A modified habit reversal procedure in a recalcitrant case of trichotillomania.

An 11-year-old girl with a severe and recalcitrant case of trichotillomania was successfully treated with a modified habit reversal procedure. Erosion estimates and serial photographic assessment methods were used to document client progress over a one-year period. Treatment effects were socially validated by attractiveness ratings of 20 same-aged children. Results extend the use of habit reversal procedures to a severe case and address the need for reliable and valid assessment procedures as well as extended follow-up.