Online therapy for trichotillomania (hair pulling) from just $25/session with licensed therapists (PhD, PsyD, LCSW, LMHC, LMFT) specializing in evidence-based approaches including habit reversal training, CBT, and acceptance and commitment therapy. At Grouport, we offer online individual therapy, online group therapy, and virtual IOP options designed to help you understand the triggers driving the pulling, develop effective strategies to interrupt the behavior, and reclaim the hair, the confidence, and the freedom that trichotillomania has been taking from you.
Whether you prefer personalized one-on-one care or the shared support of a therapist-led group, our online trichotillomania therapy connects you to expert guidance from the comfort of your own home. Online therapy is especially well-suited for trichotillomania because the visible hair loss often creates intense shame about being seen in person. Starting from home means you do not have to worry about how you look walking into an office, and you can focus entirely on treatment.
Consistently Recognized as the #1 Online Therapy pick
.svg)
.png)
.png)
.png)
At Grouport, we offer a range of online therapy options to help individuals with trichotillomania understand the triggers and patterns driving the pulling, develop effective behavioral strategies to interrupt the urge-pull cycle, and address the shame, anxiety, and emotional pain that both fuel and result from the behavior. Many members choose to mix and match therapy formats.
Online therapy for trichotillomania: personalized, flexible, and therapist-led. Understand the triggers driving the pulling, develop strategies to interrupt the behavior, and reclaim the hair, the confidence, and the freedom the disorder has been taking from you.
Whether you're interested in group therapy, individual sessions, couples or family therapy, or IOP, or a combination, you'll start by selecting the type of support that fits your needs. You can also choose the care frequency that works best for you. Complete our onboarding form and sign up directly for the plan that suits you best.
After signing up, you'll connect with a dedicated care coordinator who will walk you through available therapists, group options, and scheduling. You'll make the final choice about your care, including which therapists you'll meet with and when, based on your goals, preferences, and schedule.
Attend your weekly online sessions, whether group, individual, couples, family, or IOP, at the cadence that works best for you. Our team will be here to support you every step of the way, ensuring you're happy with your care plan and helping you make changes whenever needed.
Whether you're interested in online group therapy for trichotillomania, individual therapy sessions, a combination of both, or our virtual IOP for more intensive care, you'll start by selecting the format that fits your needs and schedule. You can customize the frequency of sessions and even pair live therapy with our DBT self-guided program for added support between sessions. Just complete our onboarding form and sign up directly for the plan that suits you best.
After signing up, you'll connect with a dedicated care coordinator who will discuss your mental health challenges, goals, and preferences. They'll walk you through the range of therapy options best suited to your needs for managing trichotillomania. You'll make the final choice about your care, including which therapists you'll meet with and select session times that are most convenient for you.
Attend your weekly online therapy sessions to build coping skills, mood regulation strategies, and stability tools tailored to trichotillomania. Our team will be here to support you at every step of the way, ensuring you're happy with your care plan and helping you make changes whenever needed.
Trichotillomania is a recognized, treatable condition. It is a clinically characterized by intense fear and avoidance of situations where escape might feel difficult or help unavailable. If these patterns year, therapy can help you break the cycle.
Common signs to watch for include:
If you recognize these patterns in yourself or a loved one, working with a licensed therapist can help.
Trichotillomania affects far more than your hair. The pulling, the hair loss, and the shame create a cascading impact across every area of your life, and the secrecy surrounding the disorder means most people suffer for years before seeking treatment.
Hair loss from trichotillomania can be devastating to your self-image. Bald patches on the scalp, missing eyebrows, absent eyelashes, or thinned hair can change how you see yourself fundamentally. You may spend significant time and money on concealment (wigs, hats, extensions, makeup) and still feel that everyone can tell. The impact on self-esteem is often more debilitating than the pulling itself.
The hair loss drives avoidance of situations where it might be noticed: swimming, windy days, physical intimacy, sleepovers, salon visits, or any activity that could displace a hat or reveal a bald spot. You may cancel plans, avoid dating, or decline opportunities because of fear of exposure. The avoidance progressively shrinks your world.
Trichotillomania carries intense shame because the behavior feels like something you should be able to control. Most people have never told anyone the full extent of their pulling. You may have lied about why your hair is thin, invented medical explanations, or gone to extreme lengths to prevent anyone from seeing your hair without concealment. The secrecy is exhausting and isolating.
Trichotillomania frequently co-occurs with anxiety, depression, OCD, and other body-focused repetitive behaviors like skin picking. The shame and functional impairment worsen these co-occurring conditions, and the emotional distress from co-occurring conditions intensifies the urge to pull.
