Behavioral Treatment of Trichotillomania in a College Woman: A Case Study

Abstract

Trichotillomania (TTM) is a disorder that involves repetitive pulling of one’s hair to the point of hair loss and clinically significant distress or functional impairment. Using Diagnostic and Statistical Manual of Mental Disorders-5 ( DSM-5) criteria, which include repeated attempts to decrease or stop pulling, the 12-month prevalence of TTM is 1% to 2%. Treatment commonly involves behavior therapies. These behavior therapies conceptualize TTM using operant learning theory and explain hair-pulling behavior as caused and maintained by environmental antecedents and consequences interacting with an individual’s biological makeup. This clinical case study describes use of an Acceptance and Commitment Therapy Enhanced Behavior Therapy for Trichotillomania (AEBT-T) protocol to facilitate treatment of a 20-year-old woman who was referred for TTM. The client remained in treatment for 14 months. After the completion of 32 therapy sessions, the client reported significantly reduced hair-pulling and anxiety, as well as increased engagement in valued activities. Implications of these findings are discussed, with an emphasis on the challenges of treating TTM in a college population.