Acceptance-enhanced behavior therapy for excoriation (skin-picking) disorder in adults: A clinical case series

Excoriation disorder (ExD) involves habitual skin picking that causes significant tissue damage and psychosocial impairment. ExD is largely understudied, and efficacious treatments have yet to be established. Preliminary evidence suggests that habit reversal is a promising intervention for ExD and that acceptance and commitment therapy (ACT) techniques may further enhance the efficacy of habit reversal. This report details treatment of ExD in four adults using a combination of habit reversal and ACT, termed acceptance-enhanced behavior therapy (AEBT). Three of four patients experienced a clear decrease in ExD symptoms from pretreatment to posttreatment. Clinical considerations and directions for future research are discussed.