form of therapy works (at least in part) by normalizing atypically increased sensorimotor circuit activity associated with excessive habit formation [100]. Habit-reversal therapy is similar to the response prevention aspect of ERP (Table 3) in that both aim to break the association between sensation(s) (sensory phenomena/obsessions/feelings of fear/anxiety) and repetitive, compulsive behaviors (compulsions/tics) [101]. However, the awareness training component of habit-reversal therapy may be particularly helpful for OCD patients in whom symptoms have become habit-like; for these patients, additional training may be needed to recognize the sensations that precede their habit-like compulsions. Consistent with this suggestion, habit-reversal training was reported to be effective in reducing OCD symptom severity in a patient with treatment-refractory OCD [102]. Further work testing the efficacy of including awareness training as an additional component of ERP in OCD patients with these types of compulsive symptoms will be important in future research.
