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The UK College of Hypnosis and Hypnotherapy

Hypnotherapy Toolkits
Habit Reversal

©UK College of Hyposis & Hypotherapy 2021


WELCOME
HOW TO USE THIS TOOLKIT

Welcome to The UK College of


Hypnosis Habit Reversal Toolkit.
Please note that this toolkit is intended
to supplement and summarise your
learning so far. This toolkit is for you to
use alongside our other materials and
it is a supplement for rather than a
replacement for your own knowledge
and expertise.

The toolkit is a quick access guide to


the information you will need to get
started treating client's who would like
to break a habit. As you make your way
through the toolkit, you will see
underlined text, if you click on this it
will take you straight to the resource
mentioned. You will be able to access Mark Davies principle of The UK College of Hypnosis

supporting videos, Habit Reversal can


be found under Stage 2:Module 5 and Where specific toolkits contain critical
also Stage 2:Module 6 and scripts. information, we have referred to them
and you can click through to read them.
We have many other useful resources
such as the online blog and in the At the end of the toolkit you will find the
future, as this booklet is updated these contact details of the producers of this
resources will be added as direct links. toolkit, if there are any technical issues or
suggestions you have please contact
We encourage you to use the them.
information here together with our
other toolkits, keeping in mind the Enjoy the toolkit!
multimodel approach we take.

©UK College of Hyposis & Hypotherapy 2021

Page 2
HABITS
DEFINING THE PROBLEM

A habit is a behaviour that people have You can use what you learn to help
learned through continued repetition people develop healthy behaviours such
We all have them. People will often as eating well. You can also use the
think of seeing a therapist for stopping protocol for a once functional behaviour
an unwanted habit, and they may not be that has now become dysfunctional, such
aware that a therapist can help them as during Coronavirus touching your face.
build healthy habits. Therapy is also
about creating healthy habits; explaining The techniques for habits have broad
this to your client can help them in their application if you consider that all we are,
journey. are habits then any behaviour could
potentially be dealt with using these
According to Salter, all we are is habits, techniques, though some techniques may
which can be a helpful psychoeducation be suited to motor habits like habit
point for your client. We develop reversal.
conscious habits, such as healthier
eating habits, but we may also create Key Points
unhealthy ones such as nail-biting, skin
picking, nervous ticks, hair twirling, lip
biting,hair plucking and nose picking. The four most common classes of habit
dealt with are nailbiting, hair pulling,
stuterring and nervous tics.
Habits can seem unconscious, but it is
Examples of other habits nose-picking,
better to view them more as automatic itch-scratch cyle, knuckle cracking,
ways of coping or automatic things we smoking
have learned. Notably, with habit Habits are dealt with by increasing self
reversal, an empowering principle is that awareness , installing a counter habit,
practice and social support., aversion
what has been learned can be
therapy and negative practice.
unlearned. Very key to habit reversal is awareness
raising if you raise awareness and bring the
In this toolkit, we focus on the protocol habit within a persons control they will find
it easier to stop.
for unwanted habits, but you will be able
Remember habits can also be a habit of
to use our suggestions in other areas. worry but this would be dealt with using
another protocol such as thought stopping.

©UK College of Hyposis & Hypotherapy 2021

Page 3
HABITS
TYPICAL FEATURES AND APPROACH

The variety of clients visiting you for habit Negative Practice


may well come for the same habit but as Involves the client deliberately doing
you can see the root of their issues, their habit repeatedly en masse while
insight, level of motivation and level of telling themselves they will practice the
self-efficacy will differ as it does in other habit so later on they will be able to
conditions. Therefore, although we lay stop it.
out the typical approaches here you may
have to teach other skills or lay other
groundwork first. Paradoxical intention
This is similar to negative practice and it
involves gaining control of the problem
Habit Reversal by the client telling themselves that
Habit reversal can be used for many they are going to do the symptom for
simple habits such as nail-biting, skin example sweating any time and that
picking, lip biting, smoking (with they can do it anytime really well. It is
additional training), nose picking and hair best used for anxiety of a symptom that
pulling. The typical approach to treating a anxiety increases.
habit is by increasing self-awareness,
installing a competing habit, practice and
social support., The key to this approach
is the inhibition of the old response with
the new response and raised awareness
of their habit.

