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Evaluation Video ViewAttendees 15

Mini Workshop

Obsessive Compulsive and Related Disorders

Session: How to Deliver Acceptance-Enhanced Behavior Therapy to Treat Body-Focused Repetitive Behaviors Across the Lifespan

Mini Workshop 9 - How to Deliver Acceptance-enhanced Behavior Therapy to Treat Body-focused Repetitive Behaviors Across the Lifespan

Friday, November 17, 2023
3:00 PM – 4:30 PM PST
Location: Elwha B, Level 5
Earn 1.5 Credit
Recorded Session
Keywords: Trichotillomania, Acceptance, Habit Reversal
Level of Familiarity: Basic to Moderate
Recommended Readings: Lee, E. B., Haeger, J. A., Levin, M. E., Ong, C. W., & Twohig, M. P. (2018). Telepsychotherapy for trichotillomania: A randomized controlled trial of ACT enhanced behavior therapy. Journal of Obsessive-Compulsive and Related Disorders, 18, 106–115. https://doi.org/10.1016/j.jocrd.2018.04.003,   Twohig, M. P., Petersen, J. M., Fruge, J. E., Ong, C. W., Barney, J. L., Krafft, J., Lee, E. B., & Levin, M. E. (2021). A pilot randomized controlled trial of online-delivered ACT-enhanced behavior therapy for trichotillomania in adolescents. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2021.01.004,   Woods, D. W., Ely, L. J., Bauer, C. C., Twohig, M. P., Saunders, S. M., Compton, S. N., Espil, F. M., Neal-Barnett, A., Alexander, J. R., Walther, M. R., Cahill, S. P., Deckersbach, T., & Franklin, M. E. (2022). Acceptance-enhanced behavior therapy for trichotillomania in adults: A randomized clinical trial. Behaviour Research and Therapy, 158, 104187. https://doi.org/10.1016/j.brat.2022.104187,   ,  
Body-focused repetitive behaviors (BFRBs) are defined as recurrent, destructive behaviors directed toward the body that may cause physical damage or injury. They include hair pulling (trichotillomania), skin picking (excoriation), and nail biting. Prevalence estimates for BFRBs in non-clinical samples range from 14 to 23% (Solley & Turner, 2018; Teng et al., 2002), with even higher estimates in clinical samples (La Buissonnière-Ariza et al., 2021). BFRBs affect people across the lifespan, so it is important to know how to identify and treat it in children, adolescents, and adults.

The psychological intervention with the strongest evidence base for treating BFRBs is habit reversal training (HRT; Bate et al., 2011; Farhat et al., 2020). HRT entails multiple components, including awareness training, competing response training, and generalization training (Azrin & Nunn, 1973). A version of HRT that incorporates acceptance-based strategies to target the emotion regulation function of BFRBs (Roberts et al., 2013) is acceptance-enhanced behavior therapy (AEBT), which has been found to be useful for treating trichotillomania in youth and adults, delivered in-person or virtually (Lee et al., 2018; Twohig et al., 2021; Woods et al., 2022).

This Mini Workshop will teach attendees how to assess BFRBs and use AEBT to treat BFRBs. Presenters will cover the various components of AEBT (psychoeducation, HRT + stimulus control, acceptance strategies, and relapse prevention), with guidance on how to adapt the intervention for youth and virtual format.

• Psychoeducation on body-focused repetitive behaviors (BFRB)
o Symptoms, prevalence rates, common forms of functional impairment
o What to look for
o Cultural and demographic considerations
o Heterogeneity and subtypes within BFRB
o Difficulty of finding quality help for BFRB

• Assessment of BFRB symptoms and processes
o How to ask about BFRB
o Useful and relevant measures
o Behavior tracking

• Treatment
o State of the evidence for BFRB treatment
o Habit reversal training (HRT)
 How to do it and when it falls short
 Demonstration of HRT components
o Acceptance-enhanced behavior therapy (AEBT)
 Demonstration of AEBT components
 Stimulus control training
 Values and motivation
 Letting go of control
 Making space for unwanted internal experiences
 Relapse prevention
o Considerations and modifications for kids and working with parents

Learning Objectives:

At the end of the session, the learner will be able to:
  • Identify symptoms and signs of BFRBs.
  • Describe the four main components of AEBT.
  • Deliver each component of AEBT.
  • Adapt AEBT to client age and treatment delivery format.
  • Long-term goals: Notice signs of and assess for BFRB with your current clients
  • Long-term goals: Provide effective treatment to clients seeking help for BFRB