Habit-Reversal Training (HRT)
Habit-reversal training (HRT) is a behavior therapy technique designed to help individuals reduce or eliminate unwanted repetitive behaviors, such as tics, hair-pulling (trichotillomania), skin-picking, nail-biting, and other body-focused repetitive behaviors (BFRB’s). It is widely used in clinical settings for managing behaviors that can be disruptive or harmful, particularly in cases where individuals may feel a strong urge to perform the behavior despite negative consequences.
HRT is composed of several key elements that work together to help individuals become aware of their behaviors, identify triggers, and develop alternative responses:
Awareness training helps individuals become more conscious of when and how often the unwanted behavior occurs. The person identifies specific situations, thoughts, or emotions that trigger the behavior by using self-monitoring strategies to track when and where the behavior happens. Sometimes a partner or, in session, the therapist provides feedback when they notice the behavior.
In competing response training, the individual learns to replace the unwanted behavior with a competing response, which is physical behavior that makes the habit impossible or difficult to perform. For example, someone who bites their nails may learn to clench their fist or press their hands together, or a person with a vocal tic might practice slow, deep breathing as an alternative response.
Since many repetitive behaviors are triggered by anxiety or stress, relaxation techniques like deep breathing or progressive muscle relaxation can help manage urges.
