Acceptance-enhanced behavior therapy (AEBT) for trichotillomania and chronic skin picking: exploring the effects of component sequencing.
In AEBT for hair-pulling or skin-picking, you can run HRT before or after ACT without hurting short-term results.
01Research in Context
What this study did
Five adults who pulled their hair or picked their skin got AEBT. AEBT mixes habit-reversal training with ACT skills.
The team switched the order for each person. One started with HRT, another with ACT, then they added the rest.
What they found
All five people cut their pulling or picking by a lot. The order of steps did not change the big drop.
Gains stayed when the team checked later. Both sequences worked the same.
How this fits with other research
Staddon et al. (2002) stopped a toddler’s hair pulling with only response prevention. Porter et al. (2008) shows adults need the fuller AEBT package.
Luiselli (1989) used contingent gloves to cut skin picking in one teen. Porter et al. (2008) got the same large drop using ACT plus HRT in adults.
Lang et al. (2010) looked at sixteen small skin-picking studies and called the evidence weak. Porter et al. (2008) adds one strong single-case set to that pool.
Why it matters
You can stop stressing about the perfect order. Start with the piece you or the client likes best. Either way you still get the full AEBT package in and can expect a clear drop in pulling or picking.
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02At a glance
03Original abstract
This pilot study examined the utility of acceptance-enhanced behavior therapy (AEBT) for trichotillomania (TTM) and chronic skin picking (CSP) and the impact of altering treatment sequence on overall treatment efficacy. Participants referred to a TTM and CSP specialty clinic were assessed by an independent evaluator within separate, nonconcurrent, multiple-baseline designs across participants. The first group of three participants received habit-reversal training (HRT) followed by acceptance and commitment therapy (ACT), and the second group of two participants received ACT followed by HRT. Results indicated that AEBT greatly reduced pulling/picking for all five participants and that the order in which ACT and HRT were implemented made little or no difference in short-term treatment outcome. Conclusions, limitations, and future areas of research are discussed.
Behavior modification, 2008 · doi:10.1177/0145445507313800