Treatment for Hair Pulling, Skin Picking, and Repetitive Behaviors (The ComB Model)
A Personalized Strategy to Break the Cycle
If you or your child are struggling with hair pulling or skin picking, you know that it isn't as simple as just stopping. These behaviors are often driven by a complex mix of triggers—sometimes it’s a physical sensation, an emotion like stress or boredom, or even just the environment you’re in.
To treat these behaviors, I use the ComB model. Don't let the name confuse you; it simply stands for a comprehensive behavioral approach. Instead of a one-size-fits-all solution, we look at the unique ingredients that make up the urge to pull or pick and create a custom plan to change them.
How the ComB Model Works
We treat the behavior using a framework called SCAMP. We look at five specific areas to see what is feeding the urge:
Sensory: Is there a specific feeling or a certain texture that starts the urge?
Cognitive: Are there thoughts or beliefs that give the behavior permission to happen?
Affective: Does the behavior happen more when you’re anxious, bored, or even excited?
Motor: Are there specific habits or autopilot moments where the behavior kicks in?
Place: Does it happen in a specific chair, in front of a mirror, or while watching TV?
Turning Insights into Action
Once we understand your unique pattern, we don't just talk about it—we take action. We develop practical tools to interrupt the cycle. This might include adjusting the environment to make the behavior harder to do, finding sensory substitutes to satisfy the urge without pulling or picking, and learning mindfulness techniques to catch the urge before the hand moves.
The amazing thing about this model is that you become the expert on your own behavior. By the time we finish, you’ll have personalized strategies that you can use for the rest of your life.