Habit reversal treatment: Learning an incompatible response or increasing the subject's awareness?

The elements of the Habit Reversal Treatment Package developed by Azrin and Nunn (1973) to counteract nervous habits were systematically analysed. Fifty nail biters (92% reported biting their nails for more than 5 yr) were randomly assigned to one of the following treatments: Habit Reversal, Habit Reversal and Self-Monitoring, Self-Monitoring, Self-Monitoring and Daily Graph Plotting, Waiting List control, Pictures of both hands were taken prior to the commencement of treatment and at 6 and 12 weeks after treatment termination. The results showed that the four treatment groups improved equally compared with the control subjects. Such data cast doubt on the importance of learning an incompatible response in Habit Reversal Treatment. An alternative explanation based on increasing the subject's awareness is put forward.     

Effects of live modeling, covert modeling and rehearsal on assertiveness in psychiatric patients.

The present study evaluated the effects of live modeling, covert modeling, and rehearsal in unassertive psychiatric patients. Psychiatric patients scoring 19 or below on the Wolpe-Lazarus Assertiveness Scale were assigned to one of five conditions, with 10 subjects in each group: (1) Test-retest (no treatment). (2) Live modeling plus rehearsal. (3) Live modeling without rehearsal. (4) Covert modeling plus rehearsal, and (5) Covert modeling without rehearsal. All subjects were videotaped (pre- and post-test) while responding to eight interpersonal situations (four training scenes; four generalization scenes) requiring assertive responses. Pre- and post-test responses for all subjects were rated independently by judges on several verbal and non-verbal components of assertiveness. The results indicated that live modeling and covert modeling effected improvements in the assertive behavior of the patients, but that the two treatments were not differentially effective. Generally, the addition of rehearsal to live or covert modeling failed to enhance treatment. But on two measures, the covert modeling plus rehearsal condition was superior to the other treatments. There was evidence for transfer of treatment effects from training to generalization scenes. No differences were found among the groups on the Wolpe-Lazarus Assertiveness Scale and the Eysenck Personality Questionnaire. The results were discussed in light of prior findings with live and covert modeling procedures.