Habit Reversal Training in Trichotillomania: A Case Series Based Practical Psychotherapy

Trichotillomania, though an impulse control disorder, is encountered in psychiatric clinical practice, with most patients being referred by dermatologists. Current literature does not recommend any single pharmacological agent showing efficacy in treatment, with add-on psychotherapy offering promising results. We present a case series based on habit reversal training for trichotillomania of three females – across of varied ages, marital status, educational status, and different comorbidities, in varied treatment settings (both – outpatient and inpatient), with varied modes of treatment (offline and online) being treated with pharmacotherapy in combination. Objective assessments were done on the Massachusetts General Hospital Hair Pulling Scale and photographic evidence, documented at baseline and at regular intervals. Over a 4 week follow-up period, the combination therapy proved to be efficacious and tolerable with satisfactory improvement in symptoms in all patients.