Abstract
The goal of this chapter is to present a clinician-friendly guide to the identification, functional assessment, treatment, and evaluation of habit and tic behaviors. We combined tics and habits into a single chapter because of the topographical and functional similarities between tics and habits. For example, people who repeatedly shrug their shoulders may do so because they have learned that the specific response of shrugging releases muscle tension (an operant behavior that is maintained by automatic negative reinforcement, also called a habit) or because it is elicited by an internal stimulus as part of an organic disorder (e.g., Tourette’s) which results in a feeling of relief or escape from aversive somatic sensation. In both instances, the topography (i.e., shrugging shoulders) and the function (i.e., negative reinforcement by escape) are the same. Regardless of whether the shoulder shrugging is labeled a tic or a habit, the general assessment and treatment procedures will be identical.
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Bibliography
Azrin, N.H., & Nunn, R.G. (1973). Habit reversal: A method of eliminating nervous habits and tics. Behavior Research and Therapy,11, 619–628. Probably the most influential article on behavioral treatment of habits and tics. The article describes the complete habit reversal procedure, which has led to many developments and refinements in the treatment of habits and tics.
Friman, P.C., & Leibowitz, M.J. (1990). An effective and acceptable treatment alternative for chronic thumb and finger sucking. Journal of Pediatric Psychology,15, 57–65. This article describes a widely used clinical treatment protocol for thumb and finger sucking. It is the only empirical study with a large sample that shows aversive taste treatment with a reinforcement procedure to be effective.
Miltenberger, R.G., Fuqua, R.W., & McKinley, T. (1985). Habit reversal: Replications and component analysis. Behavior Therapy,16, 39–50. This article illustrates the effectiveness of using a brief habit-reversal procedure consisting of awareness training and competing response for reducing muscle tics. One of several original articles that examined modified, brief versions of habit reversal.
Peterson, A.L., Campose, R.L., & Azrin, N.H. (1994). Behavioral and pharmacological treatments for tic and habit disorders: A review. Journal of Developmental and Behavioral Pediatrics,15, 430–441. One of the most recent and comprehensive reviews of habit and tic disorders. This article does a nice job of providing prevalence data and describing the most effective treatment procedures for tics and habits.
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Watson, T.S., Sterling, H.E. (1998). Habits and Tics. In: Watson, T.S., Gresham, F.M. (eds) Handbook of Child Behavior Therapy. Issues in Clinical Child Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5323-6_22
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DOI: https://doi.org/10.1007/978-1-4615-5323-6_22
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