Aversion therapy
Would be used for harder habits like
smoking. Please see our Smoking CPD
Course. The simple principle is
something aversive is paired with the
desired object, for example, imagining
wriggling worms when imagining
chocolate.

©UK College of Hyposis & Hypotherapy 2021

Page 4
HABITS
TYPICAL FEATURES AND APPROACH

The aim would be to reduce the anxiety


and struggle the client is having because
they are anxious about the symptom.

It can be used where the stimulus for the


symptom has passed but the client is left
with the habit such as a new Mum waking
for the baby still having disrupted sleep
worries about sleeping and therefore
doesn't sleep. If you instruct the new Mum
to read and try to stay awake they will fall
asleep.

Thought Stopping
Useful for unhelpful habits of thinking that
may well be connected to a physical habit
for example a client may begin a habit of
Assessment and treatment are
ruminating in response to difficult work
interwoven and a second session may
and then start twiddling their hair or
well be a follow-up to reinforce their
clenching their jaw in response to the
learning.
anxiety created by an unhelpful thinking
pattern. It can be used across client issues
However, there may be some clients
for example stopping thinking trains
where assessment reveals more
associated with being alone and unhelpful
widespread anxiety. In these situations,
thinking about the behavior of a boss.
it is appropriate to consider a longer
treatment plan with habit reversal being
Typical Number of Sessions included in the treatment plan.

We think for habit reversal one to two Start with a careful assessment.
sessions will be all your client requires for
a simple habit if they come to the session
with a completed diary.

©UK College of Hyposis & Hypotherapy 2021

Page 5
HABITS
ASSESSMENT CONSIDERATIONS

Remember
You will complete a two part
assessment one for habit reversal and
one general assessment.

The assessment is also treatment as


you raise awareness of the habit the
client is able to take more control of it.
Assessment and treatment are
interlinked.

Consider the clients motivation to


keep the habit, have them do the habit
and see that the habit produces feel
good feelings but get them to see
their is no real pay off e.g the
problems don't get fixed, nails get
damaged or time is wasted which
Assessment Considerations could be spent on other things.

It might not seem relevant to do a general You may need tools such as a mirror
assessment for a client coming in for a on hand to help your client start to
simple habit problem. However, as you become aware of their habit.

have experienced on the course unpicking a


habit may reveal Psychological issues the Assessment is also about rapport and
client hasn't dealt with and wasn't aware of. building your clients confidence that
Sometimes, you will still be able to see this you understand and can help them.
client, but you might need to do other work
Assess for stress and point out the role
with them such as assertiveness training to in maintaining your client's habit.
come up with an alternative competing Clients will say they are not stressed
response or coping behaviour. Some clients when doing the habit so take them
habits will be part of a much larger more through each situation to reveal the
people or circumstances where stress
complex issue that may be out of your
arises.
sphere of competence, such as health
perfectionism or generalised anxiety You
will need to manage expectations around
what successful treatment will look like with
clients who have more complex problems.

©UK College of Hyposis & Hypotherapy 2021

Page 6
EXAMPLE TREATMENT PLAN
ASSUMING NO COMPLICATED FACTORS

Session 1: Initial Consultation & Assessment

1. Session (120 minutes)


2. Welcome, agenda setting, intro to the
method (10 mins)
3. General assessment (10 mins)
4. HRT assessment – including awareness
training, list of situations,
5. social resources, alternative thoughts
(30 mins)
6. Teach and practice brief relaxation
(Tension Release Breathing) –
7. 20 mins
8. Teach and practice competing
response + add coping statements +
9. relaxation (15 mins)
10. Mental Rehearsal of Scenarios (15 mins)
11. optional: hypnosis with strong
suggestions for motivation and
12. change, use of method – and include
mental rehearsal and images of
success
13. Conclude with discussion and
agreement of daily practice (10 mins)

Session 2: Optional

Reinforce the techniques learned or change them.


Use hypnosis as a booster session.

©UK College of Hyposis & Hypotherapy 2021

Page 7
HABITS
TYPICAL FEATURES AND APPROACH

Maintaining Behaviours
Typical features of a client
They are unaware of all the
.What are some reasons for the behaviour
maintaining behaviours.
and how is it maintained? They are unaware of all the
behaviours leading up to doing the
A habit is a behaviour that people have habit
learned through continued repetition and They are unaware of the negative
reinforcement. effects of their habit.

