Behavior therapy techniques in treatment of exfoliative dermatitis

We report here a case study in which behavior therapy techniques were used to treat the persistent and severe scratching of a patient with long-standing exfoliative dermatitis. A multiple-baseline clinical design across different body areas was used to evaluate the behavioral treatment program. This program consisted of (1) training the patient to monitor his scratching behavior and to use an incompatible response and distraction procedure contingent on the occurrence of scratching, and (2) differential attention by the therapist, so that the therapist's attention was contingent on intervals of nonscratching, and the therapist ignored the patient when he did scratch. The results indicated that the program was effective in almost completely eliminating scratching when a variety of therapists were and were not present. This suggests that the procedures used might easily be taught to the nursing staff.