Habit Reversal Training
Habit Reversal Training (HRT) is a type of behavioral therapy to help individuals with repetitive behaviors, such as hair pulling (trichotillomania), and skin picking (excoriation disorder). HRT is also effective for Tics and Tourette’s disorder. HRT involves increasing awareness of the behavior, replacing it with an incompatible response, and using social support to reduce the frequency and intensity of the behavior.
Behavioral-Focused Repetitive Behaviors
Body-Focused Repetitive Behaviors (BFRBs) are compulsive actions that a person feels driven to do in response to an obsession. People suffering from BFRBs often feel a sense of relief or satisfaction during these actions, but they may also experience feelings of shame, guilt, and frustration afterward.
Why BFRBs Are Considered Mental Health Issues
BFRBs are more than just bad habits. They are recognized mental health conditions that require attention and care. The compulsive nature of these behaviors can lead to physical harm and emotional distress. Understanding that BFRBs are part of the mental health spectrum can help those affected seek appropriate treatment and support.
Treatment
Typically, HRT involves several structured sessions over weeks to months. An average course might range from about 8 to 12 sessions, with many individuals seeing improvement within the first few weeks. Continued practice and follow-up sessions may be necessary to consolidate skills and manage relapses.
Tics & Tourette's
Tics are sudden, brief, and repetitive muscle movements. There are two types of tics⎯motor tics and vocal tics and they can be characterized as simple or complex. Simple motor tics include eye blinking and head jerking while complex motor tics incorporate more coordinated effort, such as hopping. Simple verbal tics involve throat clearing or grunting while complex vocal tics involve more meaningful sounds such as saying phrases or words. While these movements and noises are involuntary, tics can be temporarily suppressed.
Tourette Syndrome
Tourette Syndrome (TS) occurs when someone has both motor tics and at least one vocal tic for at least one year. Tics vary in the type, frequency, and intensity, and they often come and go. Motor and vocal tics may occur several times a day, in bouts, or nearly every day. Stress and tension can make the condition worse, while relaxation or concentration can ease symptoms. Tourette’s mean age of onset is 5 to 10 years of age and peaks in intensity during early adolescence.
Diagnosis & Treatment
Up to 20% of young people may experience transient tics, but approximately 1% of them will meet the criteria for a Tic Disorder. It’s important to consult with a therapist specializing in tics to ensure early access to appropriate treatment.
Comprehensive Behavioral Intervention for Tics (CBIT) is an evidence-based treatment for tics and Tourette’s disorder. CBIT is based on HRT which teaches patients awareness training for their tics, stimulus training, competing response, training, and social support. Treatment lasts between 8-12 sessions.
