How to Find a Trichotillomania Therapist: What to Look For

If you’ve ever sat across from a doctor or counsellor who had never heard of trichotillomania, you’ll know how discouraging it can be. Many people with trich have. A trichotillomania therapist who already understands hair pulling can make it a very different experience, and those people are out there.

This guide is for adults who pull and for parents looking for help for a child. It covers why experience with trich matters, what training to look for, whether online sessions work, and where to search wherever you live.

Why does it matter to find someone who knows trich?

Because trich needs its own kind of help, and many professionals haven’t been trained in it. Someone who understands hair pulling will know it isn’t a bad habit, a lack of willpower or self-harm. They won’t tell you to “just stop”. They’ll know which approaches have been studied for it, and they’ll have practical ideas ready from day one.

Research shows the gap is real. In the Trichotillomania Impact Project, a 2006 survey of more than 1,600 adults with trich, only about 1 in 7 of those who had treatment said it had helped them a lot. In the 2024 Utah survey, many providers had out-of-date ideas about how trich is diagnosed and treated, and said their training hadn’t prepared them.

Trich is a body-focused repetitive behaviour (BFRB), one of a group of conditions where people repeatedly pull, pick or bite at their hair, skin or nails. Doctors class it in the same family as OCD (obsessive-compulsive disorder), but it isn’t OCD. That’s one more reason to look for BFRB experience, not just general mental health experience.

What training should they have?

Look for someone trained in an approach made for hair pulling, with real experience of using it. The approaches with the most research behind them are behaviour therapies built around Habit Reversal Training (HRT). HRT teaches you to notice when and where you pull, then to do something else with your hands instead. A 2026 review of about 30 trials found that therapies including habit reversal did better than those without it.

Approaches you might see on a practitioner’s profile:

• Habit Reversal Training (HRT): awareness, a competing response (something you do with your hands that you can’t do while pulling) and support. It’s often part of CBT (cognitive behavioural therapy), a talking therapy about how thoughts, feelings and actions link.
• The ComB model: short for the Comprehensive Behavioural model. It looks at everything that drives your pulling, such as sensations, thoughts, feelings, movements and places, and matches a strategy to each.
• ACT-enhanced behaviour therapy: HRT combined with acceptance and commitment therapy (ACT), which teaches you to make room for urges and feelings without acting on them.

You can read more about each approach in our guide to trichotillomania treatment. Our guide to Habit Reversal Training explains the steps. There’s a plain-English explanation in our guide to the ComB model.

Other practitioners also help people who pull, including hypnotherapists, coaches and EFT practitioners (EFT, or emotional freedom techniques, combines tapping on points on the body with talking through feelings). Research on these approaches for trich is limited, and some people find them helpful. Our guide to hypnotherapy for trichotillomania looks at what the research says. You can read about the others in our guide to EFT, NLP and coaching.

Whatever someone’s background, three things matter most:

1. They’re qualified for the work they do. Where their profession is regulated, check they’re on the official register. Where it isn’t, ask which professional body they belong to. The country section below explains how.
2. They’ve helped people who pull before. Ask how many, and what usually helps.
3. They can explain their plan. A good practitioner can tell you, in plain words, what you’ll work on and how you’ll both know it’s helping.

Should I choose online or in-person therapy?

Choose whichever makes it easiest to keep going. Online sessions let you work with someone who understands trich even if no one nearby does, and early research is encouraging. In a 2018 trial, 22 adults had 10 sessions of ACT-enhanced behaviour therapy by video, and their pulling fell more than in a group waiting for treatment. A 2021 pilot trial with 28 teenagers, run over video calls, also found pulling fell more in the treatment group on one of its main measures. Both studies were small, so more research is needed.

One limit to check: registered professionals can often only work with people in the place where they’re registered, so ask before you book. Our guide to online therapy for trichotillomania goes into more detail.

Where do I search for a trichotillomania therapist?

Start with a directory of people who already help with hair pulling, then check each person yourself. Our directory lists practitioners who have told us they understand trichotillomania and already help people who pull. You can filter by where you live, by online sessions and by the age of the person who needs help. Many offer a free introductory call. Search the directory.

Listings are information, not an endorsement, so always check a practitioner’s qualifications yourself. Here’s where to look and what to check where you live.

Wherever you live, our directory includes practitioners who offer online sessions, and we’re adding more countries. Check whether the practitioner can legally work with people in your country, and ask which professional body they belong to. Your family doctor can also tell you about local services.

