IOP in Austin, TX for Children and Adults With Body-Focused Repetitive Behaviors: Skin Picking, Hair Pulling & Shame-Free Recovery
Body-focused repetitive behaviors (BFRBs), including skin picking (excoriation disorder) and hair pulling (trichotillomania), affect both children and adults. These behaviors are often misunderstood, leaving individuals and their families feeling embarrassed, isolated, or frustrated. Children may attempt to hide patches of missing hair from teachers or peers, while adults may avoid social events or work meetings due to visibly irritated skin. Standard weekly therapy sessions may provide some relief, but often they don’t offer the structure or intensity needed to effectively break the cycle of urges and behaviors, especially when BFRBs interfere with school, work, relationships, or daily life.
Austin Anxiety and OCD Specialists offers a Mental Health Intensive Outpatient Program (IOP) in Austin, TX, designed for children and adults struggling with BFRBs. This program provides consistent, compassionate, and evidence-based care that empowers clients to pursue shame-free recovery and regain control over their daily lives.
Understanding BFRBs
BFRBs are more than “bad habits.” They are compulsive behaviors that can feel uncontrollable. Children and adults alike may pick at their skin or pull their hair when anxious, bored, or overwhelmed. Over time, these behaviors can cause noticeable skin damage, hair loss, or scarring, which can intensify feelings of shame.
Importantly, these behaviors, including hair pulling and skin picking, are recognized in the DSM-5-TR as obsessive-compulsive and related disorders. Like OCD, they are treatable mental health conditions. Understanding that these behaviors are not a personal failing and that recovery is possible is an important first step toward healing.
Common Symptoms and Experiences
People with BFRBs often notice patterns in their behaviors that can feel difficult to control, such as:
Strong, overwhelming urges to pick, pull, or scratch.
Brief relief or satisfaction after engaging in skin picking or hair pulling, often followed by guilt or shame.
Repetitive behaviors that interfere with school, work, or social life.
Attempts to hide these behaviors from family, friends, or peers.
Increased stress or anxiety when trying to resist urges.
BFRBs can appear in many ways, often beyond normal grooming habits.
Skin-Focused Behaviors: Common Symptoms of Excoriation Disorder
Visually scanning or feeling the skin for imperfections.
Picking at scabs.
Compulsively popping pimples.
Using fingernails or tools such as tweezers to remove ingrown hairs, even when it causes pain, bleeding, or scarring.
Pulling or biting hangnails.
Hair-Focused Behaviors: Common Symptoms of Trichotillomania
Visually scanning or feeling the hair for hairs that “don’t belong” (e.g., gray hair, hairs with differing texture, etc.)
Twisting, rubbing, or playing with hairs before pulling.
Pulling hair from the scalp, eyebrows, eyelashes, facial hair, or other body hair, including pubic hair.
Chewing or swallowing pulled hair (trichophagia), which can cause digestive issues or serious medical complications, like hairballs (trichobezoars) in the digestive tract if it continues over time.
These behaviors can cause discomfort, irritation, infections, and permanent scarring. They may also create tension with others who don’t understand why the behaviors persist. Over time, skin picking and hair pulling can impact confidence, self-esteem, and daily functioning. Recognizing these behaviors as treatable is an essential step toward recovery and relief.
How an IOP in Austin, TX, for Skin Picking or Hair Pulling Can Help
Weekly therapy is a great starting point, but moderate to severe BFRBs often require more frequent support. Intensive Outpatient Programs provide multiple sessions each week, offering children and adults structured guidance, consistent skill-building, and accountability. In a safe, nonjudgmental environment, participants can learn to identify triggers, manage urges, and practice alternative coping strategies while receiving feedback and encouragement from licensed therapists with specialist training in BFRBs, including Trichotillomania and Excoriation Disorder.
IOPs are particularly beneficial for those whose symptoms interfere with school, work, or family life. Multiple weekly sessions accelerate progress by providing more opportunities for skill practice, coaching, and support, which is often not possible in a once-weekly session. This structured approach helps clients regain control faster and reduces the shame and isolation that can accompany BFRBs.
Evidence-Based Treatment Approaches for BFRBs in an IOP Setting
Treatment in an IOP for BFRBs typically includes:
Cognitive Behavioral Therapy (CBT): Helps clients, both children and adults, identify triggers and patterns that maintain repetitive behaviors and develop healthier coping mechanisms.
Habit Reversal Training (HRT): Focuses on recognizing urges and replacing harmful behaviors with alternative actions
Acceptance and Commitment Therapy (ACT): Teaches clients to accept urges without judgment and focus on actions aligned with their values, such as school participation, work performance, or family interactions.
ComB (Comprehensive Behavioral Model): Examines the multiple factors that contribute to picking or pulling, including sensory, cognitive, emotional, and environmental triggers, and helps clients develop personalized strategies to prevent behaviors.
SCAMP (Structured Clinical Approach to Hair Pulling or Skin Picking): A structured program that combines CBT, HRT, and functional assessment to systematically reduce urges and manage behaviors effectively.
