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What are Body-Focused Repetitive Behaviours?

Body-focused repetitive behaviour (BFRB) is an umbrella  term for a group of related disorders including hair pulling,  skin picking, and nail biting. These behaviours are not  habits or tics; rather, they are complex disorders that  cause people to repeatedly touch their hair and body in  ways that result in physical damage. The best research suggests that 3% or more of the population  lives with a BFRB – that’s over 10 million people in North  America alone – yet they often go undiagnosed and untreated,  causing shame and isolation.  Symptoms tend to begin around puberty, and may come and  go over time, but usually require intervention to achieve lasting  remission. Women have a greater chance of being affected  than men. The causes are not fully understood, but evidence  shows that these disorders are at least partly hereditary. 


 FLOW CHART FOR BFRB TREATMENT (what to expect)


PHASE 1: ASSESSMENT AND FUNCTIONAL ANALYSIS 

Decision to target behaviour and orientation of client 

Identification of functional components 

Begin self-monitoring 


PHASE 2: IDENTIFY AND TARGET MODALITIES 

Identification of potential modalities to be targeted 

Selection of target modalities 


PHASE 3: IDENTIFY AND IMPLEMENT STRATEGIES

 Identify potential treatment strategies within the targeted modalities 

Identify the specific strategies most likely to be used by the client 

Train client in the use of strategies/implement for at least 1 week 


PHASE 4: EVALUATION AND MODIFICATION 

Evaluate effectiveness of the strategy 

Select and implement next step in treatment

Common BFRBs

 Hair pulling disorder (trichotillomania) causes people  to pull out the hair from their scalp, eyelashes, eyebrows,  and other parts of the body resulting in noticeable bald  patches 


  Nail biting disorder (onychophagia) causes people to  bite their nails past the nail bed and chew on cuticles  until they bleed, leading to soreness and infection


  Skin picking disorder 

(excoriation or dermatillomania) causes people to  repetitively touch, rub, scratch, pick at, or dig into their  skin, resulting in skin discoloration, scarring, and even  severe tissue damage and disfigurement. 


Other related behaviours include frequently chewing on the  inside of the cheeks and biting the lips until they bleed. 


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