Acceptance-Enhanced Behavior Therapy for Excoriation (Skin-Picking) Disorder in Adults: A Clinical Case Series


• Excoriation (skin picking) disorder is common, but little research on its treatment exists
• Acceptance-enhanced behavior therapy (AEBT) may be helpful in treating this condition
• We report on four consecutive patients treated with this approach in a specialty clinic
• Three of four patients showed marked decreases in symptoms following treatment
• Acceptance-enhanced behavior therapy (AEBT) is a promising treatment for excoriation disorder


Excoriation disorder (ExD) involves habitual skin picking that causes significant tissue damage and psychosocial impairment. ExD is largely understudied, and efficacious treatments have yet to be established. Preliminary evidence suggests that habit reversal is a promising intervention for ExD and that acceptance and commitment therapy (ACT) techniques may further enhance the efficacy of habit reversal. This report details treatment of ExD in four adults using a combination of habit reversal and ACT, termed acceptance-enhanced behavior therapy (AEBT). Three of four patients experienced a clear decrease in ExD symptoms from pretreatment to post treatment. Clinical considerations and directions for future research are discussed.

The authors would like to thank Alexander Betances and Rachel Johnson for their assistance in the preparation of this manuscript.

Corresponding author at: 4235 TAMU, College Station, TX 77843.Copyright © 2014 Published by Elsevier Ltd.

No items found.
No items found.