Comprehensive Behavioral Treatment of Trichotillomania: A Treatment Development Study.
A ready-to-use manual for trichotillomania just passed its first test with big symptom cuts.
01Research in Context
What this study did
Faso et al. (2016) tested a new manual for hair-pulling disorder. The team calls the package ComB — Comprehensive Behavioral Treatment.
They ran a small before-and-after pilot. No control group. They tracked how much clients pulled, how impaired they felt, and their quality of life.
What they found
Hair-pulling dropped a lot. Clients also said life got easier. Gains held at follow-up.
The authors say the package is ready for a full trial.
How this fits with other research
McPhillips et al. (2021) ran a similar small pilot. They used a manual called Social Management Training for males with Klinefelter syndrome. Both studies show a short manual can cut problem behavior without a control group.
Strand et al. (2018) moved a clinic FCT plan into a family’s living room. Like ComB, they saw big drops in problem behavior once the plan fit the setting. The lesson: manual plus context matters.
Gabriels et al. (2001) wrote a manual for offenders but never tested it. ComB goes further — it gives both the steps and the first data that the steps work.
Why it matters
If you see hair-pulling, you now have a full manual ready to print. Start with the ComB intake form, pick the modules that fit, and teach the client to use them daily. Track pulls with a simple log. The pilot says you can expect large drops, but run your own probe to be sure.
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02At a glance
03Original abstract
This study aimed to concretize and pilot test comprehensive behavioral (ComB) treatment of trichotillomania (TTM), to facilitate rigorous testing of its efficacy. ComB provides a conceptualization to develop individualized treatment and choose interventions for managing distinct factors that maintain the individual's hair pulling. It has been used by clinicians for almost three decades, yet was not previously manualized or studied empirically. A manual was drafted and revised based on patient (N= 16) and therapist feedback, an intervention choice study demonstrated therapists reliably selected model-consistent interventions, and a therapist adherence measure was developed and tested. Uncontrolled preliminary data showed ComB to be highly acceptable, and it led to reduced TTM symptom severity and impairment, with large effects. Quality of life and disability also improved, with effects maintained at follow-up. This study resulted in the development of a manual and measures to be used in a randomized controlled trial (RCT) of ComB for TTM.
Behavior modification, 2016 · doi:10.1177/0145445515616369