Treating Body-Focused Repetitive Behaviors
Comprehensive Behavioral Treatment (ComB) for Hair Pulling, Skin Picking, and More
Body-Focused Repetitive Behavior (BFRB) disorders, including Hair Pulling Disorder (also called Trichotillomania) and Skin Picking Disorder (also called Excoriation Disorder) are neither rare nor benign. Estimates suggest that as many as one in 20 people have engaged in non-cosmetic BFRBs resulting in bodily damage and personal distress and have been unable to stop the behaviors. The personal toll of BFRBs often includes impairment of social, academic, occupational and interpersonal and other important areas of functioning as well as varieties of medical consequences involving tissue damage to skin and hair, chronic interference with the body’s healing functions and joint pain and damage due to repetitive motion and postural issues. Common social and emotional consequences of BFRBs include anxiety, depression, low self-esteem, shame, secrecy and isolation. BFRBs have received increased attention by researchers and clinicians over the past two decades in efforts to better understand and treat them, Still, these disorders remain well-hidden and poorly understood by the public, by the scientific community and by most clinical practitioners. These disorders are often unidentified as legitimate clinical disorders, are frequently misdiagnosed and are inadequately treated. In short, sufferers have been and continue to be underserved by the clinical community.
This training will provide an overview of the current state of knowledge regarding BFRBs including recent research findings and it will describe varieties of existing conceptualizations and treatment approaches. The primary focus, however, is to introduce Comprehensive Behavioral (ComB) Treatment for BFRBs. The Comb approach has been described in the professional literature for decades, is employed by thousands of clinicians, has been the favored model for professional training of the TLC Foundation for BFRBs for over 20 years. It is designed to address the diverse and idiosyncratic nature of elements that maintain BFRBs. Attendees will learn to use the ComB model as a guide for patient preparation, assessment techniques, choice of treatment elements and clinical decision-making to maximize treatment effectiveness for BFRBs.
This training offers 8 CE hours if attended live. We can only provide CE to those who are present via Zoom for the live sessions. However, the sessions will be recorded and available to watch later. Registrants may access these recordings at any time for up to nine months after the live training ends.
Before registering, please review conflict of interest disclosures and complete CE information here.
Session 1 | March 10, 2025, 1:00 p.m.–3:00 p.m. EDT
- Introduction, Diagnosis, Assessment Issues and Co-morbidity
Session 2 | March 17, 2025, 1:00 p.m.–3:00 p.m. EDT
- Etiology, Clinical Presentation and Phenomenology, ComB Foundations
Session 3 | March 24, 2025, 1:00 p.m.–3:00 p.m. EDT
- ComB Treatment I: Patient Preparation, Assessment, Case Conceptualization
Session 4 | March 31, 2025, 1:00 p.m.–3:00 p.m. EDT
- ComB Treatment II: Implementation, Clinical Decision Making, Problem Solving, Termination
Participants will be able to:
- Describe the varieties and defining characteristics of BFRBs as currently understood by expert clinicians and researchers
- Identify three common secondary problems experienced by sufferers of BFRBs
- Describe how the A-B-C approach to behavioral analysis is applied to BFRBs in the ComB model
- Identify the three subtypes of BFRB behaviors that are described in the scientific literature
- Describe the importance of the clinical phenomenology of BFRBs as reflected in the Comprehensive Behavioral (ComB) treatment
- Describe how the ComB model guides assessment, patient education and clinical decision-making throughout the treatment process
We are still in the process of finalizing the CE approvals for this workshop, the full list will be displayed soon.
None
Carlson, E. J., Malloy, E. J., Brauer, L., Golomb, R. G., Grant, J. E., Mansueto, C. S., & Haaga, D. A. (2021). Comprehensive behavioral (ComB) treatment of trichotillomania: A randomized clinical trial. Behavior Therapy, 52(6), 1543-1557.Â
Clark, S. B., Mouton-Odum, S., Flessner, C. A., Ricketts, E. J., Peris, T. S., Dougherty, D. D., & Piacentini, J. (2024). Self-report measures of sensory phenomena in body-focused repetitive behaviors: A comparison to healthy controls. Cognitive Therapy and Research, 48(1), 147-155.Â
Collins, M., & Grant, J. E. (2024). Sensory processing in skin picking disorder. Journal of Obsessive-Compulsive and Related Disorders, 41, 100870.Â
Coyne, A. F., Carlson, E., Flannery, M., De Oliveira, F., & Haaga, D. A. (2023). Comprehensive behavioral treatment of an older adult man with trichotillomania. Clinical Case Studies, 22(3), 224-239.Â
Grant, J. E., Peris, T. S., Ricketts, E. J., Bethlehem, R. A., Chamberlain, S. R., O’Neill, J., & Keuthen, N. J. (2022). Reward processing in trichotillomania and skin picking disorder. Brain imaging and behavior, 16(2), 547-556.Â
Grant, J. E., Peris, T. S., Ricketts, E. J., Lochner, C., Stein, D. J., Stochl, J., & Keuthen, N. J. (2021). Identifying subtypes of trichotillomania (hailling disorder) and excoriation (skin picking) disorder using mixture modeling in a multicenter sample. Journal of Psychiatric Research, 137, 603-612.Â
We understand, sometimes things come up!
Praxis will offer a full refund to registrants of both live and live-online trainings who cancel their registration up to 14 days before the course or workshop start date, minus an administrative processing fee of $30 for a 2-day workshop or online course, and a $50 fee for a 4-day workshop. If cancelled within 14 days, no refund will be issued, however, a credit for the same amount will be applied toward another learning product, which expires within 1 year. Please email us at online@praxiscet.com to cancel a registration.
Mondays, 1:00 p.m.–3:00 p.m.
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March 10, 2025 - March 31, 2025
1:00 pm - 3:00 pm
