Habit Reversal Training for Obsessive-Compulsive Disorder: A Multiple Case Report
Open accessAbstract
Although exposure and response prevention (ERP) is currently the most effective treatment for obsessive-compulsive disorder (OCD), there are substantial refusal and dropout rates. Therefore, there is a need to find ways to make treatments for OCD more acceptable and increase efficacy. This report presents four patients with OCD who received a novel treatment, Habit Reversal Training (HRT). HRT is the treatment of choice for OCD-related disorders such as Trichotillomania, but has not been formally tested for OCD. Based on recent studies showing that excessive habit formation plays an important role in OCD, we examined whether HRT would be an effective and acceptable treatment for OCD. Single case methodology was used to investigate its feasibility, acceptability and preliminary efficacy for OCD treatment. After 9 sessions of HRT over 11 weeks, all four participants showed 32-48% reductions in OCD severity, and three showed a clinically significant treatment response. These gains were largely maintained at 3 months follow-up. All participants rated HRT as a highly acceptable treatment. This suggests that HRT could prove to be an effective, efficient, and acceptable new OCD treatment, with a novel mechanism of action – targeting the habit system.
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Those four participants showed between 30 and 50% improvement in OCD severity.
“Toffolo and Saxena (2019) [42], for instance, tested the technique in four participants, who showed between 30 and 50% improvement in OCD severity.”
From Habit as a therapeutic component in psychological treatment for obsessive-compulsive disorder: A randomised controlled feasibility study. (2026) · cites this paper as [42]
Toffolo and Saxena (2019) tested HRT in four participants with OCD.
“Toffolo and Saxena (2019) [42], for instance, tested the technique in four participants, who showed between 30 and 50% improvement in OCD severity.”
From Habit as a therapeutic component in psychological treatment for obsessive-compulsive disorder: A randomised controlled feasibility study. (2026) · cites this paper as [42]
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“…adaptive function [33 – 38] and considering the established relationship between OCD and tic disorders, including the substantial evidence linking the two, both diagnostically and in terms of shared treatment approaches [39], a logical next step would be to test HRT in OCD itself [7,16,30,40 – 42].”
Breaking the Cycle of Learned Fear: An Experimental Approach
van Dis, E. A. M. (2021) · doi:10.33540/934
- Authors
- Toffolo, M. B. J., & Saxena, S.
- Affiliations
- University of California San Diego (US)
- Publisher
- Center for Open Science
- Published
- 2019-08-24
- OpenAlex
- W3160736122
- Cited by
- 2
- References
- 43
- Citations by year
- 2024: 1 · 2021: 1
- Type
- posted content
- Language
- en
- Open access
- green
- doi.org
- Locations
- PsyArXiv (OSF Preprints) (submittedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- habit reversal training, obsessive-compulsive disorder, habit formation, treatment acceptability, treatment discontinuation, treatment refusal, trichotillomania, exposure and response prevention, treatment efficacy
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