Competing Response Training Therapy

CRT or competing response training is a method within cognitive behavioural analysis for altering responses to habits or trigger situations. It can be useful in situations where the response that currently exists is unhelpful or maladaptive.

We only use behavioural change processes to the objectives defined through client discussion and we NEVER impose social norms against the will of clients. We believe that behavioural training can empower people to have options about how they function in certain circumstances, but their unique and authentic selves must not be sacrificed. We particularly ensure that persons who are not neuro typical only use taught behaviours to enable themselves, and not to conform for the sake of others or society.

Competing Response Training (CRT) is a behavioral therapy technique used to decrease unwanted behaviors, often habits or tics, by replacing them with a more desirable or incompatible behavior. It’s a core component of Habit Reversal Training (HRT) and is used to address a variety of issues, including:

• Tics: Motor or vocal tics associated with Tourette Syndrome or other tic disorders.
• Body-Focused Repetitive Behaviors (BFRBs): Hair pulling (trichotillomania), skin picking (dermatillomania), nail biting, etc.
• Stuttering: Helping individuals manage and reduce stuttering.
• Habitual Behaviors: Thumb sucking, teeth grinding, hair twirling, etc.

How CRT Works

1. Identify the Unwanted Behavior: Clearly define the specific behavior you want to change.
2. Develop a Competing Response: Choose a new behavior that is:
   • Incompatible: Cannot be done at the same time as the unwanted behavior.
   • Discreet: Can be performed without drawing attention.
   • Manageable: Easy to do in most situations.
   • Reinforcing: Provides some positive feedback or feeling.
3. Practice the Competing Response: Regularly practice the new behavior, especially in situations where the unwanted behavior typically occurs.
4. Increase Awareness: Pay close attention to the antecedents (triggers) and early signs of the unwanted behavior.
5. Implement the Competing Response: As soon as you notice the urge or the beginning of the unwanted behavior, immediately engage in the competing response.
6. Maintain and Generalize: Continue practicing and using the competing response over time, gradually fading out any prompts or reminders. Generalize the skill to different settings and situations.

Examples of Competing Responses

• For Tics: Lightly tensing the muscles involved in the tic, deep breathing, or engaging in a brief relaxation exercise.
• For Hair Pulling: Clenching fists, holding an object, or engaging in a hand activity like knitting.
• For Skin Picking: Wearing gloves, applying lotion, or keeping hands busy with a fidget toy.
• For Nail Biting: Folding hands, sitting on hands, or placing fingers on a flat surface.

Benefits of CRT

• Reduces Unwanted Behaviors: Can significantly decrease the frequency and intensity of habits and tics.
• Increases Self-Control: Provides individuals with a sense of agency and control over their behavior.
• Non-Aversive: Focuses on positive reinforcement and avoids punishment.
• Versatile: Can be adapted to address a wide range of behaviors.

Important Considerations

• Motivation: CRT requires active participation and motivation from the individual.
• Practice: Consistent practice is essential for success.
• Support: Having support from family, friends, or a therapist can enhance the effectiveness of CRT.
• Combining with Other Therapies: CRT is often used in conjunction with other therapies, such as HRT, Cognitive Behavioral Therapy (CBT), or mindfulness-based approaches.

What might you address with CRT therapy?

Any situation where the current outcome is inappropriate can be modified with this cognitive analysis method.

Examples might include

• Anger responses
• Addiction responses
• Unsociable responses
• Withdrawn responses
• Negative outcomes such as always “saying yes” or passive behaviour
• Other habits

How does CRT work?

CRT is a form of cognitive behavioural analysis and has two main process parts:

AT or Awareness training enabled the person to become self aware in regard to the existing behaviour and it’s triggers. Related cognitive behavioural methods can be employed to achieve awareness if the client finds it hard to understand. These might include situational analysis, significant other analysis or active mindfulness.

CR or Competing response is the new strategy which is designed with the client. It is a personally chosen and individual new outcome which importantly competes with the original outcome. That is to say, the new outcome can not co-exist with the old one. Thus by doing the new behaviour, the old one can not be repeated. For example if an angry person has always gone to the pub for a pint and then overindulged, a new competing response might be to go to the gym instead.

Benefits of Competing Response Training

1. Awareness of what and happening and why enables self knowledge and the development of new options and choices.
2. Competing responses interfere with the old negative behaviour.
3. Competing responses can be chosen that provide new and positive outcomes and benefits, thus improving well being and self reinforcing.
4. By interfering with the old outcomes, these stop being reinforced and stop feeling acceptable and inevitable.
5. Learning to implement new positive outcomes that they helped to co-create enables clients to become “skilled up” in developing their own future strategies, thus gaining independence.

Reinforcing CRT with other therapies

A typical criticism of methods like CRT is that it works out what would be a better option, but then the client struggles to manage it, perhaps because of an addictive element in the old pattern, or because of a lack of self confidence or assertiveness.

CRT is therefore often complemented with other methods such as motivational interviewing style counselling for addictions, assertiveness training, psycho-education training, step by step coaching and clinical hypnotherapy, mindfulness or Neuro Linguistic Programming.

New Specifically Trauma related site NEW! HERE

Key Words
habit, addiction, trigger, outcome, maladaptive outcome, unhelpful behaviour, behavioural change, change behaviour, behavioural psychotherapy, behavioural psychology, cognitive behavioural analysis, cognitive behavioural therapy, hypnotherapy, mindfulness, CRT, competing response therapy, competing response psychotherapy, competing response psychoanalysis, Edinburgh, Stirling, Falkirk, Glasgow, Scotland

Contact via the contact us page HERE