Creative Applications of Exposure Therapy and Habit Reversal Therapy

Joelle McGovern, Ph.D.
Presenter: Joelle Beecher-McGovern, Ph.D.
View the webinar’s corresponding slide presentation here
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Dr. McGovern described Exposure Therapy and Habit Reversal Therapy and then gave us practical applications in real life scenarios.  She spoke of the challenges of implementing these therapies and ways to overcome these barriers.  She uses technology for monitoring progress and  rewards to enhance motivation.


  1. NJCTS says:

    How do I balance building awareness and also creating a tic/trich neutral environment?

    • DrMcGovern says:

      Follow the child’s lead. If they are ready and wanting people to help them build awareness and you have discussed how that will look and the child is okay with it, then you can really help them notice if they are ticcing and pulling when they may not be noticing themselves. Using positive statements, positive tone and/or non verbal cues are be helpful. At the same time you don’t want to be pointing out the behaviors too often and/or in environments where it will be embarrassing to the child. Continually check in with the child to see if your cuing is helpful or not, if it is not, stop. You are a good model for letting your child live their lives in a typical while ignoring the tics or the pulling, that is what a tic or trich neutral environment will do for them, help them lives their lives despite what their disorders throw at them.

  2. NJCTS says:

    What about relaxation and cognitive strategies, don’t they matter?

    • DrMcGovern says:

      Cognitive strategies and ways to manage general stress do matter but often even with these strategies in place children will continue to avoid, engage in rituals, tic, and pull and those actions will maintain the symptoms. Many kids know how to come up with alternative thoughts and know how to use deep breathing and PMR but are still avoiding, etc. Helping them change their response/behavior is the crucial ingredient in reducing symptoms and increasing ability to function.

  3. NJCTS says:

    What if a child already over focuses on smart phones and social media, how would I use these resources?

    • DrMcGovern says:

      Re: over focus on smart phones and social media, there are many parental control options that will let your child have access to smart phones but allow you to limit or restrict internet and/or app use. For kids who are fixated on phones, you can set these limits and then they can carry the phone around and you don’t need to worry about them fixating on the screen. With social media, again, you can set limits for time on those websites through controls on your computer and you can monitor by being their “friend” on that site. With limit setting around electronics, always talk to your child first about what you are setting up and why, let them be part of the discussion and add their ideas, and then set the limits. Restricting in a sneaky way doesn’t work well for many reasons.

  4. NJCTS says:

    My teen daughter with OCD/anxiety/TS, what techniques are especially helpful for her age group?

  5. DrMcGovern says:

    Popular media and electronics are helpful for teens, lots of stigma and feelings of embarrassment in this age group so really feeling understood and knowing they are not the only ones out there is a really helpful start. Tim Howard, Howie Mandell, Howard Stern, and David Sedaris are very open about having one of or a combination of these disorders. Getting the buy into treatment is the most important part, if the teen can really get the idea that discomfort and anxiety in the short run is a positive thing that will eventually decrease suffering and increase functioning in the long run, then it is much easier for them to engage in the treatment. Then pick the strategies that they think will work best, often I present many options and the kids know which ones will work best for them, or we try out a few and see what works. Sometimes they say none will work and then we work on what they need to do conceptually and then I ask them to come up with some ideas of what strategies will help (this is how I get my best ideas!).