Play Therapy based HRT for managing Trichotillomania in Children:A Case Report

Abstract

Trichotillomania is considered as chronic impulse control Psycho-dermatological disorder, characterized by uncontrollable urge to pull one's own hair and is usually associated with emotional distress and Obsessive-Compulsive Disorder in children. Case Presentation: We report a clinical case study of a six year-old female child, who has currently developed few patches of decreased hair density mostly over the right side of her scalp. As reported by parents; behavior of repeated touching of hair, playing with them and rarely plucking them was noticed in the child since she was three and a half year of age; the behavior were exhibited mostly when she would be alone, playing or watching television and has gradually increased leading to present alarming condition for entire family. Intervention: Ten session of Play therapy incorporated with habit reversal therapy (HRT) was planned for the child as she had difficulty comprehending and processing the conceptual understanding of formal Habit Reversal Therapy techniques; e.g. Awareness Training. During sessions she was made to address her urges and based on same; she was taught competing response of habit reversal through play based techniques. The child responded positively and effectively towards the play therapy based HRT.  Discussion: Combination of Play therapy techniques andHRT has been found efficacious in our study however; more studies need to be conducted for the establishment of play based HRT (behavioral techniques) as treatment of Trichotillomania in children.