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The effectiveness of a deliberately limited version of Acceptance and Commitment Therapy for chronic skin picking was evaluated in a pair of multiple baseline across participants designs. Self monitoring of skin picking showed that four of the five participants reached near zero levels of picking by post-treatment, but these gains were not fully maintained for three of the four participants at follow-up. The findings of the self-reported skin picking were generally corroborated by ratings of photographs of the damaged areas and by ratings on a validated measure of skin picking severity. All participants rated the intervention as socially acceptable, and reductions were found on measures of anxiety, depression, and experiential avoidance for most participants as a result of the intervention. Results support the construction of more comprehensive ACT protocols for skin-picking.


“NOTICE: this is the author’s version of a work that was accepted for publication in Behaviour Research and Therapy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in

Twohig, M. P., Hayes, S. C., & Masuda, A. (2006). A preliminary investigation of Acceptance and Commitment Therapy as a treatment for chronic skin picking. Behaviour Research and Therapy, 44, 1513-1522.

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