Habit Reversal Training: Stop Picking!
Updated: Jan 23, 2022
By Trudy E. Georgio, M.Ed., BCBA, LBA
Stop Fingernail Picking? How do I do that? Habit Reversal!
Confession: I am a picker. A fingernail picker. I picked up this 'nervous habit' many years ago, and have tried many self-management strategies to stop this behavior, without success. Even my mother screaming "stop picking!" for 30+ years didn't work! Then I learned about HRT!
In 1973 Azrin and Nunn developed a self- management technique called habit reversal. Habit Reversal Training (HRT) is a behavioral technique in which clients are taught to self monitor their ‘nervous’ habits and interrupt the behavior chain as early as possible by engaging in incompatible behavior. Skinner referred to a behavior incompatible with the behavior targeted for decrease as “doing something else” (Cooper, Heron, & Heward, 2020).
Habit reversal training the following components:
Self-awareness training: response detection and detection procedures. This involves detecting each occurrence of the behavior and relevant antecedents.
Example: I learned to recognize that when I was nervous (an environmental stimulus signals a worsening set of conditions ), I picked my cuticles. I further recognized precursors, or the beginning of the chain, such as inspecting my fingers for a loose nail or cuticle.
Competing response training: a physically incompatible response is identified, known as the competing response (CR). The CR is implemented in anticipation of the habit behavior for approximately 3 seconds.
Example: I identified a competing response: outstretching my fingers and pressing my palms firmly against my outer thighs for 3 seconds.
Motivation techniques: self- administered consequences, social support systems, and procedures for promoting the generalization and maintenance of treatment gains (Cooper et. al., 2020). Self- administered consequences may include reinforcement for meeting goals or punishment for failure to meet goals. Social support systems, a critical aspect for maintenance of habit reversal, include reversal include recruiting common individuals to provide prompts and reinforcement for targeted competing responses. Procedures for promoting generalization and maintenance may include training in multiple environments and transferring to natural forms of reinforcement.
Example: My friends praised me when she was not engaging in cuticle picking in the high-probability situations, and when I used my competing responses. If I were to show signs of finger picking, they reminded me to use my competing response. I moved from a self- administered schedule of 1 quarter in a jar for every success on a continuous reinforcement schedule to delaying reinforcement to a monthly manicure for meeting an average of 60% success! Success!
Illustrations of competing responses from Habit-Reversal: a Method of Eliminating Nervous Habits and Tics (Azrin & Nunn, 1973)
In another cool study by Mancuso & Miltenberger (2016), researchers used habit reversal training to decrease the rate of “filled pauses” such as “um”, “like”, and “tongue clicking” sounds during speeches. The participants practiced emitting competing responses for specific target behavior. Examples included substituting “um ” with a 3- second silent pause, and replacing “like” by placing the tongue against the inside of the bottom teeth for 3- seconds. In this study, competing for response training was mastered with the participant met an 80% reduction in target behavior from baseline average during speech. This study resulted in a rapid reduction of “filled pauses’ and the participants demonstrated maintenance of performance in follow-up probes. Anyone who engages in public speaking might find this helpful!
What are some habits that you have? What precursors do you have? What competing response could you use to decrease this habit? What could you use as a reinforcement strategy, motivational strategy, and social support system?
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Azrin NH, Nunn RG. Habit-reversal: a method of eliminating nervous habits and tics. Behaviour Research and Therapy. 1973 Nov;11(4):619-628. DOI: 10.1016/0005-7967(73)90119-8.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2020). Applied behavior analysis. Hoboken, NJ: Pearson Education, Inc.
Mancuso, C., & Miltenberger, R. (2016). Using habit reversal to decrease filled pauses in public speaking. Journal of Applied Behavior Analysis, 49(1), 188-192.