Habit Reversal Training for Children and Adolescents With Trichotillomania

Inclusion Criteria: * Outpatient children between the ages of 7-17 years. * Meets DSM-IV criteria for a primary diagnosis of TTM * English speaking Exclusion Criteria: * Lifetime DSM-IV bipolar, schizophrenia, or schizoaffective disorder, or substance abuse in past 6 months. * A diagnosis of an autism spectrum disorders, mental retardation, or conduct disorder * 1\) Current clinically significant suicidal intent, or 2) individuals who have engaged in suicidal behaviors within 6 months * Receiving concurrent psychotherapy or behavioral interventions. Families will have the option of discontinuing such services to enroll in the study. Those randomized to treatment as usual (TAU) will be able to continue or initiate psychosocial interventions whereas those randomized to HRT will not receive other interventions concurrent with HRT. * Any change in established psychotropic medication (e.g., antidepressants, anxioloytics) within 4 weeks before study enrollment, any change in antipsychotics within 3 weeks prior to the screening assessment, any change in fluoxetine or atamoxetine within 6 weeks of study enrollment, and any change in alpha-2 agonists or stimulants within 1 week of study enrollment. Those randomized to TAU may make medication changes following randomization, including starting a medication; those randomized to HRT will remain stable on medications during the study. * Unwillingness of parents to make the commitment to accompany their child for multiple study visits, unwillingness to take part in randomization, inability to attend weekly sessions as therapist availability allows, inability to attend assessment visits. * Presence of a significant and/or unstable medical illness which might lead to hospitalization during the study.