Maintaining Beliefs
Maintaining Affect
Clients may think they have no control
over their habit because it appears to The habit is rewarding find out how and
happen unconsciously. This may maintain give the client a replacement
beliefs of hopelessness about the behaviour. As an example, if the client
behaviour. Check self efficacy. does the behaviour when nervous
doing the behaviour allows relief which
They may assume that because the is rewarding but it doesn't fix the
behaviour is negative/unwanted they will problem.
be unable to take charge of it, they may
have tried being overcontrolling which Doing the behaviour results in a short
has the effect of the habit growing. term reduction of feelings but a long
term issue because they will then judge
They might engage in all sorts of themselves and engage in lots of
unhelpful thinking around the habit, such unhelpful thinking around doing the
as berating themselves for not giving the behaviour
habit up, making it more likely their stress
will rise and they are more likely to do Maintaining environment
their habit if it is used in a self soothing Overly harsh correcting of the
way. client's habit is unhelpful.
Stressful sitatiations or people
Replace with social support.

©UK College of Hyposis & Hypotherapy 2021

Page 8
HABITS
HYPNOSIS APPLICATIONS

Goal visualization, reinforcement, and Assertiveness Clients will often do


relapse prevention or practice is built into their habit with particular people or
the approach non-hypnotically and it is struggle with self-assertiveness. It may
integral to the approach. It is used every be worth practicing assertiveness and
day for 10 minutes as a way to embed the then using hypnosis to reinforce this.
learning in their session. Visualization can You could also include suggestions of
also be used to visualize the kind of person self-assertiveness in any hypnosis you
they will be without their habit. Clients can do that focuses on stopping the habit
also Practice dealing with trigger situations
You can let clients know that people have Suggestion Tests could be used to
successfully used this technique before help stop a habit you could use any
battle so that they are prepared to deal with imagination exercise such as arm
any challenging situations that come up. catalepsy for imagining a client's hand
has frozen in place on the way to
biting their nails or suggesting the
Relaxation If you client doesn't already hand on the way to the mouth
have a way to deeply relax then teach them becomes a tight fist.
a relaxation approach or do hypnotic
relaxation with them. Incorporate
suggestions of relaxation into any hypnosis
you do.

Expectancy Initial brief skills training may


help to raise the client's belief in the
effectiveness of the whole therapy. If you
teach some hypnosis and the client finds
they are responsive, they learn what a
powerful effect their mind has and they will
learn to expect changes and changes can
also be suggested to them and linked to
the initial abilities with skills training.

Raising Motivation
You can take clients through a very vivid
script helping them to experience all the
negative consequences of doing their habit
as a way to unhook them from it and draw
their attention to missed opportunities to
use their energy well.

©UK College of Hyposis & Hypotherapy 2021

Page 9
HABITS
STARTING OUT WITH YOUR CLIENT

This can be done at a first assessment too, however, a phone screening is a good
opportunity to set expectations about the therapy, reassure the client, build rapport
and assess whether this client is suitable for therapy.

Assess readiness to change. It is very important to assess their readiness to


change as it is with all clients. Be alert to statements such as "I should give up"
and ask the client directly "do you want to?" or What would be different if you gave
your habit up"? Some clients enjoy their habit and therefore a cost-benefit
analysis is necessary to see if they want to give their habit up.

Assess motivations Check who wants them to give up the habit. Clients may
come in because someone else has asked them to or because they fear the social
consequences of the habit. Smokers for example will often turn up because
someone else asked them to.

Assess expectations Clients may expect to turn up and have magic wand therapy.
When clients seek hypnosis for a habit they may expect that one session can fix
them, in many cases this can be true but it needs to be emphasized to them that
they can only stop their habit with practice and through being an active participant.
Clients may need a couple of sessions to stop their habit. Prevent rupture by being
clear about the time commitments, they will need to practice after the treatment
session and complete work prior to it.

Educate Consider the importance of normalising what your client is going through
clients might find their habit or not being able to give up their habit embarassing, it
can help here to tell stories of other clients you saw or helped.

Assess efficacy and build it check initial


levels of self belief. Look for ways to build
their sense of efficacy in a first phone call

.Build rapport the above points will help


you in building and maintaining rapport
with your client.

