Tic Behavioral Training: A Case Study

This client exhibits a nervous habit of hair pulling from various part of his body, also known as trichotillomania. According to Spiegler (2015) and O'Donohue and Fisher (2009), the most effective treatment approach for this is habit reversal training. As a treatment, habit reversal training consists of three main components, which are awareness training, competing response training, and reinforcement. Additionally, a forth component, relaxation training, is also important for the client to use when he is anxious in order to prevent the behavior. However, it is not always considered a major component of habit reversal training (O'Donohue & Fisher, 2009).
According to O'Donohue and Fisher (2009), the first step to take with this client would simply be assessment. This would involve the therapist asking the client to describe the hair pulling and the sequence of behaviors that lead to it. The therapist would also examine the antecedents and consequences of the habit behavior. The client would then be directed to collect data about the behavior, such as occurrence frequency and duration. Additionally, the client could record more permanent products of the behavior, such as numbers …show more content…
In other words, after identifying the urge associated with the tic behavior, a competitive response can be used to prevent the habit behavior from occurring or replace the habit behavior. This response should not only compete with the habit behavior, but should be able to be sustained for several minutes, compatible with everyday activities, and inconspicuous to others. For example, the client could cross his arms, sit on his hands, or put his hands in his pockets for two minutes instead of engaging in hair pulling, or even when he gets the urge to pull his hair. This could even be practiced in the session and allow the client to receive reinforcement from the therapist (O'Donohue & Fisher, 2009; Spiegler,