Habit Reversal

Description of the Strategy

Habit reversal was developed by Nathan Azrin and Gregory Nunn in 1973 as a treatment for habit disorders (nervous habits and tics). Habit reversal is best characterized as a treatment package because it consists of multiple treatment components used in combination, typically in outpatient treatment settings, with adults or children with habit disorders. Habit reversal was originally developed to treat nervous habits and tics and modified a year later to treat stuttering.

Habit reversal has been shown to be effective in treating a wide variety of habit disorders. What characterizes each of these habit disorders is their repetitive nature. Habit behaviors occur repeatedly across situations and continue to occur in the absence of social reinforcement. Nervous habits, also called bodyfocused repetitive behaviors by some authors, consist of repetitive hand-to-head behaviors such as hair pulling or hair twirling, hand-to-mouth behaviors such as nail biting or thumb/finger sucking, hand-to-body behaviors such as skin picking or scratching, and oral behaviors such as mouth biting or teeth grinding. There are two types of tics: motor tics and vocal tics. Motor tics consist of rapid, repetitive, jerking movements of muscle groups (e.g., head jerking, facial grimacing, shoulder shrugging), and vocal tics consist of repetitive sounds and/or words spoken with no communicative function (e.g., throat clearing, grunting, swear words). Motor and vocal tics may be part of a diagnosable disorder such as Tourette's disorder. Stuttering involves disruption in the fluency or timing of speech such as word, syllable, or sound repetition, prolongation of word sounds, or blocking when attempting to speak.

There are four major components of the habit reversal procedure: awareness training, competing response training, habit control motivation, and generalization training.