Habit reversal training (HRT) is a therapy that helps you stop or reduce the frequency of an unwanted behavior by replacing it with another. It can help you quit a wide range of behaviors, from nail-biting to specific tics. You’ll work with a mental health professional — and do homework — to complete HRT.
Habit reversal training (HRT) is a behavioral therapy that helps you eliminate unwanted behaviors (habits) by replacing them with other actions. Habits are repetitive behaviors that are often automatically reinforced and happen without you realizing it.
We all have certain habits. Some (like forgetting to close cabinet doors), while annoying, are harmless. Others (like skin picking) can interfere with your daily activities and even your health — physically and/or mentally. If you want help quitting a habit, HRT may be a useful tool for gaining back control of your behaviors.
Two psychologists developed the framework of HRT in the 1970s. Since then, several studies have shown its effectiveness in treating a variety of habits.
Habit reversal training can help treat several unwanted habits — mainly body-focused repetitive behaviors — in both children and adults. Examples include:
HRT may also be a part of treatment to manage the symptoms and behaviors of the following conditions:
If you want help to stop a habit or manage one of these conditions, consider reaching out to a mental health provider (like a psychologist) who has experience with habit reversal training.
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During habit reversal training, you’ll work with a mental health provider. In general, the steps of HRT include:
Relaxation training and generalization training may also be parts of HRT.
Awareness training is the first step in HRT. It involves making you more aware of when you’re doing the unwanted behavior. Your therapist may break down awareness training into further steps:
Competing response training is the second step of HRT. It involves learning to do a behavior that physically prevents the completion of the habit.
The replacement behavior should:
If you’re trying to replace nail biting, for example, you could:
Once you decide on a competing behavior, your therapist will help you use it during your sessions.
The final phase of HRT is intensive training. Your therapist may also call this step “motivation and compliance.” This just means that you rely on social support, like family members and friends, to help you reinforce the competing behavior.
For example, a loved one may praise you when they notice you use the competing behavior. Or they may gently remind you to do the competing behavior if they see you doing the unwanted behavior.
Habits that you’re trying to break tend to happen most often when you’re under stress. So, managing stress may help reduce the frequency of wanting to do the unwanted behavior. In relaxation training, your therapist will help you use various strategies to help minimize your stress level, like:
This component of HRT simply involves practicing the competing behavior in various situations and environments. If you continue to do the competing behavior and get comfortable with it, it’ll eventually become automatic and replace the habit.
Overall, several studies suggest that habit reversal training is an effective method for reducing a wide range of habitual behaviors.
But it’s important to note that it might not completely treat a more complex condition, like smoking in nicotine dependence or obsessive-compulsive disorder.
You may benefit from additional treatment options, like medication and other types of psychotherapy (talk therapy), for chronic (long-term) conditions. Together, you and your healthcare provider can develop a treatment plan that works best for you.
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Habit reversal training doesn’t have a set timeframe. The number of sessions with a therapist you may need depends on the complexity of the habit and other factors. You’ll also have to continue the work outside of the sessions to replace the habit with another action. This “homework” is crucial to how well HRT can work for you.
For some, successfully quitting a habit with HRT may take a couple of months. For others, it may take a year or more. Many people with chronic (long-term) conditions that cause repetitive behaviors, like tic disorders or dermatillomania, may need “maintenance” therapy sessions throughout their life after initial HRT.
If HRT isn’t working, reach out to your healthcare provider or a mental health provider. You may benefit from other therapies to manage unwanted behaviors. If your habit returns after completing HRT, reach out to your mental health provider. Follow-up HRT sessions may help get you back on track.
It can be difficult or embarrassing to admit that a habit is interfering with your life. But the sooner you get help, the sooner you can gain back control of your behavior and lead the life you want. For decades, habit reversal training has helped countless people eliminate unwanted repetitive behaviors. Reach out to your healthcare provider or a mental health professional if you want help breaking a habit. Know that they’re there to help you, not judge you.
Last reviewed on 08/16/2024.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy