Chapter 4 - Getting Started with Comprehensive Behavioral Treatment

Summary

Detailed description of ComB treatment begins in this chapter. The importance of establishing a strong therapist/client relationship is emphasized as a basis for productive, targeted treatment for the BFRB, but also for its potential impact on common, secondary issues such as shame, interpersonal problems, and diminished self-confidence. Specific recommendations and examples are provided for maximizing effective communication with the client about basic information about BFRBs, their treatment, and addressing common obstacles that may impede effective treatment, such as unrealistic expectations for treatment, ambivalence about recovery, perfectionism, frustration, and low motivation for treatment. Also presented are recommended approaches for introducing the five categories of variables relevant to Comb conceptualization and treatment (sensory, cognitive, affective, motor, and place – the anagram “SCAMP” is suggested as a memory facilitator). The remainder of the chapter describes the five phases of ComB treatment that are detailed in later chapters.