This chapter assists the reader in identifying their specific High-Risk situations (situations which put them at risk of pulling or picking). In addition to identifying these trigger environments, they also explore why they engage in their BFRB. Antecedents, Behaviors, and Consequences in these specific contexts are explored to help them understand the function that their BFRB serves in their life. With this understanding, they then are able to consider some alternate ways to get these needs met. Readers also identify some possible emotional and cognitive barriers that may get in the way of achieving their goals. Finally, the concept of relapse prevention is introduced to the reader, laying the groundwork for future struggles with adherence to the plan and, hopefully, avoiding a relapse.

Based on a review using the new criteria for empirically supported treatments, this chapter emphasizes exposure with response prevention for obsessive-compulsive disorder, a treatment that has strong research support. Cognitive therapy is also discussed. Credible components of treatment include exposure, behavioral experiments, and cognitive reappraisal. A sidebar also reviews treatments for body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation.

Distinguishes between adaptive and maladaptive anxiety. Describes the essential features of, and models and treatments for, panic attacks and panic disorder. Describes the essential features of, and models and treatments for, phobias. Describes the essential features of, and models and treatments for, generalized anxiety disorder. Describes the essential features of, and models and treatments for, obsessive-compulsive and related disorders.

Skin or rectal picking, hoarding of nonfood items, and elopement are common behavioral manifestations in PWS. Early recognition and management of excoriation behaviors by redirection and distraction can help reduce picking behavior. If behavioral interventions including habit-reversal training are ineffective, medication management should be considered. N-Acetyl Cysteine (NAC), topiramate, guanfacine extended-release, and naltrexone are some of the medicines used to manage picking behaviors. Hoarding of nonfood items is another common behavior in PWS that can lead to significant distress to caregivers. The evidence of medications in the management of hoarding in PWS is limited but behavioral management strategies are discussed. Medications may be considered when attempts to limit hoarding leads to aggressive outbursts. Finally, elopement or runaway behavior can be dangerous and potentially life threatening in PWS. In addition to ensuring security and preventing the act of running away, the underlying causes of the behavior whether psychosocial or psychiatric should be explored and treated appropriately.