Which intervention is commonly used to reduce tic disorders by teaching competing responses?

• A. Self-monitoring
• B. Relaxation training
• C. Habit-reversal training
• D. Cognitive-behavioral therapy addressing stress management

Answer: (C)

Habit-reversal training teaches a person to interrupt a tic by performing a competing response that cannot occur with the tic. The method combines awareness training—learning to notice the urge and the moment a tic is about to happen—with practicing a behavior that is physically incompatible with the tic. Repeatedly substituting the tic with this competing response weakens the tic pattern and often reduces how often tics occur, giving the individual greater sense of control.

For example, if an individual has a motor tic like a shoulder shrug, a competing response might be holding the shoulders still in a position that makes the shrug impossible, or engaging a different sustained muscle action that serves as a substitute. If a tic involves blinking, a competing response could be a deliberate, sustained gaze that prevents the eye-blink reflex for a short period. The key idea is that the competing response is learned and practiced during therapy and then used in daily life to suppress tics when urges arise.

Self-monitoring helps with awareness but does not by itself teach the new, incompatible response. Relaxation training and broader CBT for stress management can reduce general arousal or anxiety but do not specifically train the overt, competing behavior that directly interrupts tic execution. Habit-reversal training uniquely targets the tic pattern by replacing it with an incompatible action.