HABIT REVERSAL TRAINING
Habit reversal training (HRT) is an evidence-based highly effective behavioural therapy for people with unwanted repetitive behaviours or habits. HRT works on behaviours such as: hair pulling, nail biting, 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 behaviours (like relief from urges or feelings) until we look for them with the help of a professional.
HRT shows high efficacy rates in reducing Body-Focused Repetitive Behaviours (BFRBs). Patients who have had difficulties resisting the urge to bite their nails increased their nail lengths by 22 percent after using HRT.
5 steps of Habit Reversal Training:
Awareness training: brings attention to the behaviour to gain better self-control and awareness. In this stage you will work to notice when you are performing the behaviour, identify the earliest warning that a behaviour is about to take place, and identify the situations where the behaviour occurs.
Competing response training: we will work together to replace the old unwanted behaviour with a new one and practice performing this new behaviour.
Motivation and compliance: you may make a list of all the problems that were caused by the behaviour to remind you of the importance of sticking with it. Parents and friends may be asked to offer praise and encouragement for your progress, support of family and friends can increase your chances of kicking an unwanted behaviour.
Relaxation training: habits can be common when someone is under stress. While anxiety does not cause someone to develop BFRBs, studies have observed that those with BFRBs experience significantly higher levels of anxiety and depression than those without. It can be helpful to learn relaxation skills such as deep breathing, mental imaging, mindfulness, and progressive muscle relaxation to keep urges under control.
Generalization training: you will practice your new skills in a number of different situations, so the new behaviour becomes automatic.
Habit reversal training has also been used in treatment for depression, smoking, gambling problems, anxiety, procrastination, obsessive-compulsive disorders, and other behavioural problems.