Habit Disorders Program

Habit Disorders Program

Habit disorder is the term used to describe several related disorders linked by the presence of repetitive and relatively stable behaviors that seem to occur beyond the awareness of the person performing the behavior. Habit Reversal Therapy (HRT) and related behavioral techniques were originally developed in the 1970s and since then have been used extensively in the treatment of Tourette Syndrome, tics, nervous habits, stuttering, skin-picking, nail-biting, hair pulling (trichotillomania), thumb- sucking, and other habit disorders.

HRT has four main parts: awareness training, development of a competing response, motivation building, and the generalization of skills. Awareness training helps the person become aware of: the details of the behavior, the frequency of the behavior, the earliest signs of the behavior, and all the situations/contexts in which the behavior occurs. Development of a competing response involves replacing the identified behavior with an opposite and usually less noticeable and more socially appropriate behavior.

Motivation building requires the client (and caregivers if involved) to make a list of problems caused by the behavior, and with the use of praise and encouragement to continue the progress of using competing responses. Finally, in the generalization of skills, the client is encouraged and praised for practicing the new skills in a variety of contexts outside the therapy office (e.g., home, school, public, etc,).

HRT has been developed into a manualized Comprehensive Behavioral Intervention for Tics (CBIT) and has been used with children and adults. Manualized treatment lasts anywhere between eight to sixteen sessions, at times adding components such as progressive muscle relaxation, and breathing techniques in order to lower the overall levels of the patient’s distress.