Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Galen Alessi

Second Advisor

Dr. Jim Carr

Third Advisor

Dr. Mary Anderson


Based on the literature, trichotillomania (or chronic hair pulling) appears to be responsive to behavioral interventions, with habit reversal as the most promising intervention. Habit reversal has been shown effective with children and adults of varying levels of severity, but some have questioned the generality and acceptability of the procedure. Little is known about the acceptability of interventions for habit disorders. These two research studies were designed to answer questions regarding the acceptability of behavioral and pharmacological interventions for trichotillomania and to expand the conceptual knowledge of treatment acceptability.

Study 1 compared the acceptability of four interventions targeting trichotillomania. The four treatments included habit reversal, a punishment-basedprocedure, medication, and hypnosis. Age of the analogue client and severity level of the hair pulling was also manipulated to assess the effect of these variables on ratings of treatment acceptability. Results showed significant differences between the four treatment conditions, with hypnosis and habit reversal rated the most acceptable. Age of the case and severity level did not significantly influence acceptability ratings.

Study focused upon methodological and conceptual issues involved in treatment acceptability research. Currently, standard practice is to provide participants with a brief description of the procedures involved in an intervention before asking the subjects to making a rating of treatment acceptability. Rarely are participants given explanation of why interventions have been selected and how they are likely to work. In the past, rationale and efficacy has been manipulated through one sentence explanation stating the therapists intentions or general statements as to the effectiveness of the interventions. Study 2 investigated the potential ramifications of providing more thorough descriptions of the rationale behind the intervention, and specific technical data on effectiveness. Results showed significant increased in treatment acceptability ratings across treatments when a rationale statement was provided. Also, efficacy influenced treatment acceptability ratings, with higher effectiveness associated with higher treatment acceptability ratings.

Access Setting

Dissertation-Open Access