction, Tourette’s syndrome and other types of compulsive disorders or behavioral issues.

HRT in Addiction and Mental Health Treatment

Though HRT was designed to treat impulse control disorders, it can be highly effective in treating compulsive behaviors like addiction. However, only case reports and small studies have looked into the use of HRT for addiction. Currently, the push for more research on HRT for addiction appears to be gaining momentum.

Habit Reversal Training for Trichotillomania and Skin Picking

The Tourette’s Foundation and the National Institutes of Health have established the effectiveness of habit reversal training for the treatment of excoriation (skin picking disorder) and trichotillomania. Trichotillomania is the habit of pulling out one’s hair, which can lead to baldness.

Habit Reversal Training for Tic Disorders

Since it was designed for this purpose, habit reversal training for tic disorders has strong clinical evidence for its effectiveness. Clinical trials have repeatedly shown that HRT is the most effective behavioral intervention for reducing the severity of tic disorders like Tourette syndrome.

If you’re looking for help reversing unwanted habits related to addiction or a co-occurring mental health condition, The Recovery Village is here to assist you. Our experienced and caring staff will help you improve awareness of your habits and find alternative options for them. Contact us today to learn about our treatment programs and offerings.

Jonathan Strum
Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
Kevin Wandler
Medically Reviewed By – Dr. Kevin Wandler, MD
Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more
Sources

Azrin, N., Nunn, G. “Habit reversal: a method of eliminating nervous habits and tics.” Behaviour Research and Therapy, 1973. Accessed May 23, 2019.

Stock, A. “Barking Up the Wrong Tree: Why and How We May Need to Revise Alcohol Addiction Therapy.” Frontiers in Psychology, 2017. Accessed May 23, 2019.

Piacentini, J., et al. “Behavior Therapy for Children with Tourette Disorder: A Randomized Controlled Trial.” Journal of the American Medical Association, May 19, 2010. Accessed May 23, 2019.

Lee, M., Mpavaenda, D., Fineberg, N. “Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials.” Frontiers in Behavioral Neuroscience, 2019. Accessed May 23, 2019.

Dutta, N., Cavanna, A. “The effectiveness of habit reversal therapy in the treatment of Tourette syndrome and other chronic tic disorders: a systematic review.” Functional Neurology, June 3, 2013. Accessed June 10, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.