Michael P. Twohig

Trichotillomania (TTM) is a complex disorder that is difficult to treat, and few effective therapeutic options exist. This client workbook helps the client through the 10-session, therapist-guided, Acceptance and Commitment Therapy (ACT) Enhanced Behavior Therapy for Trichotillomania (AEBT-T). AEBT-T is designed to help people with trichotillomania reduce their pulling, think differently about the internal experiences that trigger their pulling, and learn to live a more valued life. The approach blends traditional behavior therapy approaches of habit reversal training and stimulus control techniques with a more contemporary ACT-based approach. This ACT-based approach teaches clients to behave flexibly and in concert with their values whenever they face the uncomfortable thoughts, feelings, urges, and cravings that often trigger the pulling. Since its original publication in 2008, the intervention has been shown to be highly effective, and can also be successfully applied to older children and adolescents, which is covered in this new edition. Fully updated to reflect new research and organized in an easy-to-use session-by-session format with accompanying therapy support forms and materials, AEBT-T has proven efficacy and will be a valuable resource and powerful tool for clients who want to learn to manage their TTM and reduce pulling.

Trichotillomania (TTM) is a complex disorder that is difficult to treat and few effective therapeutic options exist. This Therapist Guide for the Acceptance and Commitment Therapy (ACT) Enhanced Behavior Therapy for Trichotillomania (AEBT-T), and the accompanying client workbook, is a 10-session program designed to teach therapists how to help clients reduce their pulling, think differently about the internal experiences that trigger pulling, and learn to live a more valued life. The approach blends traditional behavior therapy approaches of habit reversal training and stimulus control techniques with a more contemporary ACT-based approach. This ACT-based approach teaches clients to behave flexibly and concert with their values whenever they face the uncomfortable thoughts, feelings, urges, and cravings that often trigger the pulling. Since its original publication in 2008, AEBT-T has been studied extensively and shown to be effective in individual and group format using both face-to-face and telehealth modalities. Emerging evidence suggests the treatment can also be successfully applied to older children and adolescents, and this latest version of the manual describes how the treatment can be modified for these populations. Fully updated to reflect new research and organized in an easy-to-use session-by-session format with accompanying therapy support forms and materials, this intervention has proven efficacy and will be a valuable resource and powerful tool for clinicians who commonly treat TTM, OCD and related disorders.

ACT (acceptance and commitment therapy) can be applied to any psychological disorder that involves struggle with inner experiences. With over 300 randomized clinical trials supporting its effectiveness, ACT has seen rapid growth in popularity, and an increasing number of therapists are being trained in its use. As such, the demand for practical resources on providing ACT has never been greater. ACT in Steps is aimed at any therapist who wants to get familiar with ACT. Chapters walk therapists through a recommended sequence of ACT sessions, including creative hopelessness, control as the problem, acceptance, defusion, mindfulness, values, and committed action, and provide accompanying materials for clients. The book also provides information on assessment, case conceptualization, treatment planning, and intervention that therapists can use as a starting point for practicing ACT. Exercises and worksheets are included which will continue to be useful long after readers have achieved mastery of ACT. Designed to serve as a more structured framework from which therapists can learn and experiment with ACT concepts, ACT in Steps is suitable for anyone interested in applying ACT across a range of presentations, from graduate students seeing their first clients to clinicians with years of experience interested in learning about ACT for the first time.

Bokbeskrivelse Trikotillomani, eller hårnappingslidelse, er i dag en relativt ukjent lidelse som ofte underdiagnostiseres på grunn av manglende kunnskap. Trikotillomani er en psykisk lidelse som kan behandles. Denne terapeuthåndboken presenterer forskningsbasert kunnskap om hvordan du som terapeut kan tilby en effektiv behandling av trikotillomani til dine pasienter. Gjennom ACT-forsterket atferdsterapi får pasienten hjelp til å akseptere trangen til å nappe hår uten å gi etter for den. Pasienten vil ikke lenger måtte kjempe med seg selv hele tiden, og kan heller bruke kreftene på å øke sin egen livskvalitet. I dette behandlingsopplegget jobber pasient og terapeut sammen for å konkretisere livsverdier og verdivalg i pasientens liv. Behandlingen består blant annet av vaneendringstrening (HRT) og teknikker for stimuluskontroll.

