Professional Guide to Diagnosing and Treating Trichotillomania and Other BFRBs
First and foremost, THANK YOU for exploring the advice to health professionals, written by two doctors with – you guessed it, BFRBs. Whether you are treating someone with an OCD-related condition, body-focused repetitive behaviour (BFRB), or are an individual looking for information to share with your healthcare provider, you’ll find everything you need here. If you have any questions after reading, please contact us and we’ll get back to you as soon as we can. We all all volunteers, so please bear with us. Please pass our helpline number on to your patients: +447910 114739 and let them know to keep trying if they can’t get through or send a text message.
Feeling Misunderstood
After speaking with a healthcare professional about their BFRBs, our users often report being misunderstood. Recently, a sixteen-year-old was told to “get a teddy and pick at that.” If you don’t know what advice to offer, listening is best. Some people report that it helps to hear that “It is ok to pull your hair out.” As a professional, it is probably most important for you to admit when you just don’t know something. Some of our most favourable feedback came from a lady who said “My Doctor was great, she said she hadn’t really dealt with anyone with trichotillomania before, she’d do some research and call me back in for a follow-up appointment, when she would have some advice ready.”
Understanding Body Focused Repetitive Behaviours
BFRBS are picky-type conditions, where people might pick at scars on their body or pick their lips. Trichotillomania, also known as hair-pulling disorder, is a condition where individuals feel compelled to pull out their hair, resulting in noticeable hair loss. It is categorized under Obsessive-Compulsive and Related Disorders in the DSM-5. Understanding the underlying causes and effective treatment strategies is crucial for providing the best care to your patients.
Diagnostic Criteria
To diagnose trichotillomania, look for the following criteria:
- Recurrent hair pulling, resulting in hair loss.
- Repeated attempts to decrease or stop hair pulling.
- Hair pulling causes significant distress or impairment in social, occupational, or other important areas of functioning.
- The hair pulling or hair loss is not attributable to another medical condition (e.g., a dermatological condition).
- The hair pulling is not better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder).
Treatment Options
Specialist BFRB Cognitive Behavioural Therapy (CBT)
- Habit Reversal Training (HRT): This is the most effective CBT technique for trichotillomania. It involves awareness training, developing a competing response, and building motivation.
- ACT: Acceptance and Commitment Therapy is very successful in treating BFRBs and we recommend the treatments at https://coaching.care, who have received our specialist BFRB treatment training.
- Cognitive Restructuring: Helps patients identify and change distorted thoughts related to hair pulling.
Medication
- N-acetylcysteine (NAC): An amino acid supplement that has shown promise in reducing hair-pulling behaviors.
- Memantine: A medication originally developed for dementia, has resulted in considerable improvement in BFRBs.
- Selective Serotonin Reuptake Inhibitors (SSRIs): These can help some patients, although they are generally not effective for trichotillomania.
Support Groups and Psychoeducation
- Encourage participation in support groups where patients can share their experiences and coping strategies.
- Provide educational resources to patients and their families about trichotillomania.
Mindfulness and Stress Management
- Techniques such as mindfulness meditation and stress management can reduce the urge to pull hair by addressing underlying anxiety and stress.
Communicating with Patients
- Empathy and Validation: Listen to your patients without judgment. Validating their feelings and experiences can build trust and open communication.
- Avoid Simplistic Solutions: Statements like “just stop” or “get a teddy and pick at that” can be harmful. Instead, offer practical and evidence-based advice.
- Admit Uncertainty: If you are unsure about the best course of action, it is better to admit it. Work collaboratively with your patient to find effective solutions.
Additional Resources
Trichotillomania Learning Center (TLC): Access guidelines and research from a leading organization on trichotillomania.
International OCD Foundation (IOCDF): Find comprehensive resources and support for OCD and related disorders.
Continuing Education: Explore courses and workshops to further your understanding and skills in treating BFRBs.
Contact Us
If you have any questions or need further assistance, please do not hesitate to contact us. We are here to support you in providing the best care possible.