Document Type

Article

Journal/Book Title/Conference

Psychiatric Clinics of North America

Publisher

Elsevier Ltd

Publication Date

4-3-2025

Journal Article Version

Accepted Manuscript

First Page

1

Last Page

25

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Abstract

Acceptance and commitment therapy (ACT) – enhanced behavior therapy (A-EBT) is the most empirically supported treatment for trichotillomania. The data supporting A-EBT for excoriation disorder (skin picking) is small but growing. In this paper we review the model behind A-EBT including support for targeting psychological inflexibility as well as the use of more traditional behavioral procedures to reduce non-focused behaviors. To date there are 15 studies investigating A-EBT for trichotillomania and skin picking across ages and treatment delivery methods (individual, group, telehealth, and asynchronous web-based delivery). The work has occurred by multiple research teams. Data on process of change is reviewed. Future directions and limitations are discussed.

Available for download on Friday, April 03, 2026

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