Cognitive–Behavior Therapy for Pediatric Trichotillomania

Trichotillomania (TTM) is a chronic disorder in which youth repeatedly pull their hair to the extent that they experience noticeable hair loss as well as clinically significant academic, social, and/or occupational impairment. Prevalence rates of TTM in children are largely unknown, although the onset of TTM primarily occurs in childhood. Modified habit reversal training is the current psychological treatment of choice for TTM in adults and researchers and clinicians have applied this approach to the treatment of pediatric TTM. This article describes cognitive–behavior therapy for pediatric TTM, with an emphasis on the application of standard interventions across the developmental age range. In particular, recent findings on the role of experiential avoidance in TTM and the manner with which the type of hair pulling changes across the developmental age range, recommends the flexible principle-driven application of treatment strategies with careful consideration of the developmental age of youth.