1. Trichotillomania Kristen Janowicz

2. What is Trichotillomania? According to the Trichotillomania Learning Center, “Trichotillomania (trick-o-til-o-MAY-nee-ah) is a disorder that causes people to pull out the hair from their scalp, eyelashes, eyebrows, pubic area, underarms, beard, chest, legs or other parts of the body, resulting in noticeable bald patches.” View link to hear/watch a teen talk about her battle with Trichotillomania http://www.youtube.com/watch?v=ioI2nbsBe1o

3. What are common symptoms/signs of Trichotillomania? Repeatedly pulling of hair out Pleasure/relief after pulling hair out Patchy/bald areas on the scalp or other parts of the body Chewing or eating pulled-out hair Playing with pulled-out hair Rubbing pulled-out hair across your lips or face Preoccupation, anxiety, depression, career or academic decline Wearing hats

4. Why do people pull? The cause of Trichotillomania is unclear, but it is believed that Trichotillomania can be caused by genetic and/or environmental factors. Possible reasons why people pull their hair out are provided below. A chemical imbalance in the brain’s chemistry Used as a coping mechanism for anxiety/difficult situations The result of a stressful/traumatic situation Triggered by sensory discomfort Triggered by pubertal hormonal changes ? ? ? ? ?

5. Treatment for Trichotillomania The most common treatment for Trichotillomania is Cognitive Behavior Therapy. What is CBT? -Cognitive Behavior Therapy, as stated by the Trichotillomania Learning Center, is “a form of therapy that seeks to alter behavior by identifying the precise factors that trigger hair pulling and learning skills to interrupt and redirect responses to those triggers.” There are several strategies related to Cognitive Behavior Therapy. Four strategies that are most commonly used with patients who have Trichotillomania are briefly explained on the next two slides.

6. Strategies to end hair pulling Cognitive Behavior Treatment The Comprehensive Behavior Model (ComB), developed by Charles Mansueto is used in CBT to treat Trichotillomania. There are four components, which are: 1.Assessment 2.Identify and Target Modalities 3.Identify and Choose Strategies 4.Evaluation Habit Reversal Training Used for early treatment of Trichotillomania Has three critical components, which are: 1.Awareness training 2.Competing response training 3.Social support

7. Strategies continued… Acceptance and Commitment Therapy Patients/individuals are asked to accept the urge to pull out their hair without acting on it. Patients will typically come up with a plan for treatment with their therapist. The plan would include: -Understanding a patient’s values -HRT and stimulus control -Seeing internal experiences for what they are -Commitment to the process Dialectic Behavior Therapy Assists in enhancing awareness of pulling triggers and teaches pullers to resist urges to pull. DBT has four main modules, which are: 1.Mindfulness 2.Interpersonal effectiveness 3.Emotion regulation 4.Distress tolerance

8. Tips for family members and friends who love someone with Trichotillomania Become well-informed about Trichotillomania Be patient and flexible with your loved one Make efforts to communicate in a sensitive manner Stay calm! Seek support if you need it! Try a self-help support group, read books or seek additional resources. Words from a teen with Trichotillomania: “I am embarrassed for myself. I am embarrassed for my family. They’re so embarrassed of me and I hate it, but I can’t stop…I just can’t.” T o get started on becoming a supporter of a loved one with Trichotillomania, check out the resources on the next slide!

9. Resources for those battling Trichotillomania and the people who care about them  Trichotillomania Learning Center (TLC): http://www.trich.org/index.htmlhttp://www.trich.org/index.html -Fantastic site filled with useful resources for everyone that knows someone with Trich, as well as for those who have Trichotillomania  TeensHealth from Nemours-Trichotillomania: http://kidshealth.org/teen/your_mind/mental_health/trichotillomania.html# http://kidshealth.org/teen/your_mind/mental_health/trichotillomania.html# -Useful site to find information about Trichotillomania-causes, signs, support, etc.  Tumblr-trichhelp: http://trichhelp.tumblr.com/http://trichhelp.tumblr.com/ -A site with motivation, tips and sayings-good site for support for teens  TLC’s Treatment Guidelines for Trichotillomania (PDF File): http://www.trich.org/dnld/ExpertGuidelines_000.pdf http://www.trich.org/dnld/ExpertGuidelines_000.pdf -This PDF explains what Trichotillomania is, various treatment options for individuals with Trich and provides the reader with an extensive list of books, DVDs and other resources

10. References Kidshealth. (2013). Trichotillomania. Retrieved from: http://kidshealth.org/teen/your_mind/mental_health/trichotillomania.html# http://kidshealth.org/teen/your_mind/mental_health/trichotillomania.html# Trichotillomania Learning Center. (2013). Retrieved from: http://www.trich.org/index.htmlhttp://www.trich.org/index.html Trichotillomania Learning Center’s Scientific Advisory Board. (2011). Treatment guidelines for trichotillomania, skin picking. Retrieved from: http://www.trich.org/dnld/ExpertGuidelines_000.pdf http://www.trich.org/dnld/ExpertGuidelines_000.pdf Manseuto, C.M. (1999). A Comprehensive model for behavioral treatment of trichotillomania. Retrieved from: http://www.trich.org/dnld/comprehen_model_btt.pdfhttp://www.trich.org/dnld/comprehen_model_btt.pdf Trichotillomania my battle [Video file]. Retrieved from: http://www.youtube.com/watch?v=ioI2nbsBe1o http://www.youtube.com/watch?v=ioI2nbsBe1o Trichhelp. Retrieved from: http://trichhelp.tumblr.com/http://trichhelp.tumblr.com/