When children pick at their skin or pull at their hair so much that they hurt themselves — leaving scabs or bald spots — they often say they can’t stop, even if they’re embarrassed or being bullied by other kids because of it. That’s because doing these things makes them feel better in a hard-to-understand way. These disorders include trichotillomania (hair-pulling) and excoriation (skin-picking). Experts call them body focused repetitive behaviors (BFRBs), and kids use them to alleviate stress.

This week at childmind.org we look at a specialized behavioral therapy called ComB, developed for kids who have these behaviors. ComB (comprehensive behavioral therapy) combines several different kinds of therapy to divert kids from skin-picking or hair-pulling and give them other tools to manage uncomfortable feelings. BFRBs are not the same as self-injury, when kids cut, burn, or scratch themselves to intentionally cause pain. But self-injury is also a response to difficult feelings. And some of the same kinds of therapy that are included in ComB — DBT and ACT — are used to help kids who self-injure too.

– Caroline Miller, Editorial Director | ✉