Habit Reversal Training and Relaxation Training for the Treatment of Adult-Onset Trichotillomania due to Premature Greying

This case study demonstrates the use of Habit Reversal Training (HRT) combined with Relaxation Training (RT) in addressing trichotillomania. The subject, a 28-year-old woman, reported experiencing stress and frequent lateness to work. Her hair-pulling behavior, triggered by the early appearance of grey hair, led her to spend 30 to 60 minutes each morning pulling her hair, which contributed to her tardiness. Over the course of 14 weekly therapy sessions, interventions included self-monitoring, psychoeducation, identification and modification of visual triggers, stimulus-response strategies, and restructuring daily routines. The treatment resulted in reduced stress and effective control of hair-pulling behaviors. The case suggests that incorporating a hair care regimen into therapy may further enhance positive outcomes. It also highlights the importance of considering both psychological and societal influences in the development and treatment of trichotillomania.