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 applying cooling Prohibere and fist clenching whenever pulling starts to occur
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 or playing with hair. 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 is stopped.
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