Habit reversal training includes the following: Awareness training (eg, self-monitoring, identification of triggers for the behavior) Stimulus control (modifying situations—eg, avoiding triggers—to reduce the likelihood of initiating the behavior) Competing response training (teaching patients to substitute other behaviors, such as clenching their fist, knitting, or sitting on their hands, for the excessive behavior) Because most patients have poor or absent insight, motivational techniques are often needed to increase their willingness to participate and stay in treatment.