POSITIVE REINFORCEMENT AND PUNISHMENT IN THE TREATMENT OF CHILDHOOD TRICHOTILLOMANIA

A comprehensive behavioral treatment package was developed during 13 treatment sessions and was communicated to a mother of a five year old girl with a four year history of hair pulling which had resulted in almost total baldness. Treatment consisted of a variety of positive reinforcement procedures which resulted in a gradual decrease in the hair pulling behavior, and finally the use of punishment which led to a rapid decrease and virtual elimination of the problem. The child was symptom free with shoulder length hair at a 16 month follow-up. The growing literature on behavioral treatment of trichotillomania and the ethical implications of the use of punishment are reviewed. © 1979.