A Parent Guide For Success
Effective Parenting Strategies for Children With Trichotillomania
and other BFRBsPresented by
Suzanne Mouton-Odum, Ph.D.for the
Austin Trich Support GroupAustin, Texas
February, 2014
Goal of This Talk Today:• To help you
develop compassion for your child and to teach you effective ways to be helpful in dealing with BFRB issues.
• Common mistakes parents often make.
Different Ages and Different Stages of Trich
–Toddler–Elementary Age–Middle School
Age–High School Age
Different Ages and Different Stages of Trich
– Toddler• Mommy and daddy are
in control of changes.• Toddlers tend to be
more amenable to change.
• Toddlers are learning every day.
• Parents control the schedule.
• Have fun!
Different Ages and Different Stages of Trich
– Elementary Age• Mommy and daddy are
still in control of changes, but less so.
• May not care about bald spots/scabs.
• Usually concerned about pleasing parents.
• Parents have less control over the schedule.
• Keenly aware of parent reactions.
Different Ages and Different Stages of Trich
– Middle School Age• Start of independence.• Beginning to care about
bald spots/scabs.• Not as concerned about
pleasing parents.• Parents have much less
control over the schedule.
• Keenly aware of parent reactions and how to manipulate situations to their advantage.
Different Ages and Different Stages of Trich
– High School Age• High need for
independence.• Can be very concerned
about bald spots/scabs.• Not as concerned about
pleasing parents.• Parents are much less
involved in therapy.• Power struggles
abound!• Need for social
acceptance.
What are Key Elements of Good Treatment?
Find a therapist who will: 1. Take a comprehensive
approach: Sensory triggers Cognitive beliefs Affective cues Motor behaviors Place (Situational cues)
2. Treat the child as a whole person.3. Understand the developmental
issues.4. Address family dynamics.5. Treat co-morbid conditions and
co-occurring events.
How to Help, Not Hurt: Advice for Parents
Be patient, change is a process Accept your child with a BFRB-
she is more than just hair and clear skin!
“Release,” don’t “police” as much as you want to, you can’t control this!
Shift your focus to other aspects of your child
Love unconditionally Get support for yourself
How to Help, Not Hurt: Advice for Parents
Focus on loving you child: Recognize their strengths and
abilities See them as a whole, not simply
as “having hair/clear skin or not” Acknowledge your reactions,
feelings, frustrations and learn how to better cope with them
Realize that hair pulling is ADAPTIVE, your child is pulling or picking because it is helping them in some way
Don’t nag or shame your child
How to Help, Not Hurt: Advice for Parents
Assess Motivation: Who is more motivated…you or your child?
Assess Readiness: Is your child ready to make a change?
Reduce/eliminate conflict and power struggles around hair pulling/skin picking (there are plenty of others)
Ask yourself, “What do I want for my child?”
How to help, Not Hurt: Advice for Parents
Strategies for change:• Let go, don’t nag.• Focus on the positive aspects of
your child, e.g., her successes (sports, music, riding a bike, being funny, academics, theater).
• Reward the use of strategies, not hair growth/skin healing.
• Ask your child how you can help (let them drive the nature of the support)
• View recovery as a process, not a goal.
• Focus on your child, not their hair/skin.
Common Questions • Do we tell family members?• Did I cause this?• Do BFRBs lead to “worse”
things?• Should we tell the school?• Should we tell our friends?• Should my child tell his/her
friends?• What do I say when
someone we don’t know asks what is wrong with our child?
• Should we purchase a wig?
Common Questions • What should my child say
when another child asks them what is wrong with their hair?
• Are wigs and hair extensions a crutch?
• What if s/he is not using the strategies?
• What if my child is untruthful about pulling/picking?
• Will medication help?• Will this ever go away?
Moving forward• Consult with TLC to find a trained
therapist in your area (ideal).• Find a cognitive-behavioral
therapist who is willing to learn about treatment for BFRBs.
• Educate your therapist about training opportunities (PTI) and books/articles.
• Work on yourself and any issues you may have regarding trich/behavior/control/shame.
• Get support for yourself (parent groups, list serves, therapy).
• Think about what is best for you and your family, is now the best time?
Resources• TLC• A Parent Guide to Hair
Pulling Disorder• The Hair Pulling Habit
and You: How to Solve the Trichotillomania Puzzle
• www.StopPulling.com• www.StopPicking.com• PullFree (a mobile app)
