Trichotillomania and Interventions: A Look at the Best Interventions for Trichotillomania

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Trichotillomania and Interventions: Professional Help

There are a number of ways to help people stop hair pulling and many of these treatments fall under the umbrella of cognitive behavioral therapy (CBT). While most techniques are more successful when under the initial guidance of a therapist, others can be implemented by the sufferer along with family members and friends who are willing to help.

Practical Interventions for Trichotillomania

Cognitive behavioral therapy is believed to be the most effective form of treatment for hair pulling. Read the following information on trichotillomania and interventions to determine the best way to help a sufferer:

  • Hair pulling normally develops over a period of months or years. It can take an equivalent amount of time to reverse the behavior pattern.
  • Medications can decrease the urge to hair pull but cannot change engrained behaviors.
  • Hair pullers are affected by their problem in different ways. Some are more disturbed by the hair loss and its impact on their social life while others worry about the wasted time or effect on their self-esteem.
  • A person may be asked to make a list of the physical, emotional, economic, relational, and occupational cost of their hair pulling. This will help them face the enormous impact that trichotillomania is having on every area of their life.
  • It is important to increase awareness of the hair pulling habit. This can be done by recording each movement and action that leads to pulling hair. Once these have been identified, a person can learn to distract themselves when they see they are heading towards a hair pulling session.
  • A visual record of hair pulling can be encouraging as regrowth begins. Take photographs of the affected areas and repeat the process every two to four weeks.
  • A therapist can suggest exercises or routines that partners and family members can implement to help the hair puller. These include a subtle signal such as a hand squeeze that lets the person know they are twirling their hair. Other simple actions such as reminding them to hold a book with two hands, or encouraging them to spend more time with others can cut back on hair pulling.
  • Setting goals is an important part of controlling hair pulling. Write these down and revisit them frequently. Occasional failures are to be expected but the overall results should show progress.
  • Implement a reward system that allows a treat when a goal is reached.
  • Stimulus control involves modifying the environment to reduce the opportunities to hair pull. Examples are to place a hat over the hair, wear rubber gloves at home, play with string or wire, stroke a pet, and play with a stress ball.
  • Cognitive therapies look at incorrect thought processes about hair pulling, and train the person to replace these with positive, true thoughts.

Trichotillomania and interventions is a broad subject with many aspects to consider. With professional help and the support of loved ones, most people can benefit from CBT. The ultimate aim is complete relief from hair pulling episodes and this is an attainable goal.


Help for Hair Pullers – Understanding and Coping with Trichotillomania, Nancy J Keuthen, Dan J Stein, Gary A Christenson, New Harbinger Publications, 2001