Habit reversal training was started over 30 years ago, by Nathan Azrin, PhD, in Fort Lauderdale, Florida. Dr. Azrin found that people were sometimes able to substitute a competing response for a tic that troubled them. For example, someone who made a hand movement might focus on pulling their elbow in toward their waist instead, which would be less noticeable and less troublesome.
Not all are candidates for the method. Studies over the years have been modest in size, with mixed but encouraging results. Now, the National Institute of Mental Health is providing over 5 million dollars to study the technique. It’s rare to see studies on Tourette’s that don’t involve drugs — this is a positive sign.
A few years ago, I went to Dr. Azrin’s office to interview him on habit reversal training (HRT). A bright, affable, and dedicated researcher, one of Azrin’s greatest concerns was that the steps involved in the process were sometimes minimized by behavior specialists and he suggested this could make it less effective. At the time, there were so few professionals engaging in the treatment that it was difficult for people to explore it.
We hope that there will be more practitioners offering this intervention after study results in 2012 that showed positive results for tics.
See study results here.