Background
Habit reversal training (HRT) is a well-established treatment approach for BFRDs that primarily addresses automatic pulling/picking. A number for studies have shown that HRT is effective in reducing hair pulling symptoms. However, a substantial number of patients do not respond well enough. These findings have encouraged the targeting of focused pulling/picking with augmenting strategies like Acceptance and Commitment Therapy (ACT) and Dialectical Behavioral Therapy. There is reason to believe that such an enhanced approach is more effective and provides longer lasting results than HRT alone.
Aims
The overall aim of The Norwegian Treatment Study of BFRDs (TreatBFRD) is to map the phenomenology and clinical course of BFRDs in order to improve assessment and treatment of these disorders. TreatBFRD is a research project with a broad defined aim, which implies that more specific research aims are presented in future research plans and require a separate approval of the Regional Committee for Medical Research Ethics (REK).
Methods
Patients
TreatBFRD is the continuation of two previous studies: “The Norwegian Trichotillomania Project” which started in 2012, and “The Norwegian Skin Picking Project” which started in 2014.
Patients in the new project, i.e., TreatBFRD, will be included in the existing database. We aim at including 400 new patients in (200 with hair pulling disorder and 200 with skin picking disorder or other BFRDs). Thus, merging this database with the database of the former projects will imply that the final database will include about 650 patients.
Treatment
All patients who are referred for treatment of BFRD at the outpatient department for OCD-specter disorders are invited to participate in the study. By 2023, most patients are offered group-based ACT-enhanced Habit Reversal Training, using the Norwegian translation of the treatment guide by Woods and Twohig. The manual is written for patients with hair pulling disorder and works well for patients with skin picking disorder as well. Group treatment consists of ten group sessions lasting three hours (with a break of 15 minutes), and three booster sessions. The first three group sessions focus mostly upon HRT, the next three sessions on ACT, and the last sessions on a combination of these approaches.Treatment also includes one meeting for relatives.
Measurements
Treatment effect will be measured by self-report questionnaires at five measurement occasions (pre-treatment, at session three, session seven, post-treatment, and one-year follow-up).
Project leader
Benjamin Hummelen
Participants
Toril Dammen
Torun Grøtte
Shirin Eskeland
Erna Moen
Karete Jacobsen Meland
Anniken Andersen
Diana Strand
Sidsel Myhr
Lovise Helland
International collaboration
Douglas Woods, PhD, Wisconsin, USA.
Publications
OCD-spekterpoliklinikken - Oslo universitetssykehus HF (oslo-universitetssykehus.no)
Trikotillomani | Tidsskrift for Den norske legeforening (tidsskriftet.no)
Hudplukkingslidelse | Tidsskrift for Den norske legeforening (tidsskriftet.no)