Trikotillomani eller hårnappingslidelse er i dag en relativt ukjent lidelse som underdiagnostiseres på grunn av manglende kunnskap. Trikotillomani er en psykisk lidelse som er mulig å behandle sammen med en terapeut. Personer som lider av trikotillomani vet hvor frustrerende og vanskelig det er å slutte med hårnappingen. Men det fins behandlingsmetoder som hjelper. Fagpersoner anbefaler ACT-forsterket atferdsterapi som førstevalg for behandling. Gjennom behandlingen vil du få hjelp til å akseptere trangen til å nappe hår uten at du behøver å gi etter for den. Du vil ikke lenger måtte kjempe mot deg selv hele tiden og kan heller bruke kreftene på å øke din egen livskvalitet. Denne arbeidsboken er laget for personer som lider av trikotillomani og skal benyttes i kombinasjon med kvalifisert behandling hos en terapeut. I terapien vil du jobbe med å konkretisere livsverdier og gjøre verdivalg i ditt liv. Behandlingen inkluderer vaneendringstrening (HRT) og teknikker for stimuluskontroll. I løpet av de ti ukene som behandlingen varer, vil du lære å gjenkjenne tanker og følelser som er knyttet til hårnappingen, og du vil lære å akseptere trangen og bruke ulike teknikker for å slutte å nappe. Douglas W. Woods, PhD, er professor i psykologi og Director of Clinical Training ved University of Wisconsin-Milwaukee. Dr. Woods er en anerkjent spesialist innen forskning og behandling av trikotillomani, Tourettes syndrom og lidelser i tvangsspektrumområdet. Michael P. Twohig, PhD, er førsteamanuensis ved Department of Psychology ved Utah State University i Logan, Utah. Han har hovedsakelig forsket på behandling med HRT (vaneendringsterapi) og ACT (aksept- og engasjementsterapi) av tvangslidelser (OCD) og tvangsspektrumlidelser, trikotillomani og hudplukking.

Trichotillomania (TTM) is a complex disorder which involves at least two levels of psychological functioning. At one level, it is a habitual behaviour. This type of TTM involves 'automatic pulling' and typically occurs without a person's awareness. The second type of TTM is more closely related to emotional functioning or regulation and is known as 'focused pulling'. Generally, it is believed that most individuals with TTM exhibit both types of pulling. THe most common treatment for TTM is Habit Reversal Therapy (HRT), and its main focus is the habitual, or 'automatic' aspect of the disorder. In this new treatment program, Drs Wood and Twohig have designed a treatment which combines the basic aspects of HRT with Acceptance and Commitment Therapy (ACT) to address the 'focused' aspects of the pulling. ACT seeks to alter the thoughts and feelings surrounding the pulling, and removes the compulsive aspect of the pulling urge, while HRT focuses on increasing the awareness of the pulling and teaches the person to utilise a competing behaviour instead of pulling. Together, these two techniques work to decrease all incidents of pulling, and help the client understand and come to terms with the emotional triggers of their disorder. In a clinical setting, this combined treatment was proven very effective, with high maintenance rates over a three-month period. This treatment consists of 10 60-minute sessions spread out over six weeks, with the final two sessions taking place every two weeks to ease the client out of the therapeutic environment and intrduce relapse prevention techniques. This corresponding workbook will contain monitoring forms to help the client maintain an awareness of their pulling, as well as self-assessment tests and other homework exercises.

Trichotillomania (TTM) is a complex disorder that is difficult to treat as few effective therapeutic options exist. Behaviour therapy has the greatest empirical support, but the number of mental health providers familiar with TTM and its treatment is quite small. This manual was written as a tool for therapists to become familiar with an effective treatment for TTM. The treatment approach described in this guide blends traditional behaviour with therapy elements of habit reversal training and stimulus control techniques with the more contemporary behavioural elements of Acceptance and Commitment Therapy (ACT). In the first phase of the program, clients are taught skills for stopping and preventing their unconscious pulling episodes. In the second phase, clients are introduced to ACT. Unlike traditional interventions that aim to change type or frequency of pulling-related cognitions in the hopes of reducing urges to pull hair, this innovative program uses strategies to change the function of these cognitions. Clients are taught to see urges for what they really are and to accept their pulling-related throughts, feelings, and urges wihtout fighting against them. This is accomplished through discussions about the function of language and defusion exercises that show the client how to respond to thoughts about pulling less literally. Over the course of 10 weeks, clients learn to be aware of their pulling and warning signals, use self-management strategies for stopping and preventing pulling, stop fighting against their pulling-related urges and thoughts, and work towards increasing their quality of life. Self-monitoring and homework assignments keep clients motivated and engaged throughout. Designed to be used with older adolescents and adults, this innovative intervention has proven efficacy and is sure to be a powerful tool for the clinician who treats TTM.