Time lost to pulling sessions, mirror-checking, and concealment routines can consume hours daily. Concentration suffers when urges are present but you are trying to resist. Visible hair loss can undermine confidence in professional or academic settings, leading to avoidance of presentations, meetings, or classroom participation.
Beyond hair loss, trichotillomania can cause repetitive strain injuries in the hands, arms, and shoulders from the pulling motion. Pulling from the scalp can cause follicular damage and, over time, permanent hair loss if the follicle is destroyed. Trichophagia (eating pulled hair) can cause serious gastrointestinal complications including intestinal blockage requiring surgical intervention.
Starting therapy when you are already exhausted and unmotivated can feel like a big ask. Here is what your first few sessions typically look like.
Your therapist will ask about your pulling: when it started, where you pull from, what triggers it, how much time it consumes, and what you have tried. For many people, this is the first time they have told anyone the full truth about their hair pulling. Your therapist understands that this is a recognized neurobiological disorder and will respond without judgment.
Together, you will create a detailed functional analysis of your pulling: the antecedents (triggers, settings, emotional states, sensory cues), the behavior itself (focused vs automatic, pulling sites, duration, rituals with the hair after pulling), and the consequences (relief, shame, concealment). This map is the foundation for targeted intervention.
You and your therapist will define what progress looks like for you. This might include reducing pulling frequency by a specific amount, eliminating pulling from one site, developing a competing response for your highest-risk situations, going a day without pulling, or attending a social event without concealment. Goals are realistic, measurable, and paced to your readiness.
Your therapist will introduce evidence-based techniques tailored to your pulling profile: habit reversal training to interrupt the behavioral chain, stimulus control to modify your environment, acceptance-based strategies for managing urges without acting on them, and cognitive work for the thoughts maintaining the cycle. You will leave with a clear plan and specific strategies to start using immediately.
See how our therapy options have helped our members experience life-changing results
Stephanie
“Grouport is time flexible and affordable and if it didn’t exist, I don’t know where I would go. I had looked into other places before Grouport and there really wasn’t any option like it.”
Michael
“I highly recommend this to anyone who is struggling with anxiety or depression. The therapists are top notch and have made me feel really comfortable and my anxiety has improved tremendously in only a few sessions!”
Isabel
"I joined Grouport to work on myself and to heal. I’m learning so much at every session! The change I see not only in myself but in my fellow group members is abundantly encouraging and profoundly fulfilling. Group therapy with Grouport is a powerful healing tool."
Sheldon
“I was feeling very down at the end of 2020 and I was ready to do something drastic that I know I'd likely regret. The group definitely helped show me that there are people who feel the same way as I do.”
Nancy
“The therapy from Grouport is high quality and convenient. I am becoming much more self aware and am liking myself more. My relationships at work are better and I’m much happier.”
Emily
“I like the connection you can make with total strangers and the confidentiality it comes with.”
Danielle
"Grouport can help you with your issues. Their therapists are well trained to work with you on your issues. I felt my anxiety greatly improve after only a few sessions. I highly recommend it!"
Glenn
"Grouport's approach to DBT is a real strength. This approach provides tools and methods for working with difficult emotions and getting a handle on them. It has given me hope where other approaches have failed."
At Grouport, our virtual trichotillomania therapy integrates several evidence-based techniques designed to help you interrupt the pulling behavior, manage the urges that drive it, and address the emotional and cognitive patterns that maintain it:
Habit reversal training is the first-line, most extensively researched treatment for trichotillomania. HRT has three core components. Awareness training helps you recognize the pulling behavior as it is happening or about to happen, including the hand movements, posture changes, and sensory cues that precede pulling. Many people pull without conscious awareness, so this awareness is foundational. Competing response training teaches you to perform a physically incompatible behavior when an urge arises (such as clenching your fists, pressing your hands flat against your thighs, or gripping an object) for at least one minute until the urge passes. Social support involves enlisting someone you trust to gently prompt awareness when they notice pulling behavior. Research shows HRT reduces pulling by 50% or more in the majority of people who engage consistently.
Stimulus control modifies your environment to reduce the triggers and opportunities for pulling. Strategies include wearing bandages or finger covers on pulling fingers, using fidget toys or textured objects to keep hands busy, changing your seating position or lighting during high-risk activities (reading, TV, computer), wearing hats or silk scarves to create a barrier, keeping hair tied back, and restructuring routines associated with pulling. Stimulus control works by creating friction between the urge and the behavior, buying time for other skills to take effect.
