Habit Reversal Training (HRT)

In Habit Reversal Training (HRT), the person has identified a habit they would like to change, usually because that habit has begun to be problematic for them in some way. Some examples of issues that can be addressed with HRT are Trichotillomania (hair pulling), Dermatillomania (skin picking) and nail biting. 

Increasing Awareness

The first step in this approach is to develop a very thorough understanding of the habit. For instance, what are you usually thinking about, feeling or doing before you engage in this habit? In what situations is this behavior most likely to occur? How do you feel while you are engaging in the habit? What are the positive or negative things that happen as a result of you doing the behavior? This kind of thorough assessment leads to greater awareness and understanding of the behavior for the person trying to change the behavior as well as anyone supporting the person in making the change (e.g., therapist, parents, partners). 

Competing Response

Once the behavior is very well understood, a competing response is introduced. There are many possible competing responses and different things will work for different people. The general idea is to do something that is incompatible with the habitual behavior you are trying to change. The competing response, or responses, are practiced regularly, sometimes when you are not even feeling the urge to do your habitual response. 

HRT in Therapy

Working with a therapist who has training in HRT can be helpful in collaborating to form a plan, increasing and maintaining motivation for follow through and gaining support from an outside perspective. Since some habits occur more when a person is feeling upset, bored or anxious, CBT can be used to address emotions or moods that might increase the likelihood of the habitual behavior occurring.