The Face Safety Game: Habit Reversal Training for Covid-19

People touch their faces an average of 23 times an hour. At Behavioral Sciences, we use habit reversal training (HRT) to teach people with tic disorders, including thumb sucking, lip biting, skin picking, and many other habits to significantly reduce the frequency of those behaviors. You can use these techniques to reduce your face, mouth, and eyes touching.


Most of our day-to-day behaviors are automatic. We have to intervene to break up this automaticity of everyday living.


Here are the three most essential steps from habit reversal training to help you, your kids, and others to reduce the frequency of touching their faces, noses, and mouths. I’ve added a bonus Step 4 that enhances self-awareness and increases motivation.


Step 1 Start developing awareness. As you go through the day, note the situations in which you touch your face, like talking on the phone, watching TV, looking for groceries on shelves in a store, thinking about a decision. Keep a tallyof the frequency on your phone or on a notecard. This will give you a target or baseline number to improve.


Step 2 Decide on a competing alternative to touching your face and practice. Fold your arms while you shop. If you catch yourself touching or starting to touch your face, grab your elbow instead. If you have an itch on your face, try to breathe through it until the itch passes or use your forearm or shoulder for scratching it. When you’re physically inactive, practice occupying your hands while watching TV, reading a book, or talking on your phone. Interlace your fingers in your lap, hold a tennis ball in your free hand, fold your arms, put your hands in your pockets, sit on your hands. Continue to tally your slip-ups because this helps you improve self-monitoring.


Step 3 Ask for support from your kids, your partner, and your friends, to point out when you are doing something else with your hands. “Hey, I noticed how well you keep your hands occupied. You’re really good at self-monitoring.” Let significant people know the improvement you’re making. This isn’t bragging. It helps everybody be self-aware. After all, you’re protecting them, and they’re protecting you.


Really cool bonus, Step 4. After you set a reward for improvement, use a response cost behavior modification program. Take an index card and cut tabs in the card equivalent to the number of times you tallied for your one-day baseline. Hopefully, it’s not 368 per day. When you catch yourself, or your loved ones see you touch your face, pull a tab from your card. This is just feedback for learning. Pulling a tab is not for shaming. Success is to have at least onetab left at the end of the day. You earn a reward for this because you met your goal. If you lose all your tabs, do a chore for somebody and start over. Beating your baseline tally may have made it too hard.


For families, nothing helps us learn to monitor ourselves better than a response cost program. We do this all the time for kids with ADHD to help them learn to pay attention. Every member of the family can have a card and a goal. Celebrate at the end of the day. For kids, you may need to break the day down into two or three time segments with rewards after each segment. Improvement comes every few days when you count the number of tabs lost, take an average. The average becomes the new target, and you reduce the number of tabs with which you start the day.


Take the card with you to the grocery store or the gas station, so you are learning to transfer the learning to situations other than home.


Setting this up for children starts with a supportive and positive attitude. Would you like to play Chutes and Ladders, play a video game, or have a bowl of ice cream when we’re through with the Face Safety game at the end of the day?


Something to avoid:

Don’t catch somebody touching and yell, threaten, or lecture. We know that punishment only suppresses behavior when the punisher is around. You want to learn, and you want your loved ones to learn to monitor themselves and do alternative behaviors when you are not present. We know that we learn best through repetition and positive reinforcement. This will work better with patience and a positive attitude.


Advanced behavioral practice. When you slip, do positive practice. For example, start to touch your eye, nose, mouth, stop short moving your hand instead to massage your shoulder muscle, or touch your elbow. Repeat 25 times in succession. Here, you’re creating awareness of the move and learning to inhibit the motion.


Let us know about your progress with the Face Safety Game


David L. Barnhart, EdD

Licensed Counselor

Board Certified Clinical Mental Health Counselor

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