CBT for trichotillomania targets the cognitive patterns that maintain the pulling cycle. Common thought patterns include permission-giving thoughts ("Just one hair, then I will stop"), beliefs about the hair itself ("That hair feels wrong, it needs to come out"), perfectionism about hair texture or symmetry, and the self-critical spiral after pulling ("I am disgusting, I have no willpower"). CBT helps you identify these thought patterns, evaluate them realistically, and develop alternative responses. It also addresses the body image distortions that hair loss can create and the avoidance behaviors that maintain shame.
ACT for trichotillomania helps you develop a different relationship with pulling urges rather than trying to eliminate them through willpower. The core insight: fighting urges often makes them stronger, while observing them without acting allows them to pass. ACT teaches mindful awareness of urges (noticing the tingling, the itch, the tension without judging it), cognitive defusion (seeing "I need to pull that hair" as a thought, not a command), and values-based action (choosing behavior aligned with what matters to you rather than behavior driven by momentary urges). ACT is especially effective for people who have tried willpower-based approaches and found they consistently fail.
AEBT combines the behavioral techniques of HRT with the acceptance-based principles of ACT, creating what is increasingly considered the most comprehensive treatment for trichotillomania and other body-focused repetitive behaviors. AEBT recognizes that pulling is maintained by both behavioral patterns (habits, triggers, sensory reinforcement) and experiential avoidance (using pulling to escape uncomfortable internal states like boredom, anxiety, or understimulation). By addressing both the habit loop and the emotional function simultaneously, AEBT produces outcomes that exceed either approach alone. This integrated model is considered the current gold standard for BFRB treatment.
DBT skills provide practical tools for managing the emotional states that trigger pulling episodes. Distress tolerance skills help you ride out intense urges without acting on them. The TIPP technique (temperature, intense exercise, paced breathing, progressive muscle relaxation) can reduce physiological arousal quickly enough to interrupt a pulling episode already in progress. Emotion regulation skills help you identify and process the feelings (stress, boredom, frustration, understimulation, loneliness) that pulling has been managing, building alternative ways to meet those emotional needs.
Every Grouport therapist is a licensed, accredited mental health professional with specialized training in body-focused repetitive behaviors, OCD-spectrum conditions, and behavioral interventions.
Our therapists typically have over a decade of clinical experience across diverse settings, with specialized expertise in trichotillomania, body-focused repetitive behaviors, OCD-spectrum conditions, and behavioral interventions, and evidence-based interventions like habit reversal training, CBT, ACT, and stimulus control.
We continually evaluate outcomes through internal studies and outcomes studies with researchers from leading universities such as Carnegie Mellon, University of Essex, and University of Cologne.
MEET OUR THERAPISTS
a healthier future starts right here
80%of our members start with moderate to severe mental health symptoms
70% of our members feel significantly better within just 8 weeks
50% of our members achieve remission levels within just 8 weeks
80%
of our members start with moderate to severe mental health symptoms
70%
of our members feel significantly better within just 8 weeks
50%
of our members achieve remission levels within just 8 weeks
Group, individual, couples, family, IOP, and teen therapy — all online, all therapist-led. Mix and match care options to fit your needs — and get discounted pricing when you bundle.
.svg)
Trichotillomania often co-occurs with other mental health conditions. Our licensed therapists are experienced in treating a wide range of challenges, and many members address multiple concerns simultaneously through our flexible therapy options.
Grouport provides online group therapy, individual therapy, couples therapy, family therapy, teen therapy, intensive outpatient program (IOP), all held virtually over video chat. We also offer a DBT self-guided program. Many members combine multiple therapy types to best fit their needs.
Trichotillomania (also called hair pulling disorder) is a DSM-5 diagnosis classified under obsessive-compulsive and related disorders. It involves recurrent pulling out of one's own hair, resulting in hair loss, despite repeated attempts to decrease or stop. Common pulling sites include the scalp, eyebrows, eyelashes, beard, and body hair. It affects approximately 1-2% of the population, is more common in women, and most commonly begins between ages 10-13.
Related but distinct. Trichotillomania is classified in the DSM-5 as an obsessive-compulsive and related disorder, meaning it shares features with OCD but is a separate diagnosis. OCD involves intrusive, unwanted thoughts (obsessions) that drive compulsive behaviors to reduce anxiety. Trichotillomania may not involve obsessive thoughts at all; pulling is often driven by sensory experiences, boredom, tension, or automatic habit. The treatment approaches overlap but are not identical, with habit reversal training being the primary intervention for trichotillomania.
