Acceptance-enhanced behavior therapy for trichotillomania in adults: A randomized clinical trial
Open accessAbstract
Given the limited treatment options for trichotillomania (TTM), or Hair Pulling Disorder, this large randomized clinical trial evaluated the efficacy of acceptance-enhanced behavior therapy for TTM (AEBT-TTM) in reducing TTM severity relative to psychoeducation and supportive therapy (PST). Eighty-five adults (78 women) with TTM received 10 sessions (over 12 weeks) of either AEBT-TTM or PST. Independent evaluators masked to treatment assignment assessed participants at baseline (week 0), midpoint (week 6), and endpoint (week 12). Consistent with a priori hypotheses, 64% of the adults treated with AEBT-TTM were classified as clinical responders at post-treatment relative to 38% treated with PST. Clinical responders were identified by a score of 1 or 2 on the Clinical Global Impressions-Improvement (CGI-I) scale. Relative to the PST group, the AEBT-TTM group demonstrated significantly greater pre-to post-treatment reductions on the self-report Massachusetts General Hospital-Hairpulling Scale (MGH-HS) and the evaluator-rated National Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS). There were no significant post-treatment group differences on the Clinical Global Impressions-Severity (CGI-S) scale, or rate of TTM diagnoses. Results suggest AEBT-TTM provides greater treatment benefit than PST. Future research should continue to investigate AEBT-TTM along with mediators and moderators of its efficacy.
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Acceptance-enhanced behavior therapy has empirical support as a treatment for trichotillomania.
“In particular, acceptance-enhanced behavior therapy (AEBT) is an empirically supported intervention for trichotillomania (Woods et al., 2022), which combines habit reversal training with elements from ACT to increase effective responding to urges to pull (trichotillomaniaspecific psychological flexibility) and behavioral changes guided by personal values.”
From The role of psychological flexibility in acceptance-enhanced behavior therapy for trichotillomania: Moderation and mediation findings (2023) · cites this paper as Woods et al., 2022
Acceptance-enhanced behavior therapy combines habit reversal training with acceptance and commitment therapy elements to increase effective responding to urges and values-guided behavior.
“In particular, acceptance-enhanced behavior therapy (AEBT) is an empirically supported intervention for trichotillomania (Woods et al., 2022), which combines habit reversal training with elements from ACT to increase effective responding to urges to pull (trichotillomaniaspecific psychological flexibility) and behavioral changes guided by personal values.”
From The role of psychological flexibility in acceptance-enhanced behavior therapy for trichotillomania: Moderation and mediation findings (2023) · cites this paper as Woods et al., 2022
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- Authors
- Woods, D. W., Ely, L. J., Bauer, C. C., Twohig, M. P., Saunders, S. M., Compton, S. N., Espil, F. M., Neal-Barnett, A., Alexander, J. R., Walther, M. R., Cahill, S. P., Deckersbach, T., & Franklin, M. E.
- Affiliations
- Marquette University (US)
- University of Wisconsin–Milwaukee (US)
- Utah State University (US)
- Duke University (US)
- Kent State University (US)
- Diploma Hochschule (DE)
- Rogers Behavioral Health (US)
- Corresponding author
- Woods, Douglas W.
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2022-11
- Volume
- 158
- Pages
- 104187
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC9561035
- OpenAlex
- W4294740943
- Cited by
- 51
- References
- 36
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 8 · 2023: 30 · 2022: 1 · 2018: 1
- FWCI
- 10.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
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- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 679 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
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- Behaviour Research and Therapy (acceptedVersion)
- PubMed (publishedVersion)
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- Funders
- National Institute of Mental Health (R01MH080966)
- National Health Research Institutes
- National Institutes of Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- trichotillomania, acceptance and commitment therapy, treatment efficacy, adults, symptom severity reduction
- MeSH terms
- Adult, Behavior Therapy, Female, Humans, Trichotillomania, United States, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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