In-Person and Online Therapy
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Serving the community since 1999

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Specializing in the Treatment of OCD and Related Anxiety Based Conditions

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Comprehensive Behavioral (ComB) Treatment

The Comprehensive Behavioral (ComB) treatment model is an evidence-based therapy specifically designed for people struggling with Body-Focused Repetitive Behaviors (BFRBs) such as hair pulling (trichotillomania), skin picking (excoriation disorder), nail biting, and similar behaviors. ComB takes a highly individualized approach, identifying the unique factors that maintain the behavior and tailoring treatment strategies across five specific domains.

Developed by Drs. Charles Mansueto, Ruth Goldfinger Golomb, and colleagues, ComB goes beyond standard behavioral therapies by helping clients understand why their behaviors occur and how to address the emotional, cognitive, sensory, and environmental components that fuel them.

Who is ComB For?

ComB is well-suited for:

  • Children, teens, and adults with BFRBs such as trichotillomania, dermatillomania, or nail biting
  • Individuals who have tried other therapies (like HRT or CBT) but need a more tailored, in-depth approach
  • People looking to understand the function of their behavior and gain practical, flexible tools to interrupt it
  • Those seeking treatment that integrates behavioral tools with emotional and environmental awareness
Click here to email the OCD Center or call us at 310 824-5200
Click here to meet the OCD Center Staff

How ComB Treatment Works

ComB centers around identifying why a behavior happens—what purpose it serves—and then creating targeted strategies to interrupt it. This process includes:

1. Assessment & SCAMP Mapping

The therapist helps you explore the five domains that influence your BFRB:

  • Sensory: Seeking certain physical sensations (e.g., pulling for texture or relief)
  • Cognitive: Thoughts or mental images tied to the behavior (e.g., perfectionism, boredom)
  • Affective: Emotions that trigger the behavior (e.g., stress, frustration, shame)
  • Motor: Automatic physical routines that happen without conscious awareness
  • Place (Environmental): Locations or situations where the behavior occurs most often

This SCAMP assessment provides a full picture of what drives the behavior.

2. Treatment Planning

Once the SCAMP profile is mapped, a personalized plan is created, drawing from strategies that match your triggers.

3. Behavioral Interventions

These might include:

  • Using physical barriers (e.g., gloves, fidget tools)
  • Changing routines or environmental setups (e.g., covering mirrors, altering lighting)
  • Mindfulness or emotion regulation strategies
  • Replacing the behavior with a safer or more intentional action

4. Skill Building & Generalization

You’ll practice these skills across different environments (home, school, work) and learn how to adapt when situations change.

5. Ongoing Review & Adjustment

As your patterns shift, your treatment evolves. ComB is meant to be flexible and responsive to your progress.

Click here to take one of our free online tests for OCD and anxiety

Frequently Asked Questions (FAQs)

What makes ComB different from HRT or CBT?
ComB looks at why a behavior happens across multiple domains—not just what the behavior is. It’s more individualized than standard CBT and often more comprehensive than HRT alone.

Is ComB evidence-based?
Yes. ComB is supported by clinical research and used by leading specialists in the treatment of BFRBs. Studies show that it can lead to significant and lasting symptom reduction.

How many sessions does it take?

Treatment usually ranges from 8–14 sessions, though this can vary depending on your needs and goals.

Is ComB only for severe cases?
Not at all. ComB is helpful whether your BFRBs are mild and frustrating or more severe and distressing. It’s adaptable to your level of impairment and readiness for change.

Can it be used with children or teens?
Yes. ComB can be adjusted for younger clients using age-appropriate strategies and family involvement when needed.

What You Can Expect

  • A customized treatment plan based on your unique triggers
  • Increased awareness of when and why your behaviors happen
  • A toolbox of strategies tailored to your needs and goals
  • Support in reducing shame and building confidence
  • Long-term skills for maintaining progress and preventing relapse

We offer ComB as a primary treatment for individuals struggling with BFRBs. Our clinicians are trained to guide you through the SCAMP process and create a plan that enables you to get better. Whether you’ve tried other treatments or are just beginning your journey, ComB offers a structured yet flexible path toward meaningful change.

Click here to read client reviews and testimonials
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NEW In-Person OCD Group at our Brentwood Location

Thursday Evenings from 5:30-7:00PM

Please contact our client coordinator, Lisa, at (310) 824-5200 ext. 4 or lisa@ocdla.com for more information.

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(310) 824-5200 (ext. 4)

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