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What are BFRBs?
Physique centered repetitive behaviors or BFRBs are extra generally referred to as pores and skin choosing or hair pulling issues. They contain “any repetitive self-grooming habits that includes biting, pulling, choosing, or scraping one’s personal hair, pores and skin, lips, cheeks, or nails that may result in bodily injury to the physique and have been met with a number of makes an attempt to cease or lower the habits.” (TLC basis)
One therapy choice that has promising information and analysis to assist is the ComB mannequin.
What’s the ComB mannequin?
The great behavioral therapy or the ComB mannequin is a therapy protocol developed by (Mansueto 2019) that tackles the complexity of treating BFRBs. It begins with utilizing a CBT evaluation software, a practical evaluation. This appears at ways in which inside and exterior environments are impacting the BFRB that the shopper needs to vary. It’s a method for the clinician to develop a really distinctive and particular therapy for the shopper. It’s a strategy to arrange your setting so that you’re extra more likely to handle the urge to select or pull.
Let’s undergo an instance!
The SCAMP mannequin is a framework that guides the clinician by way of completely different areas or domains to evaluate. Every area tackles therapy from a wide range of inventive angles and leaves the shopper with a wide range of abilities and strategies for particular triggers.
Sensory – All of us have a nervous system that has completely different wants. Utilizing this area, we have a look at specific sensory wants the shopper has and select strategies primarily based on that. For instance: If a shopper’s nervous system is craving a easy feeling, the clinician can present examples of easy objects the shopper can use similar to utilizing a face masks or pimple patches that create a smoothness over a pimple or bump. Or utilizing a fear stone or calm patch to the touch.
Cognitive – There are particular cognitive perception programs and ideas that incessantly come up in remedy. The self-help e book lists out a few of them. This can be a strategy to see how the shopper’s inside self-talk and ideas can unknowingly enhance choosing/pulling or managing it. For instance: “I’ll simply decide/pull for a minute/only one” Rebuttal: How typically do I cease after a minute or after only one? Reply: By no means!. Utilizing post-it notes within the toilet with a few of these rebuttals might be useful.
Affective – Our moods and feelings influence how we view issues and the way we work together with them. This a part of the mannequin goes by way of emotion regulation abilities. For instance: If a shopper’s choosing/pulling occurs each time they get careworn, the clinician would supply stress relieving strategies and choices for the shopper to do as a substitute of choosing/pulling.
Motor – Particular motions {that a} shopper does or a place they place their hand would possibly set off an urge to select or pull. Considering of issues to make it much less interesting or more durable to tug/decide. For instance: getting gel nails or a manicure can change the sensation of the shopper’s nails and they’re much less more likely to get the identical reduction/feeling from choosing and pulling.
Place – Particular locations would possibly set off a shopper to select or pull extra, similar to the toilet or whereas driving. For instance: dimming the lights within the toilet so as to’t see within the mirror as clearly/intently and fewer more likely to get triggered by a hair or pores and skin bump.
I’d advocate the next in case you are inquisitive about receiving extra coaching or assets. The TLC basis BFRBs coaching program:“Medical Coaching Institute – TLC Basis for Bfrbs.” Medical Coaching Institute – TLC Basis for BFRBs. Accessed 21 Aug. 2023.
Ebook: Mansueto, Charles S., et al. Overcoming Physique-Targeted Repetitive Behaviors: A Complete Behavioral Remedy for Hair Pulling and Pores and skin Selecting. New Harbinger Publications, 2019.
This publish is offered in collaboration with ADAA’s OCD and Associated Problems SIG. Be taught extra in regards to the SIG.
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