How to Find the Best Therapist for BFRBs (Body-Focused Repetitive Behaviors) in Ohio
If you struggle with hair pulling, skin picking, nail biting, or other body-focused repetitive behaviors (BFRBs), you are far from alone. These behaviors can cause deep shame and frustration, yet they are not signs of weakness or lack of willpower. BFRBs are complex conditions that require specialized, compassionate treatment and finding the right therapist can make all the difference.
As a therapist who specializes in BFRB treatment in Ohio, I know how powerful it can be to finally work with someone who understands what you’re going through. This post will help you know what to look for in a therapist, where to start your search, and how evidence-based treatment can help you heal.
1. Look for a Therapist Who Understands BFRBs
The most important factor in finding a BFRB therapist is choosing someone with the right training. Many therapists are unfamiliar with the unique cycle of urges, tension, and relief that drives pulling or picking behaviors. Traditional talk therapy alone often isn’t enough.
A therapist who treats BFRBs should be trained in:
Habit Reversal Training (HRT): A structured behavioral approach that helps you identify triggers, increase awareness, and use competing responses instead of engaging in the behavior.
Comprehensive Behavioral Treatment (ComB): A personalized model that looks at why the behavior occurs by examining sensory, emotional, cognitive, and environmental factors.
BFRB-specific care: A deep understanding of the shame, anxiety, and self-soothing patterns that often fuel these behaviors.
When contacting potential therapists, ask specifically if they use HRT, ComB, or specialize in BFRB treatment. These are the gold-standard, evidence-based interventions that lead to meaningful change.
2. Understanding How BFRBs and OCD Overlap
BFRBs are related to, but distinct from, obsessive-compulsive disorder (OCD). Both conditions involve repetitive behaviors, distressing urges, and a sense of being “stuck” in a loop but they differ in motivation and emotional tone.
In OCD, behaviors like checking, washing, or counting are driven by intrusive thoughts and fears (“What if I didn’t lock the door?” or “What if something bad happens?”). The compulsion is meant to reduce anxiety about a feared outcome.
In BFRBs, the repetitive action itself pulling hair, picking skin, biting nails is not done to prevent a feared event. Instead, it provides temporary relief from tension, boredom, or uncomfortable sensory sensations. Over time, this can become an automatic habit that feels impossible to control.
However, the overlap matters because many people experience both OCD and BFRB symptoms. The same parts of the brain particularly those linked to habit formation, impulse control, and anxiety regulation are involved in both. This means a therapist who understands OCD and BFRB connections can better tailor your treatment.
At Ember & Oak Counseling, I work with clients who experience BFRBs, OCD, or both. Together, we look at how these patterns interact and develop a treatment plan that addresses both the behavior and the underlying emotional drivers.
3. Choose a Specialist Who Leads with Compassion and Science
Working with a BFRB-trained therapist means more than just learning techniques it means having someone who can hold space for your story without judgment. Many people living with BFRBs have been dismissed, misunderstood, or told to “just stop.” True healing requires compassion, structure, and specialized care.
At Ember & Oak Counseling, I combine Habit Reversal Training (HRT) and Comprehensive Behavioral Treatment (ComB) with mindfulness-based and self-compassion techniques. Together, we work to:
Identify your unique triggers and urges
Learn new ways to manage discomfort and tension
Build awareness without shame
Strengthen self-trust and confidence
Reduce the frequency and intensity of pulling or picking over time
Whether you meet in-person in Worthington or virtually anywhere in Ohio, my goal is to help you feel calmer, more in control, and more connected to your body again.
4. What Effective BFRB Treatment Looks Like
While each person’s path is unique, successful treatment often includes:
Awareness training: Noticing early sensations and emotions that precede the behavior.
Competing response training: Practicing physical actions that replace or interrupt the behavior.
Stimulus control: Making small environmental changes to reduce triggers and promote mindfulness.
Cognitive and emotional work: Addressing perfectionism, anxiety, and stress that keep the cycle going.
Relapse prevention and self-compassion: Learning to navigate setbacks without shame.
With practice and consistency, these tools help reduce the urge to engage in BFRBs and increase a sense of calm control.
5. Trusted BFRB Resources
In addition to therapy, reliable education and community support can make recovery feel less isolating. Here are a few trusted resources:
The TLC Foundation for Body-Focused Repetitive Behaviors: The leading nonprofit offering education, research, and support for people living with BFRBs.
Cleveland Clinic: Habit Reversal Training Overview: A summary of the behavioral science behind HRT.
SkinPick.com: Educational tools and online support groups for dermatillomania.
BFRB Precision Medicine Initiative: Current research on biological and environmental factors in BFRBs.
6. Getting Started with BFRB Therapy in Ohio
Healing from a BFRB begins with finding the right therapist — someone who blends science, compassion, and experience. I specialize in helping adults across Ohio learn the tools to reduce pulling or picking, manage urges, and rebuild self-confidence using HRT and ComB-based approaches.
If you’re ready to begin your healing journey, you can schedule a free 15 minute phone consultation by clicking the button at the top of the page. Together, we can help you understand your urges, reconnect with your body, and find calm again.