What Is Habit Reversal Training (HRT)?
Habit Reversal Training (HRT) is a behavioral treatment used for repetitive behaviors such as hair pulling (trichotillomania), skin picking (excoriation disorder), nail biting, and tic disorders (such as Tourette syndrome).
HRT helps people become more aware of these patterns and interrupt them more effectively when urges arise.
HRT Isn’t About Willpower
People struggling with repetitive behaviors are often told to “just stop” or use more self-control.
Unfortunately, these behaviors are rarely that simple.
Hair pulling, skin picking, and tics are often preceded by urges, tension, sensory discomfort, or feelings of incompleteness. Performing the behavior may bring temporary relief, which can make the behavior more likely to occur again in the future.
Rather than relying on willpower alone, HRT focuses on understanding the cycle that maintains the behavior and learning practical strategies to interrupt it.
The Core Components of HRT
HRT typically focuses on increasing awareness, developing competing responses, and changing how people respond to urges.
Building Awareness
Many repetitive behaviors become highly automatic over time. Treatment focuses on helping people recognize urges, triggers, and situations where the behavior is more likely to occur.
Developing this awareness creates an opportunity to respond intentionally rather than automatically.
Learning Competing Responses
One of the best-known components of HRT involves using a competing response: a behavior that is physically incompatible with the unwanted behavior and can be maintained until the urge passes.
The specific competing response depends on the behavior being treated and is individualized during therapy.
Responding Differently to Urges
A central goal of HRT is helping people learn that urges can be noticed without automatically acting on them. Over time, people often become better able to tolerate urges and interrupt repetitive behavioral patterns before they occur.
What Conditions Is HRT Used For?
Habit Reversal Training is commonly used for hair pulling disorder (trichotillomania), skin picking disorder (excoriation disorder), nail biting, tic disorders such as Tourette syndrome.
HRT is also a core component of Comprehensive Behavioral Intervention for Tics (CBIT), one of the leading behavioral treatments for tic disorders and Tourette syndrome.
Progress Doesn’t Require Perfection
The goal of treatment isn’t to eliminate every urge or never engage in the behavior again.
Instead, progress often involves becoming more aware of urges, reducing how frequently the behavior occurs, interrupting automatic patterns more effectively, and feeling less controlled by the behavior over time.
Habit Reversal Training in Arlington, VA
I provide Habit Reversal Training (HRT) for children, adolescents, and adults experiencing hair pulling, skin picking, tic disorders, and related repetitive behaviors. Treatment focuses on increasing awareness, interrupting automatic behavioral patterns, and helping people gain greater control over repetitive behaviors over time.
Hair pulling, skin picking, tics, and other repetitive behaviors can feel automatic and difficult to change, but they are often highly treatable. If you’d like to learn more about Habit Reversal Training (HRT), contact me to discuss whether treatment may be helpful for you or your child.