Research shows that some people may have an inherited predisposition to skin picking or hair pulling. Several studies have shown a higher number of BFRBs in immediate family members of persons with skin picking or hair pulling than would be expected in the general population. However, this does not mean your child will develop a BFRB; there are a number of other factors that are involved, such as temperament, environment, age of onset, and family stress factors.
Parents play an important role in the treatment process for BFRBs. Your most important role is to educate yourself about BFRBs in order to be your child's best advocate and find a therapeutic match.
It's also important that you listen to your child's feedback on a therapist to gauge treatment efficacy. What's working and what's not? What therapeutic intervention needs your support? Where can you be most helpful? Are there opportunities for you to meet with the therapist to gain insight on how best to support your child?
Children do best in treatment when their parents are supportive and loving, without adding pressure, judgment, or expectations. Refrain from telling your child to stop pulling, picking, biting, or scolding them when they act on their behaviors. This only leads to increased behaviors and emotional shut down.
Keeping the lines of communication open with your child is important to their overall physical health and emotional well-being.
Receiving a formal medical diagnosis provides your child with access to therapeutic support and possibly academic accommodations. It's important that your family discuss the pros and cons of receiving a formal medical diagnosis and check with your insurance provider to determine coverage. Most therapeutic providers specializing in BFRBs have long waiting lists, so be prepared for a wait of between two and six months, possibly longer.
While taking your child to a therapist is optional, without therapeutic treatment such as cognitive behavioral therapy (CBT), habit reversal training (HRT), or other form of psychotherapy, managing behaviors can be challenging. Your child may at first be resistant to try therapy or access therapeutic support for their BFRBs. Being honest and encouraging about how therapy can help them manage their behaviors is a great start. It is extremely important to find a therapist who you and your child both trust, and is knowledgeable about BFRBs.
Most therapists specializing in BFRBs have waiting lists. Be prepared to wait from between two to six months. Be patient and persistent.
While you're waiting to access therapeutic support, register for TLC's health education and community programs, to get connected and learn more.
The TLC Foundation for BFRBs is an excellent resource to find well trained professionals who have experience treating BFRBs. Many of these therapists have participated in an intensive training program called the Virtual Professional Training Institute (VPTI) created by The TLC Foundation to provide training in state-of-the-art treatment for BFRBs. However, if you cannot find someone who has this specific training, a therapist with a cognitive behavior therapy (CBT) background may be helpful.
No, not at all. Chances are, your child would have developed their BFRB even if you were around all of the time. Try not to blame yourself (or your child) for this problem! It is truly out of their control and you have not caused their BFRB in any way whatsoever.