©UK College of Hyposis & Hypotherapy 2021

Page 10
HABITS
STARTING OUT WITH YOUR CLIENT

Anticipate any fears about hypnosis or their ability to stop the habit. Clients may
feel that habits are very hard to break, address this by saying that the way we deal
with stopping a habit is by creating a new more powerful one. You can ask for
previous attempts to stop and gather data on what helped and use this to help
them. Mention elements of the treatment that make it successful and that are
different from usual hypnosis or other therapies such as relapse prevention which
is often a missing step in other therapies. (add in this may come up at any point
from first contact to in therapy)

Raise expectancy - this happens throughout therapy but initially, to inspire your
client you can mention that the protocol for example habit reversal is evidenced
based with a very high success rate. You can also raise expectancy by talking
about your own habits you have overcome or tell stories of your client's successes
while still, of course, observing confidentiality.

Raise motivation by telling clients the key to the approach is to practice every day
just like they practiced their other habit they will practice this new habit while we
unpick the other one. They will practice taking control of their habit.

Send out
1. ego strengthening track
2. information about hypnosis and explain to your client the importance of motivation
and self-belief.
3. Client therapist roles plus rational
4. Contract
5. Habit Reversal Diary with an explanation of its purpose.

©UK College of Hyposis & Hypotherapy 2021

Page 11
HABITS
ASSESSMENT TOOLS

Habit Reversal Questionaire


Helps you gather the data necessary for
going through the habit reversal protocol
and helps raise awareness of the habit for
the client.

Habit Diary
Give this to the client so they can begin to
build an awareness of the situations that
trigger their habit, frequency of the habit
and different thoughts and behaviors
they note happening. It is also an
introduction to working in the Hypno-CBT
way.
Imaginal recall
In habit reversal this can be used for
assessment purposes and it is also a tool
for awareness raising with the client.
When the client goes through a past
.episode where the habit occurred they BASIC ID
will learn to spot the early signs that they Multimodal assessment of the client's
are about to do their habit, how it feels issue.
and the steps and stages of them PHQ-9
performing the habit from start to finish. Assessing for depression which is
They will also be able to find any triggers unlikely but it is still worth having a
client complete it to check they are not
for the behaviour in the situation and start contraindicated for treatment.
to address these.
GAD-7
Your client's habit could be part of a
Hierarchy forms
larger anxiety issue such as health
Could be adapted to form a hierarchy of anxiety or social anxiety at a clinical
situations in which the client thinks there level in which case your client will need
is a low, medium or high risk of their habit to seek alternative support.
being triggered so they can practice The form for these two forms are
coping at the lower levels and then build available here .
confidence for the higher levels

©UK College of Hyposis & Hypotherapy 2021

Page 12
HABITS
OPTIONAL SCRIPTS

1.Ego strengthening
It can be useful to give this to all
clients to help build their self-belief
initially and as an introduction to
hypnosis.

2 Future goal visualization


This could help clients who are
struggling with motivation. You could
supplement it with a form exploring
the costs of choosing to keep their
habit,
Idealised Self Image Script

3. Tension Relief Breathing


The main relaxation technique we
use. To refresh your knowledge with
teaching Tension Relief Breathing see
day Day 2 Stage 2. Remember do not
use this technique with overly
anxious people who control their
breathing or for people where using a
relaxation technique reinforces their
problem.

