Personalized BFRB Treatment in Houston & Online
Compassionate, Evidence-Based Care Where You’re Most Comfortable
Many individuals struggling with hair pulling, skin picking, or other body-focused repetitive behaviors (BFRBs) feel most at ease in familiar surroundings. At OATH Therapy, we provide personalized BFRB treatment designed to meet you where you are whether that’s in our Houston office or via secure telehealth sessions across Texas.
Our licensed therapists, led by Saharah Shrout, MA, LPC-S, specialize in body-focused repetitive behaviors like trichotillomania and dermatillomania. We guide each client through evidence-based therapies, including ERP (Exposure and Response Prevention), Habit Reversal Training, and mindfulness techniques, in a supportive, nonjudgmental environment.
What Are Body-Focused Repetitive Behaviors (BFRBs)?
Body-Focused Repetitive Behaviors (BFRBs) are actions where a person repeatedly damages their own body, often without intending harm and sometimes without realizing they're doing it. Common BFRBs include:
- ✔ Trichotillomania: compulsive hair pulling from the scalp, eyebrows, eyelashes, or other areas
- ✔ Dermatillomania (Excoriation Disorder): compulsive skin picking, often leading to sores, scarring, or infections
- ✔ Nail biting (onychophagia)
- ✔ Cheek or lip biting
- ✔ Nose picking or scab picking
These behaviors can cause physical damage, shame, isolation, and distress — but they are treatable with evidence-based therapy.
Are BFRBs Related to OCD?
✔ Repetitive, compulsive behaviors
✔ Urges triggered by stress, boredom, or intrusive thoughts
✔ Difficulty stopping despite wanting to quit
✔ Feelings of guilt or embarrassment afterward
At OATH Therapy, we treat BFRBs as a specialized subcategory of OCD-related disorders, using gold-standard techniques like ERP therapy to help you break the cycle and regain control.
How We Treat BFRBs
We use a combination of structured, evidence-based methods tailored to your unique needs to help you overcome BFRBs.
Comprehensive Behavioral Model (ComB)
An evidence-based approach for treating BFRBs by identifying emotional, environmental, and sensory triggers. Combines CBT techniques with personalized coping strategies to replace harmful habits with healthier alternatives.
Habit Reversal Training (HRT)
Increases awareness of the behavior, identifies early warning signs, and teaches alternative responses. Helps clients break the automatic cycle of BFRBs.
Mindfulness & Self-Compassion
Encourages mindfulness to reduce body-focused attention and fosters self-acceptance during the healing process, promoting long-term recovery.
Service Area – Where We Travel
We offer in-home therapy across Houston and nearby neighborhoods, including:
- Bellaire
- West University
- The Heights
- Montrose
- River Oaks
- Museum District
- Rice Village
- Galleria area
- And more – ask us if your area is covered
If you're outside of central Houston, reach out, we may still be able to accommodate your location.
What Clients Say About Telehealth
“I was nervous to try online therapy, but now I can’t imagine doing it any other way. It’s just as personal and even more convenient”
“Living in a small town meant options were limited. Telehealth with OATH Therapy gave my son access to a specialist we couldn’t find locally”
Who Is This Therapy For?
Our BFRB treatment is ideal for:
- ✔ Children, teens, and adults
- ✔ People who hide their behaviors out of shame
- ✔ Clients who have tried to stop but can’t
- ✔ Individuals who feel overwhelmed by anxiety, perfectionism, or sensory discomfort
- ✔ Caregivers noticing hair pulling, picking, or other behaviors in a loved one
Where We Offer Treatment
We provide in-person sessions in Houston and offer telehealth therapy throughout Texas, so anyone can access expert support from wherever they are.
Schedule a Free ConsultationTop Frequently Asked Questions about BFRB
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Possibly. If the behavior feels compulsive, causes distress, or interferes with your life, it may be a BFRB. We can help assess and guide you.
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While not always physically dangerous, they can cause infections, hair loss, scarring, and significant emotional distress.
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BFRBs are more than habits. They’re complex behaviors often tied to anxiety, sensory issues, or perfectionism, and they require targeted treatment.
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Yes. Many people improve significantly with behavioral therapy approaches like ERP, HRT, and CBT. In some cases, therapy may be combined with medication.
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That’s completely understandable. Our therapists are warm, nonjudgmental, and experienced in working with BFRBs. You won’t shock us, we’re here to help.
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Yes. We offer therapy for children and teens, and also support parents in understanding and managing BFRBs in their child.
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While the urges may not disappear entirely, therapy teaches tools to manage and reduce them, leading to more control, fewer episodes, and less distress.
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Many BFRBs happen automatically. Therapy helps increase awareness, recognize early signals, and use alternate strategies before the behavior occurs.
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Yes! We offer secure, HIPAA-compliant telehealth therapy across Texas.
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We’ll guide you through compassionate ways to support your child, improve communication, and create an environment that encourages recovery.
Ready to Start?
If you or someone you love struggles with a Body-Focused Repetitive Behavior, there is help, and hope. Let’s work together to break the cycle.