Personalize Your BFRB Treatment Plan in Three Steps

Featured Image for this article: a succession of small plants growing from seedling to mature plant
Step 1: Identify Your Triggers
  • Sensory: Sensations I have before, during, and after I pull/pick (ex. scalp itches; hair feels coarse)
  • Cognitive: Thoughts I have before, during and after I pull/pick (ex. I can't resist, this has to go)
  • Affective: Feelings I have before, during, and after I pull/pick (ex. anxious, angry, soothed)
  • Motor Habits: Positions/actions that lead me to pull/pick (ex. leaning on face, twirling hair); What I do with hair/skin (ex. bite, swallow, twirl)
  • Place: Places where I pull/pick (ex. watching TV); Things nearby when I pull/pick (ex. mirror, tweezers)
Step 2: Consider Strategies
  • Sensory strategies – e.g., baths, massages, bath sponge, koosh balls, brushing hair, lotion, Vaseline
  • Cognitive strategies – e.g., identify/reframe unhelpful thoughts, visualize successfully using my strategies
  • Affective strategies – e.g., identify and address emotion, keep a journal, deep breathing, yoga
  • Motor strategies – e.g., Band-Aids, medical tape, gloves, rubber finger tips, hat, glasses, crochet/knit
  • Place strategies – e.g., remove tweezers, cover mirrors, dim lights, leave door open, stay around others
Step 3: Make an Action Plan
  • What are my triggers?
  • Which of my triggers am I ready to address?
  • What possible strategies can I try?
  • What do I need in order to address these triggers?
  • What will be my first step to enact this plan?

Diagnosis & Treatment
Self Help Strategies
Cheek Biting
Hair Pulling
Nail Biting
Other BFRBs
Skin Picking
Medical Providers