TRB Skills Training Script

TRB Client Handout

TRB Principles

©UK College of Hyposis & Hypotherapy 2021

Page 13
Oddball Imaging Studio

HABITS
GUIDELINES AND TIPS

"...therapy is education rather than healing"-Lazarus

Raise Self-Efficacy Tell stories of how other clients have succeeded. This allows a client to
be persuaded that they can overcome their problem and it might help them to overcome
their issues through vicarious learning. It also prepares the client and raises response
expectancy..
Prepare for relapse Their habit will reoccur but not at the rate it was before. You need to
prepare clients to expect that it will happen and help them with appropriate attitudes for
handling it. Help clients to see their habit and stop it is a different thing to them doing their
habit mindlessly and frequently. As long as they use their protocol they are taking action in
the right direction. If clients have learned other coping tools (as they will in smoking
cessation) part of relapse prevention can include reminding clients they have these tools if
needed. You can also set up a session for after therapy has finished in case clients need it
which can help them feel more secure. In using all the approaches it is important to
emphasize that relapse or the desired behavior reoccurring is expected and normal the
most important thing for your client to understand is that their ability to stop and redirect
the behavior is key and their practice. We want the behavior to reoccur so it can stop.
What kind of therapist? (link to assessment toolkit) Your ability to role model includes
demonstrations that are planned but also remembering everything within an hour is
therapy. You need to role model helpful attitudes and also build and maintain rapport.
Examples of role modeling that could be relevant to habit reversal are self-assertiveness,
showing an ability to be self-supporting and nip behaviors in the bud. Being assertive with
your client too is important. Another example of helpful role modeling is an attitude of
compassionate curiosity, particularly when a client is being self recriminating. or a mistake
happened and providing verbal reinforcement to yourself or the client. For a full list of
helpful therapist, qualities see our assessment toolkit.
Provide a rationale to the client If you are using hypnosis then this also includes the
rationale for hypnosis and why the habit reversal protocol works. Explain initially why their
habit exists. Then explain that even just knowing why their habit occurs or when is a step
towards breaking the unawareness and hooks of their habit that appears to happen
automatically and out of awareness. The method works because we provide a competing
response that cannot be done at the same time as their habit. We are retraining their
bodies with this competing response and increased awareness which means that habit will
be less likely to occur. Even if the habit does occur it doesn't matter because we won't
reinforce it instead we will see it as a sign to practice stopping the habit. We will stop future
occurrences by replacing negative self-talk with positive reinforcement and stress
reduction. We notice and self-reward when we have stopped and changed our behavior
making it more likely we will stick to building the new healthy habit.
Raise Expectancy Draw on anything that helps raise a client's belief that they will respond
to hypnosis or have a good outcome in therapy. As an example telling previous smokers
that have already quit a few times that this makes it even more likely they will stop this
time.

©UK College of Hyposis & Hypotherapy 2021

Page 14
HABITS
GUIDELINES AND TIPS

If using hypnosis choose the correct induction. for the client and the goal Choose an
induction that fits with the client's expectations of hypnosis, that isn't overly long if you are
doing a single session for habit reversal and that is easy for the client to use and practice.
Eye induction may well be the best choice.
Use relaxation and explain that relaxation weakens habit strength we can't do a habit if
relaxed and learning to be more relaxed overall will help decease their habit. Explain that
relaxation will build beliefs they are managing their habit with confidence as when we are
more relaxed we feel more confident. Explain relaxation as a reward they can look forward
to after stopping their habit so they will no longer need their habit.
Coach clients in relaxation. Clients will use TRB in the habit reversal protocol which should
help build the client's awareness of doing their habit (muscular tension) and letting it go
(relaxation)/release). Clients may want to use another method in which case you could use
some of our other ways of relaxing such as progressive muscle relaxation but teach clients
how to practice it so that they can apply it quickly and across multiple different settings.
Encourage “as if now” imagining Clients are asked to imagine that visual scenes are "as if
now" and to "pretend they are real", to help counteract cognitive issues such as discounting,
i.e., "This doesn't count, it's just images they're not real."
Wait or help clients get “into” their scene Clients are given time to picture scenes to their
satisfaction, nodding their head to signal when they are ready to proceed. This may
improve the quality of visual imagery and reduce anxiety about being able to comply with
instructions.
Measure Self-efficacy may help measure accurate outcomes and. It also allows the client
to see and register the change making a more objective appraisal of the situation. Self-
efficacy ratings can be used for the application of copings skills. Clients need to be asked
how confident they feel 0-100 in gaining control of their habit.
Encouragement: Clients are given congruent verbal praise for improvement, based on the
principle of successive approximation by positive reinforcement. “You’re doing really well.”
Debriefing: After completion of the exercise, clients are asked about their responses in
detail to help identify and reinforce positive strategies, including appropriate spontaneous
changes made by the client to their thinking or imagery. Debriefing helps highlight any
issues too.
Support Let clients know they can come back for a follow-up session sometimes this can
really help clients have more confidence in the process when they know someone is there
if things do not go according to plan. Make sure clients have social support this is very key
for habit reversal as the people around them help them stop their habit.
Increase motivation Really look at how the habit is negative and costs them time and
energy without delivering. Show them and make real the cost of their behavior using either
forms or imagination exercises. look at how their values might be affected by their behavior.
EWS Don't worry if clients only have one, one is enough to stop the behavior.
Discourage Discounting

