Body-focused repetitive behavior (BFRB)

Body-focused repetitive behavior (BFRBs) refers to compulsive and repeated actions of self-grooming behaviors. This can include everything from biting your nails to picking your skin to pulling out your hair. Most of these behaviors are relatively common and, for most people, benign. However, when the frequency of these behaviors increases, the impact is beyond that of a “bad habit”. For example, conditions like trichotillomania (repetitive hair pulling) or dermatillomania (repetitive skin picking) can cause baldness or skin infections and affect an individual’s ability to work or socialize. If you are worried that your “nervous habits” are beyond your control, reach out to one of TherapyDen’s BFRB experts today!

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BFRBs function differently in each individual. In some cases, it's harmless stimming but it can also progress to highly destructive habits. I use ERP and Habit Reversal Training to develop a treatment plan that respects folks' neurological needs for stimulation while reducing or eliminating harmful picking/pulling behaviors.

— Katie Playfair, Licensed Professional Counselor in Vancouver, WA

BFRBs can be driven by anxiety or neurodivergence and it's important to know the difference. Together, we will figure out the FUNCTION of your BFRB and pick the right interventions to reduce its destructive power while honoring underlying sensory needs.

— Katie Playfair, Licensed Professional Counselor in Vancouver, WA

I treat Trichotillomania and other Body-Focused Repetitive Behaviors using ComB (Comprehensive Behavioral Treatment of Trichotillomania), which incorporates cognitive therapy, behavioral therapy, and habit reversal.

— Michael Greenberg, Clinical Psychologist in Beverly Hills, CA
 

I have expertise in the treatment of BFRBs, including hair pulling and skin picking. I use the research supported Combined Behavioral (Com-B) methods for treatment of these difficulties. Together, we determine the cues and drives for these behaviors and seek to meet needs in a less harmful and more productive way through satisfying sensory needs and emotion management strategies.

— Kimberly Dwyer, Clinical Psychologist in Centennial, CO

I've completed advanced therapist training on treating this issue and sought out other relevant training and information. Rather than oversimplifying treatment by focusing on just getting rid of these behaviors, I work with my clients on exploring deeper unmet needs or relationship issues/dynamics that might be driving the behaviors. Our focus will typically include identifying what needs these behaviors are meeting, which might include sensory-related issues and/or underlying emotional needs.

— Nicole Powell Cantu, Licensed Clinical Social Worker
 

Trichotillomania (hair pulling), dermatillomania (skin picking) Cognitive behavioral therapy, habit reversal therapy

— Christine Block, Counselor in Houston, TX

Along with my training in OCD, I also have received training in the treatment of body-focused repetitive behaviors including trichotillomania and excoriation disorder.

— Kristin Fitch, Clinical Psychologist in New Orleans, LA
 

The treatment of choice for BFRBs is Cognitive Behavioral Therapy (CBT). There is a specific kind of CBT approach created for BFRBs called the comprehensive behavioral treatment (ComB). At the beginning of treatment, I will walk us through an assessment to help both of us understand how BFRBs are impacting your life. You’ll learn about BFRBs, understand how to relate to BFRBs in a more empowered, compassionate way, and use individualized strategies that we will create together.

— Andrea Millen, Clinical Psychologist in Portland, OR

I have specialized training in treating BFRBs, and have found a treatment approach that combines elements of CBT, ERP, HRT, and mindfulness to be very effective in treating these disorders. There is not a one-size-fits-all treatment for BFRBs, so it is very important to first understand why you are doing the behaviors or what needs they are serving.

— Laura Chackes, Clinical Psychologist in Creve Coeur, MO
 

I have training in treating BFRB's such as hair pulling and skin picking. I use Cognitive Behavioral Therapy to support individuals in habit reversal, as well as coping with anxiety and depression that can result from BFRB's.

— Khloe Clawson, Counselor in Seattle, WA

Along with my training in OCD, I also have received training in the treatment of body-focused repetitive behaviors including trichotillomania and excoriation disorder.

— Kristin Fitch, Clinical Psychologist in New Orleans, LA