We employ cognitive behavioral therapy, the most empirically supported type of treatment for Body Focused Repetitive Behaviors (BFRBs). Rather than focusing on trying to merely stop the problem behaviors, we teach clients to use “strategies”, which are healthy alternatives to pulling, picking or biting. These strategies address the various internal and external triggers (things inside and outside of you that lead to the problem behaviors). Our treatment is based on a cognitive-behavioral model of trichotillomania originally developed by Dr. Charles Mansueto at Behavior Therapy Center of Greater Washington, referred to as the Comprehensive Model for Behavioral Treatment of Trichotillomania (ComB).
For both parents dealing with children with BFRBs and adult individuals struggling with the problem themselves, we emphasize learning and practicing healthy alternative behaviors, rather than to just “stop.” The ComB approach is based on principles that we often employ in our therapy with clients. First of all, we view problematic behaviors as serving a purpose or function, rather than as a sign of something being deeply wrong with an individual. During the treatment phase of awareness building, through self-monitoring, we collaborate with clients in identifying the unique internal and external triggers and associated behaviors and consequences that drive and maintain the pulling or picking behaviors. The second principle, based on learning theory, is that change comes through practice and learning of new behaviors and ways of thinking. Based on their individual pulling or picking profile, clients collaborate in behavioral assignments that involve frequent practice of using specific healthy alternative behaviors in their trigger situations. Treatment involves monitoring and re-assessment to determine if goals in therapy are being met. Learn more about BFRBs from TLC Foundation for BFRBs