How to use Prohibere
Prohibere was designed to be applied directly to scalp when a pulling episode begins. Cooling sensation may take up to 5-10 minutes to occur.
Below is the standard plan for habit reversal training for trichotillomania incorporating Prohibere as a competing response tool.
Competing response training
1. Competing Reaction Training- Subject learns the inconspicuous competing response of clenching fists and/or applying cooling Prohibere whenever pulling occurs
2. Awareness Training- Subject learns to be aware of the specific movements involved in hair pulling especially by observing themselves in mirror or using awareness bracelet.
3. Identifying Response Precursors- A common response that is a precursor to hairpulling is face-touching as is also hair straightening. Subject learns which are specific to his or her habit.
4. Identify Habit Prone Situations- Subject learns to identify which situations lead to hair pulling, such as watching TV, reading, studying, and driving.
5. Relaxation Training- Nervousness is a common precursor to hair puling. The subject is taught how to relax with deep breathing, mindfulness training, and postural adjustment.
6. Prevention- Practice competing reaction by applying cooling Prohibere and 3 min of clenching fists whenever nervousness or a response precursor exists, thereby preventing hair pulling.
7. Habit Interruption- Subject practices using the competing response (hair cooling prohibere and/or fist clenching) to interrupt hair pulling immediately
8. Positive Attention (over correction)- The subject practices positive hair care such as applying hair growth products, hair nourishing masks, or brushing hair after each episode of hair pulling.
9. Daily Practice of Competing Reaction- Subject practices the competing reaction before a mirror at home on a scheduled basis to be assured of the inconspicuousness of the competing reaction.
10. Self-recording: Subjects recorded each instance of actual hair pulling and each strong compulsion to hair pull on a recording chart to provide greater awareness and feedback for progress in hair pulling