Acceptance and Commitment Therapy and Habit Reversal Training for the Treatment of Trichotillomania
Cognitive and Behavioral Practice
Trichotillomania is a behavioral problem, and is often referred to as a habit disorder, but it is important to consider the cognitive and emotional components of the behavior. Current treatment recommendations include a traditional behavioral approach (Habit Reversal Training; HRT) combined with an approach that addresses the cognitive and emotional components of the behavior (Acceptance and Commitment Therapy [ACT] or Dialectical Behavior Therapy [DBT]). Current evidence indicates a combination of ACT and HRT is an effective treatment for trichotillomania. The goal of this article is to replicate the effectiveness of the ACT/HRT treatment package for trichotillomania and to provide practical clinical guidance on how to deliver the treatment. This guidance is presented in the context of an empirical study in which 5 participants demonstrating high levels of pulling at pretreatment were treated with 8 sessions of a combination of ACT and HRT. Treatment resulted in an 88.87% reduction in pulling across participants from pretreatment to posttreatment, and all 5 responded to the treatment. At 3-month follow-up, 2 participants maintained the treatment gains, 2 lost half of the treatment gains, and 1 was at pretreatment levels. A discussion of the results is presented along with implications for clinical practice and future directions for research.
Crosby, J. M., *Dehlin, J.P., & *Mitchell, P. R., & Twohig, M. P.(2012). Acceptance and commitment therapy and habit reversal training for the treatment of trichotillomania. Cognitive and Behavioral Practice, 19, 595-605.