Question

A client who is diagnosed with trichotillomania meets with a social worker after being referred by her primary care physician. The client says she feels guilty and ashamed, but is having difficulty stopping the behavior. She says that she doesn't even know why she started the behavior in the first place. What should the social worker do FIRST?

A. Explore the feelings behind the behavior.
B. Have the client wear a wig until she can stop the behavior.
C. Reinforce that hair-pulling will likely lead to complete baldness.
D. Teach the client thought stopping strategies.

Answer 1

A social worker should first explore the feelings behind the trichotillomania behavior to understand the client's emotional context, which is crucial for developing an effective treatment plan.

Step-by-step explanation:

In addressing the situation of a client diagnosed with trichotillomania, a social worker should first explore the feelings behind the client's behavior. It is important to create a supportive environment where the client feels comfortable discussing emotions associated with the condition. This could help uncover any underlying issues that may be contributing to the hair-pulling behavior and would be an initial step toward developing a tailored treatment plan that could include cognitive-behavioral therapy (CBT), habit reversal training, or other therapeutic strategies.

Encouraging the client to wear a wig or reinforcing negative consequences like baldness can be shaming and is unlikely to address the core psychological reasons for the behavior. Similarly, while teaching thought stopping strategies can be a useful component of treatment, it is not the first step to take before understanding the emotional context of the behavior.