A child with the hair pulling disorder known as trichotillomania can face an uphill battle, not only with its physical aspects, but also with the social, emotional, and mental complications of the disorder. The best trichotillomania treatments for children often differ from one child to the next. The physician in charge of the treatment plan will conduct a physical, mental, and emotional assessment of the child in order to prepare the best options.
A publication of the Scientific Advisory Board of the Trichotillomania Learning Center describes a treatment plan for children with trichotillomania as one that is often unique for each child and family involved. For some children the best treatment to stop or reduce hair pulling is behavioral therapy on its own; while others will require cognitive behavioral therapy along with medication.
Medication is not generally the first line of treatment unless the child also suffers from depression and anxiety. Medications, such as those with SSRIs are most commonly prescribed if no headway is being made with CBT alone. Often adding the medications can help boost the benefits of the behavioral therapy.
One-on-one behavioral therapy is viewed as a very effective treatment, but it may also include the involvement of at least the primary caregiver of the child. This allows a parent or guardian to be able to help the child to better cope at home and to ensure that they follow through with the lessons learned in therapy. It is also a great way for the parent to learn more about the disorder and the struggles that their child faces.
Cognitive behavioral therapy works to change the behavior and thoughts of the child in order to reduce and hopefully put into remission the compulsion to pull hair. One technique used is habit reversal where the child is taught;
1) To be more aware of their actions
2) To understand and realise what triggers their hair pulling episodes
3) How to replace hair pulling with a healthy habit.
Keeping a Journal
Depending on the age of the child the doctor may suggest keeping a journal that details what occurs before, during, and after an episode of hair pulling. If the child is not old enough to keep a log of their behaviors then the parent or caregiver will write one for them. A journal will help the doctor to understand the child's hair pulling triggers so that they can better target their treatment plan and show the child how to avoid triggers or teach them how to cope with them.
The journal will also include a log of how many hairs were pulled and if the child was aware they were pulling their hair at the time. These are important factors that need to be noted in order to make the treatment of trichotillomania more effective.
As stated earlier, medications are not the first line of defense when dealing with TTM but they are often used in collaboration with CBT or other treatment protocols that your child's doctor has put into place. Most of these medications are typical anti-depressant and anti-anxiety medications such as Prozac. Your doctor will inform you of the benefits and possible dangers of each medication prescribed. The child will be monitored for effectiveness of the drug and you and the doctor will determine if continuing with it is necessary.
Although not completely proven, many mental health professionals believe that it is plausible that the earlier the trichotillomania is diagnosed and treated the less likely the child will experience major relapses of hair pulling in their teen and adult years. The opinion of many therapists is that it is possible that early detection and early treatment can greatly reduce the chances of having a life long battle with hair pulling. This is important information for parents to know so that they can begin seeking help for their child at an early age. Trichotillomania is notorious for causing children to have a low self esteem, issues with social development and relationships, as well as being a cause of depression in some children, teens, and adults. Your child's therapist will discuss all of this with you as they prepare their treatment plans.
NB: The content of this article is for information purposes only and is not intended to replace sound medical advice and opinion.
Trichotillomania Learning Center, https://www.trich.org
MedLine Plus-Trichotillomania, https://www.nlm.nih.gov/medlineplus/ency/article/001517.htm