Getting the word out: cognitive-behavioral therapy for trichotillomania (hair-pulling disorder) and excoriation (skin-picking) disorder.

BACKGROUND: To date, there has been no investigation of dissemination outcomes for cognitive-behavioral training programs for body-focused repetitive behaviors (BFRBs). METHODS: Sixty-three past participants of the Trichotillomania Learning Center (TLC) intensive professional training institutes completed an online survey assessing referral sources, skills utilization, and treatment outcomes before and after training. The intensive training focused on the treatment of trichotillomania (hair-pulling) disorder and excoriation (skin-picking) disorder using in-person or videotaped didactics, role playing, and case presentations with supervision upon request. RESULTS: Participants endorsed a greater number of referral sources and BFRB patients after attending training. Paired t tests indicated significant pre- to post-training increases in self-reported utilization of all individual cognitive-behavioral therapy (CBT) skills as well as overall mean skills usage (both P<.001). Changes after training in the reported percent of abstinent patients and mean reduction in symptom severity were also noted. CONCLUSIONS: The TLC intensive professional training institutes may be useful for disseminating CBT skills for the treatment of BFRBs, but additional research is warranted.

Consumer advocacy meetings: an innovative therapeutic tool.

BACKGROUND: Consumer advocacy groups are fulfilling an increasingly important role in psychiatry. The Trichotillomania Learning Center (TLC) aims to improve the quality of life of individuals with body-focused repetitive behavioral (BFRB) disorders such as trichotillomania (hair pulling disorder [HPD]) and skin picking disorder. The annual TLC retreat is an educational event focused on experiential learning and building a supportive community. METHODS: We assessed attendees' impressions of and experiences from the 2010 TLC retreat. RESULTS: Sixty-two (57 female; mean age: 32.4, standard deviation: 14.6) attendees completed the survey. Fifty-five reported ≥1 current BFRBs, 6 were family members of attendees, and 1 participant reported HPD in remission. Most attendees found the TLC retreat to be a helpful intervention that offered support and information on BFRB disorders. Attendance was accompanied by reduced stigma, shame, and loneliness. Attendance also increased many respondents' levels of motivation to stop pulling or picking (85%); 61% of respondents reported reduced pulling or picking. Most respondents (95%) reported learning new ways of managing the condition. CONCLUSIONS: Survey findings suggested most attendees found the annual TLC retreat to be a helpful intervention. The retreat may serve as a novel and innovative model for helping individuals suffering from a range of other psychiatric disorders.