In this chapter we have suggested ways for readers to keep hair, skin, and nails healthy. Often BFRBs are attempts to “fix” a perceived problem. Finding healthier ways to address things that are bothersome about hair and skin, in ways that don’t cause harm to the body, is one of the goals of this chapter. We also review a number of self-care approaches that are designed to help improve one’s life in general, including sleep, nutrition, exercise, and emotional well-being. The chapter expands the BFRB plan to include specific techniques to help reduce BFRBs (e.g., to address cues and triggers for pulling or picking), as well as more general self-care activities that will improve life for the reader overall, thus improving the BFRB more indirectly. We find that addressing BFRBs on multiple levels tends to set people up for the greatest likelihood for success.

This chapter assists the reader in identifying their specific High-Risk situations (situations which put them at risk of pulling or picking). In addition to identifying these trigger environments, they also explore why they engage in their BFRB. Antecedents, Behaviors, and Consequences in these specific contexts are explored to help them understand the function that their BFRB serves in their life. With this understanding, they then are able to consider some alternate ways to get these needs met. Readers also identify some possible emotional and cognitive barriers that may get in the way of achieving their goals. Finally, the concept of relapse prevention is introduced to the reader, laying the groundwork for future struggles with adherence to the plan and, hopefully, avoiding a relapse.

In addition to reviewing the SCAMP domains of the ComB Model, this chapter is focused on awareness – awareness of the specific BFRB domains while asking the reader to notice relevant BFRB patterns and encouraging them to become aware of their body and mind at any given moment. The Awareness Form is introduced to the reader. Readers are asked to practice mindfulness exercises daily, to fill out the Awareness Form each day, and to begin to notice important aspects of their behavior that will be critical to formulation of an intervention plan.

This chapter helps the reader to identify relevant place and activity variables relevant to their BFRB. Readers should already have identified specific aspects of certain settings that make pulling or picking more likely to occur. Common environmental triggers include things like: physical location, time of day, lighting, presence or absence of other people, implements, and activities. We offer an array of different ways to change both behavior and the environment to make the BFRB less likely to happen in these difficult environments.

This chapter reviews an array of cognitions (thoughts and beliefs) that can be very helpful or unhelpful for those struggling with a BFRB. First, we review different types of thoughts that encourage BFRB activity, as well as describe ways to challenge them. Next, we discuss perfectionistic thoughts and beliefs and review the importance of embracing one’s flaws and vulnerabilities, instead of desperately attempting to hide them. Finally, we talk about cognitive flexibility and learning the value of accepting urges as they arise, allowing them to diminish on their own.

In this chapter the reader learns about what emotions can trigger a BFRB, how urges affect behavior, and how to manage difficult emotions differently, without picking or pulling. We also explore how BFRBs function as a response to certain emotional experiences or as an effort to try and solve these emotions, though in an unhealthy manner. Readers learn how to better manage difficult emotions through coping skills, distress tolerance techniques, and acceptance strategies that are geared toward learning how to tolerate emotions without trying to change them. Finally, readers learn about the nervous system and how sometimes feeling over-or under-stimulated can lead to hair pulling and/or skin picking.

In this chapter we review the gamut of senses that can be involved in BFRBs including, touch, sight, taste, sound, and smell. In addition, targeted solutions are offered to help the reader relieve the sensations that might trigger a BFRB, while also increasing positive sensory input to help settle one’s nervous system and foster desirable internal states. The focus of much of this chapter is to help the reader achieve a balanced and satisfied nervous system. So often, people engage in actions to address imbalances in the nervous system, without even realizing why they are doing them. BFRBs are often attempts to achieve a desirable sensation or ways to relieve undesirable ones. By directly addressing sensory experiences in healthy ways, BFRBs will weaken because the function of them has become less necessary.

This chapter provides a summary of the previous 9 chapters and reviews the highlights of each. It takes the reader through the highlights of the book, while encouraging them to continue on their path toward success. The ideas of relapse prevention and maintenance of therapeutic gains are addressed, instilling hope for the future. Readers are encouraged to think about successful behavior change as a process of many small changes over time, rather than one big change all at once. The authors give final words of wisdom about continuing on the journey to recovery.

This chapter assists the reader in identifying their specific High-Risk situations (situations which put them at risk of pulling or picking). In addition to identifying these trigger environments, they also explore why they engage in their BFRB. Antecedents, Behaviors, and Consequences in these specific contexts are explored to help them understand the function that their BFRB serves in their life. With this understanding, they then are able to consider some alternate ways to get these needs met. Readers also identify some possible emotional and cognitive barriers that may get in the way of achieving their goals. Finally, the concept of relapse prevention is introduced to the reader, laying the groundwork for future struggles with adherence to the plan and, hopefully, avoiding a relapse.

In this chapter readers identify specific aspects of their BFRB that might be occurring outside of full, conscious awareness. A main point of this chapter is to help readers become even more aware of the chain of events that occur with each episode of their BFRB. The idea is that stopping the behavior at the first step in the chain can prevent the rest of the chain from occurring. A host of behavioral techniques are presented to help increase reader awareness in specific situations, situations where one is not keenly aware of their BFRB as it is happening. In addition to using blocks or barriers, postural changes and an array of environmental changes are offered.