Annual Conference on BFRBs: Hair Pulling & Skin Picking

Exposure and response prevention (ERP) entails intentionally activating anxiety, “leaning into” or staying with the anxiety while refraining from rituals or compulsive behaviors until distress naturally subsides. As a therapeutic intervention, ERP is widely used to treat anxiety disorders and obsessive-compulsive disorder, with solidly demonstrated efficacy and effectiveness for a variety of presentations and populations. We believe that ERP also has a role in the treatment of BFRBs. In this workshop, the theoretical underpinnings of ERP will be presented, and the rationale for applying to the treatment of BFRBs will be provided. We will discuss two major ways in which ERP can be used in the treatment of BFRBs. The first is to help target urges to pull or pick. ERP can be particularly effective for individuals who pull or pick due to perfectionism or sensory stimuli. ERP can also be beneficial for reducing fear and shame that often accompanies BFRBs, especially when interacting with others. For example, many individuals with BFRBs experience significant anxiety about others finding out or judging them or their appearance. These fears can be alleviated via exposure. Presenters will model this technique via live role-play. Attendees will be invited to ask questions or share their own cases to facilitate discussion of real-world applications. Finally, common pitfalls will be presented to help attendees avoid potential problems.