Treatment Options: Cognitive-Behavioral Therapy (CBT)
Note: the following treatment overview was written for hair pulling, but also applies to skin picking. More in-depth information about skin picking treatment is coming soon.
Cognitive-Behavioral Therapy (CBT) is a form of therapy that seeks to alter behavior by identifying the precise factors that trigger hair pulling and learning skills to interrupt and redirect responses to those triggers. Broadly stated, CBT is based on learning theory which has shown that as we practice new behaviors and thoughts in response to familiar emotions or situations, our brain's physical structure actually changes, too. We develop new neural pathways and, with repetition, the new behavior becomes an automatic response.
CBT should be performed by a psychologist trained in this method and well versed in treatment of these behaviors-something that may be easier said than done as there is not an abundance of psychologists with this specialty. The therapist will encourage hair pullers to develop an increased awareness of the times of day, emotional states, and other factors that promote hair pulling as an important precursor to being able to control the behavior. Some hair pullers have had success with simple behavioral devices such as putting bandages on their fingers to interfere with pulling, keeping records of their hair pulling, or changing environmental cues that can trigger pulling.
Methods of cognitive-behavior therapy, such as Habit-Reversal Training and the Comprehensive Model for Behavioral Treatment of Trichotillomania, have shown to be the most successful treatments for trichotillomania known today.