Body Focused Repetitive Behaviours (BFRB's) refers to repetitive self-grooming behaviours, in which pulling, picking, biting or scraping of the hair, skin or nails result in damage to the body. This list of problems below falls under the umbrella of BFRB:

  • Trichotillomania (Compulsive hair pulling)
  • Dermatillomania (Compulsive skin picking)
  • Onychophagia (Compulsive nail-biting)
  • Compulsive nose picking
  • Compulsive biting of the inside of the cheek
  • Lip-biting or picking

The specific characteristics and diagnostic criteria for this group of disorders are not yet well established due to a dearth of research. Epidemiological studies estimate high prevalence rates for BFRB's, ranging from 2% to 6.5% of the adult population.

Peoples' experiences of BFRB are extremely distressing, where high levels of shame and blame are felt. Individual's reports changes in relationships and a significantly negative impact of their quality of life in terms of occupational, educational, social and private leisure activities.


  • Recurrent pulling out of one's hair, resulting in hair loss and/or recurrent skin picking resulting in skin lesions
  • Repeated attempts to decrease or stop behaviour
  • Significant distress as a result of the BFRB
  • Significant impairment to activities of daily living e.g. work, home and social activities

Best Evidence-Based Treatments

The National Institute of Health Care and Excellence have not issued guidance for the treatment of BFRB's. Preliminary evidence from research studies focusing on treatment efficacy for BFRB's suggests mood enhanced CBT is more effective than Behavioural Therapy.

Cognitive Behavioural Therapy (CBT) guided by the Comprehensive Behavioural Treatment Protocol:
Cognitive behavioural therapy focuses on the relationship between thoughts, feelings, behaviours and physiological sensations. The cognitive facet assumes that the meaning one gives to an event is important and if you can change the interpretation or perception you can change the feeling (affect) associated with it. The behavioural facet assumes changing what you do is often a powerful way of changing other things in your life, and reducing BFRB's. The Comprehensive Behavioural treatment protocol has four phases: the ‘assessment and functional analysis' phase, the ‘identify and target modalities' phase, the ‘implement strategies' phase, and the ‘evaluation and modification' phase.

Elite Psychology comprises of an expert team, specialising in the range of best private evidence-based therapy for BFRB's. Our highly qualified associates are accredited in all of the most successful therapies, complimented by Psychiatrists who can prescribe medication on private prescriptions. We can assess you and provide the most efficacious therapy tailored to your difficulties. We know the importance of being understood, and endeavour to deliver the highest standard of psychological interventions to meet your needs.

Call us on 020 3815 7935 for further information or to book an assessment. Alternatively you can complete the online contact form.