Habits are automatic. They're unconscious behaviors that often occur without our awareness. Some habits are healthy and make you feel good, like brushing your teeth or engaging in regular physical activity. But we might also develop habits that are unwanted, like biting our nails or smoking cigarettes.
So what should you do when those bad habits take hold? Sometimes we're able to break them on our own. But often, we need some help. That's where habit reversal training comes into play. This therapeutic technique was specifically designed to help people overcome unwanted habits and replace them with more helpful behaviors. If you could use extra support to stop certain behaviors, this therapy might be for you.
What Is Habit Reversal Training?
According to the American Psychological Association (APA) habit reversal training is a strategy used in behavioral therapy. Also called habit reversal therapy, it is commonly used to help people unlearn certain habits and reduce unwanted patterns of behavior.
Behavior therapy is centered around a specific unhelpful behavior, called a "response." A behavioral therapist also identifies the environment where the behavior occurs and other reinforcing factors that may contribute to the habit. These are referred to as the "stimulus." Habit reversal therapy works by interfering with the stimulus-response chain of behavior by helping people recognize their triggers and adopt a new, helpful response.
The APA notes that habit reversal training has been used to treat a wide variety of conditions, such as:
- Nail biting
- Overeating
- Smoking
- Tic disorders
- Trichotillomania (hair pulling)
How Does Habit Reversal Training Work?
Habit reversal is an evidence-based behavioral approach to psychotherapy treatment. There are three steps involved in the therapeutic process, and habit reversal is usually completed over the course of 12 sessions.
Sessions 1-6 are typically held every week at the start of treatment. Sessions seven and eight are often held every two weeks, while the final sessions of 9-12 are held about every four weeks.
These timelines may vary depending on the behavior that is being treated, as well as the unique needs of an individual and their healthcare provider. For a more accurate timeline of treatment, be sure to talk to your behavioral therapist.
Step 1. Awareness Training
The first step of habit reversal training is dedicated to helping people recognize their triggers. This can help you to be more mindful of the aspects and environments where the behavior occurs, and give you a clearer picture of why the habitual behavior is activated.
Awareness training also involves three core elements:
- Response description: Therapists and patients work together to create a detailed description of the unconscious behavior. For example, it can include specific outlines of nail-biting behavior, such as putting their fingers in their mouth or picking at cuticles.
- Response detection: Individuals take note of every time that the unwanted behavior occurs during the session. They receive reinforcement from their therapist every time they catch the behavior, and are informed when the habit occurs without their awareness.
- Early warning training: Once patients become pretty good at recognizing when the unconscious behavior occurs, they are prompted to discover the earliest signs of their urges. Continuing with the nail-biting example, this can include things like rubbing the fingers together, bringing the hands closer to the face, or biting their lip. Individuals might also be encouraged to think of environments and situations where their unwanted behaviors commonly occur.
Step 2. Competing Response Training
The second step of habit reversal training involves brainstorming new behaviors that can't be performed at the same time as the unhelpful behavior. Before an individual creates this list, it might be a good idea to learn a few behavioral therapy vocabulary words.
Simultaneous response
These are behaviors that can be completed alongside an unwanted habit. Engaging in simultaneous behaviors does not reduce the occurrence of unhelpful habits, because people are still able to follow through with the response.
Some simultaneous behaviors for the habit of nail-biting could include, scrolling on your phone, watching a movie, talking to a loved one, or any other activity that you might do while biting your nails.
Competing response
This is a behavior that is physically impossible to achieve while engaging in the unwanted behavior. It offers an alternative response and helps people reduce the occurrence of unwanted habits. People should also be able to engage in these behaviors for at least one minute and they should be inconspicuous in social settings.
For example, if a person engaged in nail-biting, some competing responses to try include:
- Braiding their hair
- Massaging their calves
- Squeezing their hands into fists
- Sitting on their hands
- Tying their shoes
All of these above behaviors can't be completed if a person is biting their nails because both hands are required for the activities. Individuals can choose whatever competing behavior they wish, practice it in therapy sessions, and then begin to utilize the behavior in real-world settings.
Step 3. Intensive Training Exercises
The third and final step of habit reversal training involves social support. Family members and loved ones are recruited to help an individual follow through with their habit reversal training at home.
This support network provides an individual with praise and positive feedback when they successfully engage in their competing behavior. They encourage the person to continue their hard work. In addition, they're also responsible for keeping a patient accountable if they forget to use their competing behavior or fall back into old patterns. This helps provide constant support and guidance for individuals working on habit reversal.
Is Habit Reversal Training Right For You?
It's not easy to form a healthy habit. But it can feel equally as hard to reverse an unhelpful one. Although it might take some practice and encouragement from others, it's not impossible to break a bad habit that bothers you. If you're interested in habit reversal therapy or other forms of behavioral therapy that might help reduce unwanted behaviors, talk to your healthcare provider to learn more about treatment options that might be a good fit for you.