©UK College of Hyposis & Hypotherapy 2021

Page 15
HABITS
TREATMENT

Habit Reversal Protocol


Keep Records. Starting before training has even begun, a daily record is kept of the
frequency of the habit, so that progress can be consciously monitored and reviewed
throughout. Being very clear about the rate of progress seems to help people remain
motivated and focus on making further improvements. This could be a record of the
number of occurrences per day, or per hour, or the percentage of time spent doing it,
depending upon the nature of the habit in question, e.g., “I bit my nails five times today.”
Build Motivation. Write down and review all of the situations in which the habit causes
difficulty, all the annoyances and inconveniences caused, in order to reinforce the
motivation to change, e.g., “People laugh at me; I don’t feel in control; I avoid certain
activities like shaking hands”, etc. This is similar to the technique of listing “reasons for
quitting” used in smoking cessation treatment.
Identify Habit-Associated Behaviours. The client learns to identify and write down a list
of the mannerisms and behaviours which normally precede the habit, e.g., “I usually stare
at my fingers for a few minutes before I start biting the nails; Sometimes I cup my chin in
my hand for a while first, before putting my fingers to my mouth.” Stopping the
behaviours which precede the habit makes it easier to “nip it in the bud”, i.e., to block the
habit before it even begins.
Increase Habit-Awareness. Increased awareness is cultivated, of exactly how and when
the habit occurs, in order to interfere with the habit process. One method involves
performing the habitual action in front of a mirror and closely observing the actions
involved. A second technique involved performing the action very slowly and
deliberately while describing each movement aloud to yourself. A third method is to
spot the first inclinations to perform the habit just as it is beginning and put a stop to it, in
order to realise how it begins to happen.
Learn Relaxation Techniques. A simple relaxation technique is learned and practised to
reduce tension, which often precipitates or exacerbates the habit itself. The relationship
between habit and anxiety is usually circular, as anxiety makes the habit more likely to
occur, and performing the habit, even if it temporarily seems to reduce anxiety, will often
ultimately increase it. A person with a nervous tic may simply be made more anxious by
their habit, whereas a fingernail-biter may be distracted and comforted temporarily.
However, the nail-biter will usually become more anxious as they reflect afterwards on
the ragged condition of their nails and are confronted by situations, such as shaking
hands, which they would rather avoid. The researchers recommend assuming relaxed
posture and breathing.
Identify Habit-prone Situations. Identify and list specific people, activities, situations
which trigger the habit, list. Anxiety is, of course, one of the most common triggers for
such habits, though by no means universal. However, even people who deny that their
habit is “caused” by nervousness, usually report that it occurs more frequently under
stress.

©UK College of Hyposis & Hypotherapy 2021

Page 16
HABITS
TREATMENT

Habit Reversal Protocol


Learn & Practice the Competing Reaction. ‘The central feature of the present method is
the use of a competing reaction to the habit.’ (Azrin & Nunn, 1977: 79). This technique was
similar to Wolpe’s concept of reciprocal inhibition, albeit at a muscular rather than
autonomic level. A specific repertoire of competing behavioural responses was developed
by the researchers to be learned in order to stop and correct the habit reaction. These are
to be practised daily, whenever the habit occurs, in order to directly counter-act it, and also
in anticipation of the habit in order to prevent it from even beginning. The most common
competing responses are making a fist and holding the hand outstretched making any
habit involving the hand impossible. The competing habit should be maintained for at least
one to three minutes, by which time the urge to perform the original habit will usually have
receded. One to three minutes will feel like a long time for your client so make sure they
understand they must hold it for at least one minute.
Mentally Rehearse the Competing Reaction. In advance of the real event, the client
visualises (“symbolically rehearses”) habit-prone situations and outwardly (“overtly”)
rehearses their competing response while giving themselves self-instruction statements
aloud, e.g., “Now I am holding the receiver of the telephone. My other hand is beginning to
touch my face. I am clasping my hand firmly and clenching the fingers into a fist to prevent
myself from biting the nails”, etc. The researchers recommend spending at least 15
minutes per day mentally rehearsing, decreasing to five minutes with practice, but only
about 15 seconds at a time on each specific habit-prone situation. Although the competing
action is physically rehearsed, it is not maintained for the full three minutes but only a few
seconds.
Obtain Social Support. The help of friends is enlisted to gently point out when the habit
occurs and offer encouragement and reinforcement, “reminding not nagging” as the
authors say. Friends are asked to delay a few seconds before commenting on a habit to
give the client time to spot it for themselves.
Seek Opportunities to Display Improvement. The client deliberately seeks opportunities
to demonstrate their progress to others and themselves, i.e., confronting situations and
activities they previously avoided such as showing their nails to other people, or, for a
stutterer, asking questions in a meeting, etc. This entails both facing fears, and obtaining
opportunities to increase social support and feedback.
Practice, Practice, Practice. The competing responses are repeatedly practised in the
manner outlined until they become habitual and automatic themselves. It is possible to
interpret the results of habit reversal from different perspectives. Azrin and Nunn adopted
a classical conditioning model. However, from the perspective of operant conditioning,
using the competing response, which clients usually find mildly unpleasant to maintain for
a full 3 minutes, can be seen as a form of self-punishment. If this is correct, from an
operant conditioning perspective, even when someone unintentionally bites their nails, or
exhibits the habit, it would make sense to use the competing response anyway,
immediately after the habit.

