Abstract
Multiple tics and snapping scapulae were treated effectively with the habit reversal technique, which was introduced first by Azrin, N. H. and Nunn, R. G. in 1973. The patient of multiple tics was an outpatient, a 13-year-old fatherless boy. His tics consisted of blinking, turning up the whites of the eyes, twitching of the mouth and grunting. The boy suffered from these tics for a period of two years. Grunting was first treated by the habit-reversal method, since it was the most annoying of the tics. Grunting decreased moderately after a few sessions. But complete elimination came only after self-monitoring. The other nontreated tics decreased almost completely without applying habit-reversal, and these good results lasted for 24 months. The patient of snapping scapulae was an inpatient, a 42-year-old single female clerk. She was sent for psychiatric treatment after 4 years' noneffective orthopedic conservative treatment. In this case, the habit-reversal procedure was so dramatically effective that snapping scapulae was rarely observed after 2 weeks of treatment. And the result was maintained for 16 months after discharge. In this case, practicing competing response training was the only treatment. The habit-reversal procedure introduced by Azrin and Nunn comprises some elements such as awareness training, competing response training practice, habit control motivation and generalization training. Till now, it is not yet known which element of the procedure is the most essential. We found from the treatment of the above 2 cases that the competing response was the most important element of the habit-reversal procedure.