Habit reversal training
Habit reversal training (HRT) is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders".[1]
Behavioral disorders treated with HRT include tics, trichotillomania, nail biting, thumb sucking, and skin picking.[2]
HRT consists of five components:[1]
- awareness training,
- competing response training,
- contingency management,
- relaxation training, and
- generalization training.
For tic disorders
In the case of tics, these components are intended to increase tic awareness, develop a competing response to the tic, and build treatment motivation and compliance.[1] HRT is based on the presence of a premonitory urge, or sensation occurring before a tic.[3] HRT involves replacing a tic with a competing response—a more comfortable or acceptable movement or sound—when a patient feels a premonitory urge building.[3]
Controlled trials have demonstrated that HRT is an acceptable, tolerable, effective and durable treatment for tics;[1] HRT reduces the severity of vocal tics, and results in enduring improvement of tics when compared with supportive therapy.[4] HRT has been shown to be more effective than supportive therapy and in some studies medication.[5] HRT is not yet proven or widely accepted, but large-scale trials are ongoing and should provide better information about its efficacy in treating TS.[6] Studies through 2006 are "characterized by a number of design limitations, including relatively small sample sizes, limited characterization of study participants, limited data on children and adolescents, lack of attention to the assessment of treatment integrity and adherence, and limited attention to the identification of potential clinical and neurocognitive mechanisms and predictors of treatment response".[1] Additional controlled studies of HRT are needed to address whether HRT, medication, or a combination of both is most effective, but in the interim, "HRT either alone or in combination with medication should be considered as a viable treatment" for tic disorders.[1]
See also
References and notes
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found. As reported in Piacentini JC, Chang SW. PMID 16536370
- ↑ 3.0 3.1 Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Michael B. Himle, Christopher A. Flessner & Douglas W. Woods (2004): Advances in the Behavior Analytic Treatment of Trichotillomania and Tourette’s Syndrome. JEIBI 1 (1),58-65 BAO
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