IOP Support for Children, Teens, and Adults
Isolation, embarrassment, and shame often prevent children, teens, and adults from seeking help for BFRBs. At Austin Anxiety and OCD Specialists, our BFRB IOP provides a personalized, one-on-one approach to support each client’s unique needs. Children receive individualized guidance in learning coping skills in ways that feel engaging and developmentally appropriate. Children, teens, and adults all work closely with clinicians to identify triggers, reduce urges, and build strategies for navigating daily challenges. Parents of children and teens are also included in the treatment process, receiving guidance on how to support their child’s recovery and navigate family dynamics affected by BFRBs.
Shame-Free Recovery with IOP in Austin, TX
Shame and self-criticism often reinforce BFRBs, making recovery feel impossible. At Austin Anxiety and OCD Specialists, clients are encouraged to approach treatment with self-compassion. Clinicians emphasize that BFRBs are recognized behavioral health conditions, not a reflection of character or willpower. Focusing on skills, strategies, and small wins helps clients rebuild confidence and self-esteem, which is crucial for lasting recovery.
Personalized BFRB IOP Treatment Plans
Every child, teen, or adult in Austin Anxiety and OCD Specialists’ IOP receives a personalized treatment plan based on the frequency and severity of their skin picking or hair pulling, co-occurring conditions like OCD, anxiety, or depression, and individual goals. Plans include practical strategies for school, work, or home, skill-building for managing urges, and family education and support. This individualized approach ensures that every participant receives treatment tailored to their needs and circumstances.
Shame-Free Support for BFRBs Through Our IOP in Austin, TX
If you or your child is struggling with skin picking, hair pulling, or other body-focused repetitive behaviors, effective help is available. Austin Anxiety and OCD Specialists offers a specialized IOP for children, teens, and adults seeking evidence-based, compassionate, and shame-free treatment. Our team of therapists works collaboratively with each client and family, guiding them toward recovery and helping them regain control over daily life.
Here’s how to get started:
Contact us at hello@austinanxiety.com or 512-246-7225 to schedule your free consultation.
Learn how our IOP in Austin, TX, is tailored to support recovery from BFRBs with evidence-based strategies and compassionate care.
Partner with us to take meaningful steps toward healing, confidence, and lasting change.
Additional Therapy Services at Austin Anxiety and OCD Specialists in Austin, TX
Because anxiety, OCD, and related concerns show up differently for everyone, our support goes well beyond our Intensive Outpatient Program. We work with youth and adults managing issues such as OCD, phobias, panic disorder, generalized anxiety, PTSD, social anxiety, selective mutism, emetophobia, separation anxiety, tics, body-focused repetitive behaviors (BFRBs), and depression. Our clinicians also offer parent coaching, SPACE treatment, psychological assessments, and group therapy, with the convenience of online therapy available anywhere in Texas.
We’re also proud to provide Camp Courage, an experiential program where kids and teens gradually confront fears, practice coping skills, and build lasting confidence in a safe, supportive setting.
Whether you’re looking for early intervention or a higher level of structured care, our approach is individualized, collaborative, and centered on your goals. Every therapist on our team is dedicated to offering evidence-based treatment delivered with compassion, respect, and a true understanding of what it’s like to live with anxiety.
Meet the Team Behind Our Intensive Outpatient Program (IOP) in Austin, TX
At Austin Anxiety and OCD Specialists, our Intensive Outpatient Program is led by a team of skilled, compassionate clinicians who combine deep expertise with a genuine commitment to client care. We work with children, teens, and adults experiencing anxiety, OCD, and related concerns—always providing individualized, values-based support tailored to each stage of recovery.
Dr. Samantha Myhre, PhD – Assistant Clinical Director & IOP Coordinator
Dr. Myhre has extensive training in evidence-based treatments for anxiety and OCD, along with additional focus on mindfulness, depression, and self-worth. She works with clients starting at age six, using a warm, collaborative style that helps individuals build clarity, confidence, and sustainable growth.
Ann Elise specializes in adult care and holds certification in perinatal mental health through Postpartum Support International. With advanced experience in anxiety, OCD, trauma recovery, and postpartum challenges, she blends CBT, ACT, ERP, and EMDR to help clients reconnect with themselves and create lasting change.
Ayla brings strong experience in working with children, adolescents, and families around issues such as OCD, ADHD, anxiety, and behavioral struggles. Drawing on CBT, ERP, and PCIT, she uses a strengths-focused approach to help young clients face fears, grow resilience, and build practical coping skills.
Dr. Youssef primarily supports adolescents and young adults navigating OCD, anxiety, and depression. Known for her warmth and cultural sensitivity, she tailors evidence-based care to meet each client’s unique needs, creating a safe space for authentic growth and healing.
Whether you’re seeking support for yourself, your teen, or your child, our IOP team offers developmentally appropriate, compassionate care—walking alongside you through both challenges and milestones.