Comprehensive Behavioral (ComB) Treatment for BFRBs
Side Quest Psychotherapy | Jenna Stone, LCSW-C
Comprehensive Behavioral (ComB) Treatment is a flexible, evidence-based approach that helps people reduce body-focused repetitive behaviors (BFRBs) like skin picking, hair pulling, nail biting, and more—not by relying on willpower, but by understanding what’s driving the behavior and creating new ways to meet those needs.
Instead of focusing only on stopping the behavior, ComB helps you:
✨ Understand the patterns, triggers, and rewards keeping the behavior going
✨ Build healthy, alternative strategies that meet your sensory, emotional, and cognitive needs
✨ Increase awareness of when and why you’re most at risk
✨ Break free from shame, secrecy, and the cycle of “just one more time”
ComB is widely used to treat BFRBs because it’s individualized, compassionate, and adaptable. It integrates behavioral, cognitive, mindfulness, and sensory-focused strategies to fit the complexity of these conditions.
How ComB Works
ComB is designed to personalize treatment to you—looking closely at what drives your picking or pulling, what maintains it, and what helps you shift toward recovery.
We explore five key domains, known by the acronym SCAMP:
Sensory – Addressing the physical sensations or urges that drive behavior
Cognitive – Challenging unhelpful thoughts and mental rules
Affective (Emotional) – Managing feelings like stress, boredom, anxiety, or overwhelm
Motor (Behavioral) – Interrupting automatic habits and developing competing responses
Place (Environmental) – Modifying the spaces, tools, or routines that increase risk
Together, we create meaningful, practical strategies in each area and adjust them over time to fit your life and goals.
Why This Matters
Skin picking, hair pulling, and other BFRBs are not just “bad habits” or failures of willpower. They are complex, deeply ingrained behaviors often tied to sensory needs, emotional regulation, perfectionism, or self-soothing.
ComB helps you understand why the behaviors happen, rather than focusing only on stopping them. It offers tools to reduce shame and isolation, work with your brain and body, and manage urges and triggers across different settings. Over time, you can build lasting skills for resilience, self-compassion, and recovery.
Who ComB Helps
At Side Quest Psychotherapy, I use ComB to support individuals dealing with:
Trichotillomania (Hair Pulling Disorder)
Excoriation (Skin Picking Disorder)
Nail biting, cheek biting, and other BFRBs
Co-occurring anxiety, OCD, or perfectionism
Neurodivergence, sensory processing differences, or emotional intensity
ComB is adaptable and tailored to your goals, whether you’re looking for short-term skill-building or longer-term support.
✨ Ready to break free from the cycle of picking, pulling, and shame?
Let’s work together to help you understand your patterns, meet your needs, and rebuild a sense of agency and self-trust.