OCD spectrum · Treatment guide

Body-Focused Repetitive Behaviors

Trichotillomania (hair-pulling), excoriation (skin-picking), and related repetitive grooming behaviors.

In this guide

Overview

BFRBs respond best to Habit Reversal Training (HRT) and its modern expansion, the Comprehensive Behavioral (ComB) model. Shame is high; reduce moralizing language about the behavior.

First-line treatments

Also consider

  • ACT

    AEBT (Acceptance-Enhanced Behavior Therapy) integrates ACT with HRT.

  • DBT

    When emotion dysregulation drives the urge.

  • CFT

    Targets shame about the behavior and its visible effects.

Cautions

  • Pure willpower advice is iatrogenic — function-based replacement behaviors are the mechanism.

Related tools

Related worksheets