Habit Reversal Training (HRT) or Comprehensive Behavioral Intervention for Tics (CBIT) is an evidence-based highly effective behavioral therapy for people with unwanted repetitive behaviors or habits. HRT works on behaviors such as: tics, hair pulling, nail biting, thumb sucking and skin picking to name a few, and is appropriate for people at any age. Often we don’t really understand what is driving our behaviors (like relief from urges or feelings) until we look for them with the help of a professional.
Habit Reversal Training is made up of five parts:
- Awareness training: brings attention to the behavior so the person can gain better self-control and awareness. In this stage you will work to notice when you are performing the behavior, identify the earliest warning that a behavior is about to take place, and identify the situations where the behavior occurs.
- Competing response training: you will work with your therapist to come up with a different behavior to replace the old unwanted behavior and practice performing this new behavior.
- Motivation and compliance: you may make a list of all the problems that were caused by the behavior to remind you of the importance of sticking with it. Parents and friends may be asked to offer praise and encouragement for the person’s progress, support of family and friends can increase your chances of kicking an unwanted behavior.
- Relaxation training: habits or tics can be common when a person is under stress, it can be helpful to learn relaxation skills such as deep breathing, mental imaging, mindfulness, and progressive muscle relaxation to keep urges at bay.
- Generalization training: you will practice your new skills in a number of different situations so the new behavior becomes automatic.
Habit reversal training has also be used in treatment for depression, anxiety, bedwetting, procrastination, obsessive-compulsive disorders, and other behavioral problems.