©UK College of Hyposis & Hypotherapy 2021

Page 17
HABITS
SESSION SKILLS TO CONSIDER

Cost-benefit analysis of keeping the habit Self-talk also includes not discounting experiences
REI rational-emotive imagery to come up with for example saying that hypnosis doesn't count
alternative coping because it isn't real or attributing success to you .
Emotional dial to practice increasing and
decreasing anxiety and yet still gaining control; Remember, their own chosen inner dialogue needs
of their habit or even as a way to experiment to be meaningful to them and realistic! Encourage
with making the connection for them between realistic, task appropriate or supportive dialogue.
anxiety and extreme stress and the need to do
the habit.
Self-talk and self-instruction addressing this
affects the way a client integrates their
experience, whether they stick to the
homework and whether they continue to do
their behaviour. Address self talk and make
sure clients are reinforcing their ability to
succeed in therapy and with stopping their
habit after therapy has ended. Remind them
how important their inner dialogue is to their
success.
Get them to address self-talk when they spot
the behaviour, during the protocol and after so
they can integrate the experience as a success
and stop maintaining the behaviour. When they
spot that they are doing their behaviour they
remind themselves that spotting the behaviour
is a sign treatment has been effective and they
are now taking control of the behaviour by Disputation Help clients to effectively
choosing to do the competing response and dispute faulty beliefs for example frowning
not getting caught up in it. helps me concentrate.
Relaxation there are many ways to apply
this and many tools. You may need to
choose something different for your client or
they may need something different, it is
perfectly fine to adapt what is taught on the
"I am spotting I am doing the behaviour! course.
I am taking a moment to enjoy relaxation. Assertiveness if the prob;em is other people
I am applying my competing response or difficulties being self-assertive.. Roleplay
I am feeling good about taking control of my and hypnosis.
behaviour and taking a moment to relax. Problem solving
General stress reduction skills maybe the
client needs to work in longer therapy and
build up a catalogue of skills to help them
work on things like their attention or time
management.

©UK College of Hyposis & Hypotherapy 2021

Page 18
HABITS
CLIENT TOOLS AND TIPS

Handouts
Home practice and clients taking an active role in their own therapy improves
outcomes, don't forget to mention this benefit to your client to encourage
them to do the home practice. Giving your client's homework handouts helps
to avoid any confusion over what they need to do at home.

Habit Reversal Training Daily Practice


Tension Relief Breathing
Explanation of hypnosis
Please see our Assessments and Case Conceptualisation booklet for some
ideas of further handouts you could create.

We hope you have found this guide helpful. Don't forget that all materials in this
toolkit are available online along with other scripts and exercises and we have more
toolkits. You can access all of our resources in our professional development hub.

©UK College of Hyposis & Hypotherapy 2021

Page 19
This Phobia Toolkit was brought to you by ...

Shelley Cushway
Lecturer at The UK College of Hypnosis
Toolkit: Design and content
Shelly@ukhypnosis.com

Mark Davies
Owner of The UK College of Hypnosis
Toolkit: Source material owner and creator
Mark@ukhypnosis.com

Lauren Williams
Alumni of The UK College of Hypnosis
Toolkit: Design and copy
Lauren@ukhypnosis.com

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