Yes, every Grouport therapist is accredited and licensed. Our network includes Licensed Psychologists (PhD, PsyD), Licensed Social Workers (LCSW), Licensed Mental Health Counselors (LMHC), and Licensed Marriage and Family Therapists (LMFT). Our therapists specialize in evidence-based approaches including habit reversal training, CBT, ACT, and comprehensive behavioral treatment for BFRBs.
This is the most important question. Trichotillomania is a neurobiological condition, not a willpower failure. Pulling is maintained by multiple mechanisms: it provides sensory gratification (the feel of the pull, the texture of the root), it temporarily relieves tension or uncomfortable emotions, it becomes an automatic habit wired into neural pathways, and the shame it creates generates more distress, which fuels more urge to pull. The disorder hijacks the brain's habit and reward circuitry. Professional treatment works because it addresses these mechanisms, not just the surface behavior.
Yes. Trichotillomania and excoriation disorder (skin picking) are both classified as body-focused repetitive behaviors (BFRBs). They share many features: both involve repetitive self-directed behaviors causing physical damage, both have focused and automatic subtypes, both respond to the same treatment approaches (HRT, ACT, stimulus control), and they frequently co-occur. If you also experience skin picking, nail biting, or cheek chewing, your therapist can address all of these behaviors together.
In most cases, yes. Hair follicles are resilient, and hair typically regrows once pulling stops or significantly decreases. However, prolonged pulling from the same area over many years can damage follicles permanently, resulting in permanent hair loss in those areas. This is why early intervention matters. During recovery, many people experience the relief and motivation of watching their hair grow back, which reinforces continued progress.
Most people with trichotillomania engage in both types. Focused pulling is intentional and conscious: you feel a specific hair that seems "wrong" (coarse, kinky, out of place) and deliberately pull it. It often involves searching, selecting, and rituals with the hair afterward. Automatic pulling happens outside awareness during other activities like reading, watching TV, driving, or falling asleep. You may not realize you have been pulling until you see the pile of hair. Effective treatment addresses both types with different strategies.
Finding the right therapy starts with understanding your needs. If you need focused, personalized treatment to map and interrupt your specific pulling patterns, individual therapy is ideal. If you benefit from breaking the secrecy and connecting with others who understand, group therapy is powerful. For severe cases, our virtual IOP offers multiple weekly sessions. Schedule a free call with a care coordinator for a personalized plan.
We offer flexible therapy options with straightforward pricing:
Online Group Therapy: Averages $32/session ($140/month).
Online Individual Therapy: Averages $103/session ($448/month).
Online Couples Therapy: Averages $114/session ($492/month).
Online Family Therapy: Averages $148/session ($640/month).
Virtual IOP: Averages $311/week ($1,348/month).
Online Teen Therapy: Averages $103/session ($448/month).
DBT Self-Guided Program: One-time fee of $500.
Payment Options: Monthly, Quarterly (Save 10%), Biannually (Save 15%). No long-term commitment. Switch therapists anytime. Cancel anytime!
Yes. We offer separate therapy groups for Adults (18+) and Teens and Adolescents (under 18). Our teen therapy programs are tailored for adolescents. Trichotillomania most commonly begins between ages 10-13, making early intervention during this critical window especially important. Teens may face bullying, social isolation, and intense shame, and having a therapist who understands the disorder can be transformative.
Many people see meaningful reduction in pulling frequency within 6-8 weeks of consistent habit reversal training. Achieving stable, long-term management typically takes 3-6 months. Some people benefit from longer-term therapy if pulling is deeply entrenched, connected to significant emotional triggers, or co-occurring with other conditions. Trichotillomania is typically managed rather than permanently "cured"; the goal is to reduce pulling to a level that no longer causes significant hair loss or distress, and to have effective tools for managing flare-ups when they occur.
Our therapy outcomes are backed by outcomes studies with researchers from leading universities such as Carnegie Mellon, University of Essex, and University of Cologne. 80% of our members start therapy with moderate to severe symptoms. Within just 8 weeks, 70% of members see clinically significant reduction in anxiety and depression, and 50% achieve remission levels.
You can cancel your subscription at any time. No long-term commitment is required. Simply email us at support@grouporttherapy.com and we will send you a quick cancellation form to fill out. If your sessions occur within the member portal, you can also cancel under the manage subscription tab.
Whether hair pulling has been consuming your time, affecting your appearance, and stealing your confidence-related anxiety, or looking to prevent another year of lost months, therapy can help you take back control. Start building a life where the seasons don't dictate how you feel.
