Trichotillomania: An ACT-Enhanced Behavior Therapy Approach (Second Edition): Therapist Guide

Trichotillomania (TTM), also known as hair-pulling disorder, is a chronic condition characterized by repetitive hair-pulling that leads to noticeable hair loss, functional impairment, and significant emotional distress (American Psychiatric Association, 2013). While historically under-recognized, recent research indicates a current prevalence rate of approximately 1.7% in the general population (Grant et al., 2020). TTM most commonly begins in late childhood or early adolescence, with an average onset between ages 10 and 13, and it often follows a chronic, waxing-and-waning course (Grant & Chamberlain, 2016; Stein et al., 1999). The disorder affects individuals physically, socially, and psychologically. Along with hair loss, common physical complications include scalp irritation, follicle damage, and, in extreme cases, trichobezoars, which can lead to gastrointestinal obstructions caused by hair requiring surgical intervention (Snorrason et al., 2021). Socially, individuals with TTM frequently report avoidance of public activities, interpersonal difficulties, and occupational impairment (Woods et al., 2006). Psychiatric comorbidities such as depression, anxiety, and substance use disorders are prevalent, affecting up to 80% of individuals with TTM (Houghton et al., 2016a).

Authored by leading psychologists including David Barlow, Michelle Craske and Edna Foa, Treatments That Work™ is a series of manuals and workbooks based on the principles of cognitive behavioral therapy (CBT). Each pair of books (Therapist/Clinician Guide and Workbook) - contains step-by-step procedures for delivering evidence-based psychological interventions and will help you to provide the best possible care for your clients.