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Body-focused repetitive behaviours (BFRBs) are repetitive, self-directed behaviours that can lead to damage to hair, skin, or nails. Many people describe doing them automatically or without noticing until after it happens. BFRBs can cause physical effects and can also impact confidence, mood, and daily life.
Comprehensive behavioural treatment for BFRBs is a structured, skills-based approach that helps you understand what drives the behaviour, reduce triggers, and practise safer alternatives. Treatment often combines Habit Reversal Training (HRT) with additional strategies to support emotional regulation, reduce relapse risk, and improve long-term follow-through.
BFRBs can include:
This approach is not only about stopping a behaviour through willpower. It focuses on practical steps:
You learn to notice patterns earlier—what you feel, where you are, what you are doing, and what tends to happen before a BFRB episode. Tracking can help identify predictable risk moments.
Stimulus control involves changing routines or environments to reduce triggers and make the behaviour harder to do automatically. This might include reducing access during high-risk times or adding supportive tools that interrupt the behaviour loop.
A competing response is a practical action that is incompatible with the behaviour. It gives your body something else to do when an urge appears, and is practised until it becomes easier to use in real situations.
Many BFRBs are influenced by stress, anxiety, fatigue, boredom, or sensory discomfort. Therapy supports healthier ways to manage emotions and urges so the behaviour is not the default coping strategy.
Functional analysis looks at what the behaviour does for you in the moment—relief, focus, soothing, stimulation, or emotional discharge—so you can find safer ways to meet the same need.
Goals are set in realistic steps. Progress is tracked and reinforced so change feels measurable and sustainable.
You build a plan for setbacks and high-risk periods. Lapses are treated as data—used to refine strategies—not as failure.
CBT for BFRBs is collaborative and tailored. Sessions often include:
This approach can help children, teens, and adults who experience BFRBs that affect:
At The Cohen Clinic, CBT for BFRBs is delivered as a structured, supportive approach focused on practical skills and steady progress. If you are seeking therapy for hair pulling, skin picking, nail biting, or related behaviours in Toronto, our psychologists, psychotherapists, and social workers can help you build a plan that fits your triggers, goals, and daily life.