You can also ask your doctor for a referral, or ask in a support group whether anyone can recommend someone. Our guide to trichotillomania support groups lists groups that meet online and in person. If you’re not sure how to raise it with your doctor, our guide to talking to your doctor about hair pulling can help. For what sessions usually cost where you live, see our guide to the cost of trichotillomania therapy.

What should I ask before I book?

Whether you’re calling a hair pulling therapist, a psychologist or a coach, ask a few questions on the first call. Good practitioners expect them, and the answers tell you a lot:

• Have you helped people with trichotillomania or other BFRBs before? How many?
• What approach do you use, and why does it suit hair pulling?
• How many sessions do people usually have, and how will we know it’s working?
• What will I practise between sessions?
• Do you offer online sessions, and can you work with people where I live?

Good signs are clear answers and questions about when and where you pull. Think twice if someone tells you to just stop, promises to make pulling disappear, or can’t say how they’d work with you. Our guide to questions to ask a therapist has a full checklist. If you’re nervous about the first session, our guide to what happens in therapy for trich walks you through it.

What if I’m looking for help for my child?

Look for someone who works with children and families as well as hair pulling. You can filter our directory by the age of the person who needs help. Work with children often involves parents, who learn to support practice at home without nagging or telling off. Ask how the practitioner involves parents.

Pulling in toddlers and very young children often stops on its own, so a family doctor is a good first stop for under-fives. For older children and teenagers who have been pulling for a while, it’s worth finding someone who understands trich. Our guide for parents of children with trichotillomania covers what to say and what helps at home.

If you’d like a clear place to start as a parent, read The Parent’s Guide to Trichotillomania: understanding what your child is going through.

When is it time to reach out?

Reach out if pulling is causing you distress, taking up a lot of your time, or getting in the way of work, school or relationships. You don’t need to wait until it’s “bad enough”, or to have tried everything on your own first.

It’s normal to feel embarrassed or worried about showing someone your hair or brows. Someone who understands hair pulling has heard it all before. They shouldn’t judge you, and you can go at your own pace. For a fuller picture of the condition before you call, see our complete guide to trichotillomania.

When you’re ready, search our directory for someone who understands hair pulling, near you or online. You can also read what the International OCD Foundation says about body-focused repetitive behaviours.

If you’re feeling very low or hopeless, please talk to someone today.

In an emergency, call your local emergency number or go to your nearest emergency department.

• Find a helpline (international directory) (findahelpline.com)

Questions people ask

Sources

1. Woods, D.W., Flessner, C.A., Franklin, M.E., Keuthen, N.J., Goodwin, R.D., Stein, D.J., Walther, M.R. & TLC Scientific Advisory Board (2006). The Trichotillomania Impact Project (TIP): Exploring phenomenology, functional impairment, and treatment utilization. Journal of Clinical Psychiatry, 67(12), 1877–1888.
2. Capel, L.K., Petersen, J.M., Woods, D.W., Marcks, B.A. & Twohig, M.P. (2024). Mental health providers’ knowledge of trichotillomania and skin picking disorder, and their treatment. Cognitive Therapy and Research, 48(1), 30–38.
3. Fisak, Shorb, Patel & Ezcurra (2026). The efficacy of psychotherapeutic and pharmacological interventions for trichotillomania: A review and meta-analysis. Journal of Psychiatric Research, 197.
4. Lee, E.B., Haeger, J.A., Levin, M.E., Ong, C.W. & Twohig, M.P. (2018). Telepsychotherapy for trichotillomania: A randomized controlled trial of ACT enhanced behavior therapy. Journal of Obsessive-Compulsive and Related Disorders, 18, 106–115.
5. Twohig et al. (2021). A pilot randomized controlled trial of online-delivered ACT-enhanced behavior therapy for trichotillomania in adolescents. Cognitive and Behavioral Practice, 28.
6. International OCD Foundation. Body-focused repetitive behaviors (BFRBs).
7. Cleveland Clinic. Trichotillomania (hair pulling disorder).
8. NHS. Trichotillomania (hair pulling disorder).
9. NHS. Find an NHS talking therapies service for anxiety and depression.
10. UK Parliament POST (2025). Regulation of psychological professionals in mental health care.
11. Health and Care Professions Council. The professions we regulate.
12. PSYPACT. Psychology Interjurisdictional Compact.
13. Canadian Psychological Association. Provincial and territorial regulatory bodies.
14. Australian Government Department of Health. Better Access initiative.
15. Ahpra. Registers of practitioners.
16. New Zealand Psychologists Board. Public register.