Body Focused Repetitive Behaviours: SCAMP
Body Focused Repetitive Behaviour (BFRB) is an umbrella term for behaviours such as compulsive hair-pulling, skin-picking, cheek-biting, lip-biting, teeth-grinding, etc. Basically anything that involves repetitive engagement with your body that can potentially cause physical or emotional harm. While picking at one’s skin or pulling out a hair are very common, in certain individuals, these behaviours interfere with daily functioning causing shame and isolation. Many people may think they have “just a bad habit, chronic acne, or eczema”, leaving this complex self grooming undiagnosed and untreated.
It is estimated that 5% of the population lives with a clinical BFRB. That is 1 in 20, or about 2 million Canadians. Research supports using a Comprehensive Behavioural (ComB) Treatment method which combines elements of Cognitive Behavioural Therapy (CBT), and Habit Reversal Training (HRT). The ComB method assess the BFRB along the five SCAMP domains to tailor treatment to each individual.
The SCAMP model acts as a helpful brainstorming tool to determine blindspots that individuals might not have considered when trying to manage their BFRB. Jason from Island Clinical Counselling has summarized the SCAMP model in this 1 min video. This post will introduce each of the domains below.
This domain is related to the 5 senses: touch, taste, smell, sight, hearing. By noticing the particular sensations involved with the BFRB, one can find ways to alter or replace them. It is common to focus on the touch or sight senses, but the others are often overlooked.
This domain is related to thoughts or cognitions related to the BFRB. Many people struggle with cognitive distortions like a high levels of embarrassment, guilt, and perfectionism that perpetuate the BFRB cycle. By examining these subconscious automatic thoughts, one can begin to build different responses to step outside the negative thinking loop.
This domain is related to feelings and emotions within the body. Initially, it can be difficult to name the associated feelings so it may be helpful to use a multiple choice answer approach. The HALT (Hungry, Angry, Lonely, Tired) acronym could be an example of this.
This domain is related to movements in the body. People often engage in their BFRB without even realising it, and because the BFRB is pleasurable and soothing it can be very difficult to stop. To become more aware of the BFRB, it is useful to begin exploring the Motor domain as the information is fairly intuitive and accessible relative to the other domains. One can start by miming their BFRB in a non-activated state, and notice which fingers are involved or follow the arm trajectory with their other hand. By bringing awareness to these movements that precede the BFRB, we can find opportunities to better intervene and manage the behaviour.
This domain explores the environment related to the BFRB. The environment can be examined and altered to minimise triggering objects or situations. For example, those who engage while driving their car, watching TV, or in the bathroom, can ensure their fidgets and sensory tools are readily accessible.
People often get stuck thinking in only one or two domains. Exploring the SCAMP model with a trained counsellor can help provide a more robust and nuanced BFRB management plan.
If you are interested in learning more, book with a BFRB trained counsellor at Island Clinical Counselling.
Written by Jason Yu