Comprehensive Behavioral Therapy of Trichotillomania: A Multiple-Baseline Single-Case Experimental Design

Gioia Bottesi; Allison Jane Ouimet; Silvia Cerea; Umberto Granziol; Eleonora Carraro; Claudio Sica; Marta Ghisi

doi:10.3389/fpsyg.2020.01210

Comprehensive Behavioral Therapy of Trichotillomania: A Multiple-Baseline Single-Case Experimental Design

Front Psychol. 2020 Jun 10:11:1210. doi: 10.3389/fpsyg.2020.01210. eCollection 2020.

Authors

Gioia Bottesi^{1

2}, Allison Jane Ouimet³, Silvia Cerea^{1

2}, Umberto Granziol¹, Eleonora Carraro^{1

2}, Claudio Sica⁴, Marta Ghisi^{1

2}

Affiliations

¹ Department of General Psychology, University of Padova, Padova, Italy.
² Centro di Ateneodei Servizi Clinici Universitari Psicologici (SCUP), University of Padova, Padova, Italy.
³ School of Psychology, University of Ottawa, Ottawa, ON, Canada.
⁴ Department of Health Sciences, University of Firenze, Firenze, Italy.

Abstract

Despite rapidly increasing knowledge about Trichotillomania (TTM), no gold-standard evidence-based psychological intervention has been identified. In the current study, we evaluated the potential efficacy of an eight-session psychological intervention for TTM, namely the Comprehensive Behavioral Model (ComB) treatment, using a multiple-baseline single-case experimental design with three Italian women with TTM. The study included three phases: baseline, intervention, and 3-month follow-up. We assessed the intervention using daily self-monitoring of number of hair-pulling episodes, number of pulled hairs per episode, degree of resistance to pulling urges, and degree of associated distress. We also assessed for reliable improvement in general distress from baseline to post-intervention. All participants completed treatment and showed improvements on those symptom measures that were most relevant to their individualized case conceptualization. However, no participants recovered completely or demonstrated reliable improvement in general distress. Our results provide initial evidence for the utility of the ComB treatment for TTM in an Italian clinical setting. Furthermore, they support the delivery of individualized and flexible psychological treatments when treating TTM.

Keywords: Comprehensive Behavioral Model; Trichotillomania; psychological treatment; self-monitoring; single-case experimental design.