Therapist-Delivered Video Therapy Habit Reversal Training for Body-Focused Repetitive Behaviors

To examine the effectiveness of therapist-delivered video therapy habit reversal training (HRT) in large real-world samples of children, adolescents, and adults with trichotillomania and excoriation disorder (ED). The sample included 543 patients with trichotillomania (57 children, 75 adolescents, 411 adults) and 528 patients with ED (40 children, 46 adolescents, 442 adults). Treatment followed a protocol of weekly HRT sessions, transitioning to biweekly sessions. The Repetitive Body Focused Behavior Scale was administered at baseline, weeks 5-7, and weeks 14-16 and during maintenance periods through week 52. =0.68-1.54 for excoriation. This analysis shows promising evidence that therapist-delivered video therapy HRT is associated with reductions in both hair-pulling and skin-picking severity and improvements in related symptoms in a real-world setting. The large treatment effects and improvements across the lifespan for both conditions suggest this delivery format may help address barriers to accessing evidence-based care for body-focused repetitive behaviors.