Acceptability of treatments for trichotillomania. Effects of age and severity.
Habit reversal is the most welcomed treatment for hair pulling no matter the client’s age or severity.
01Research in Context
What this study did
College students read short stories about a person who pulls their hair.
Each story ended with one of four treatments: habit reversal, hypnosis, medicine, or punishment.
The students rated how fair, kind, and reasonable each treatment felt.
What they found
Habit reversal and hypnosis scored highest.
Medicine and punishment scored lowest.
The person’s age or how bad the pulling was did not change the scores.
How this fits with other research
Kazdin (1980) asked the same question about kids with behavior problems. That study also ranked reinforcement top and punishment bottom.
Roberts et al. (1987) asked parents of children with intellectual disability. Parents again picked reinforcement-based options first.
Tallant et al. (1989) looked at electric shock. Professionals only rated it okay when every milder fix had failed. Together these papers show a clear line: people like positive, skill-building steps and dislike harsh or medical ones.
Why it matters
When you meet a new client with trichotillomania, start by offering habit reversal. It is the most welcomed tool across ages and severity. Skip the scary or pill talk unless the family asks. You will save time and build trust from day one.
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02At a glance
03Original abstract
Based on the literature, trichotillomania (TTM, chronic hair pulling) in children and adults appears to be responsive to behavioral interventions such as habit reversal. However, some have questioned the generality and acceptability of such procedures. This study compared the acceptability ratings of four interventions targeting TTM (habit reversal, hypnosis, medication, and punishment). In the study, 233 college students read case vignettes in which the age of the analogue client and the severity of the hair pulling were manipulated. Results showed significant differences between the four treatment conditions, with hypnosis and habit reversal being rated most acceptable. Age of the analogue client and severity of TTM did not significantly influence acceptability ratings.
Behavior modification, 2002 · doi:10.1177/0145445502026003005