If you’ve spent any time researching hair pulling, skin picking, nail biting, or other body-focused repetitive behaviors, you’ve probably encountered the TLC Foundation. It’s the central hub for BFRB resources in the United States—and increasingly, globally.
Here’s what they offer, how to use their resources, and why they matter.
What Is the TLC Foundation?
The TLC Foundation for Body-Focused Repetitive Behaviors is a 501(c)(3) nonprofit based in Santa Cruz, California. Originally founded in 1991 as the Trichotillomania Learning Center (hence “TLC”), it expanded its scope to cover all BFRBs and rebranded accordingly.
Their mission covers three areas:
- Education: Public awareness and clinical training about BFRBs
- Research: Funding studies and connecting researchers with participants
- Support: Connecting people affected by BFRBs with each other and with qualified clinicians
The organization is the closest thing the BFRB community has to a central authority. When researchers publish BFRB studies, when journalists cover BFRBs, and when clinicians seek specialized training, the TLC Foundation is almost always involved.
Therapist Referral Directory
For many people, this is the most immediately useful resource.
How It Works
The TLC Foundation maintains an online directory of mental health professionals who treat BFRBs. You can search by:
- Location (state, zip code, or country)
- Specialty (trichotillomania, skin picking, nail biting, or general BFRBs)
- Telehealth availability (critical for people without local specialists)
- Insurance accepted
What to Know
- Listing is self-reported. Therapists aren’t vetted through a formal certification process, though many have completed TLC Foundation training programs.
- The directory skews toward U.S.-based providers, but includes some international listings.
- Not all excellent BFRB therapists are listed. Some specialists don’t register with directories.
- Use the listing as a starting point. In your first contact, ask about their specific experience: How many BFRB clients have they treated? Do they use HRT, ComB, or ACT? Have they had BFRB-specific training?
If No One Is Listed Near You
This happens frequently, especially outside major metro areas. Options:
- Telehealth: Most listed therapists now offer remote sessions. Geography matters much less than it did five years ago.
- TLC Foundation training alumni: Check if your state has clinicians who completed the TLC’s professional training but aren’t listed in the directory.
- OCD Foundation referrals: The International OCD Foundation’s provider directory sometimes includes BFRB specialists, since the conditions are clinically related.
Education Programs
For People with BFRBs and Families
The TLC Foundation produces a steady stream of educational content:
- Webinars: Free and paid webinars covering BFRB topics—treatment approaches, research updates, coping strategies, parenting children with BFRBs, managing BFRBs in school settings. Archived webinars are available for later viewing.
- Articles and fact sheets: Plain-language explanations of each BFRB, treatment options, and related topics. These are useful for sharing with family members, teachers, or healthcare providers who aren’t familiar with BFRBs.
- Newsletter: Regular updates on research, events, and community stories. Free subscription.
- Social media: Active presence on Instagram, Facebook, and YouTube with awareness content, personal stories, and expert Q&As.
For Clinicians
The TLC Foundation runs several professional training programs:
- Professional Training Institute: A multi-day intensive training on BFRB assessment and treatment. Covers HRT, ComB, ACT approaches, and clinical decision-making. Considered the gold standard for BFRB clinical training in the U.S.
- Online training modules: Self-paced courses for clinicians who can’t attend in-person training. CE credits available.
- Expert consultation: Some programs connect newer BFRB clinicians with experienced mentors for case consultation.
The training programs matter because most graduate programs in psychology, social work, and counseling don’t cover BFRBs. A therapist can complete their entire training without learning about trichotillomania, let alone ComB or stimulus control for nail biting. TLC-trained clinicians represent a meaningful step up in specialization.
The Annual Conference
The TLC Foundation’s annual conference is the largest BFRB-focused event in the world. It’s also widely described as the most impactful experience in the BFRB community.
What It Includes
- Expert presentations: Researchers and clinicians present on treatment advances, neurobiology, medication research, and clinical techniques
- Workshops: Hands-on sessions on specific topics—HRT skills practice, ACT for BFRBs, managing BFRBs in children, couple relationships and BFRBs
- Support groups: Facilitated small-group sessions organized by condition, age group, or topic
- Keynote speakers: Researchers, advocates, and people sharing their BFRB experiences
- Community events: Social gatherings, art exhibits, and informal meetups
Who Attends
The conference is open to:
- People with BFRBs (the largest group)
- Family members and partners
- Mental health professionals
- Researchers
- Students
Why It Matters
For many attendees, the conference is the first time they’ve been in a room with other people who share their experience. The impact of that can’t be overstated.
Common themes from attendee feedback:
- “I didn’t know anyone else did this”
- “The shame I’d been carrying for years started to dissolve”
- “I learned practical strategies I’d never encountered in regular therapy”
- “Meeting researchers working on my condition gave me hope”
Practical Details
- The conference is typically held annually in a different U.S. city
- Registration fees apply, but scholarships are available through the TLC Foundation’s financial assistance program
- Virtual attendance options have been available in recent years
- Check bfrb.org for current year dates and location
Support Groups
Online Support Groups
The TLC Foundation facilitates online support groups through their website:
- Groups are organized by condition (trichotillomania, skin picking, nail biting) and sometimes by demographic (teens, adults, parents)
- Facilitated by trained peer support leaders or licensed clinicians
- Typically meet weekly or biweekly
- Some are free; others have a small fee
In-Person Support Groups
Local support groups exist in some metro areas, often organized by TLC Foundation-affiliated volunteers. Check their website for groups in your area OR start one—the TLC Foundation provides resources for launching a local group.
Peer Mentorship
Some TLC Foundation programs pair people earlier in their journey with individuals who have more experience managing their BFRB. This one-on-one support can supplement therapy and group participation.
Research Initiatives
The TLC Foundation plays a significant role in BFRB research infrastructure.
Research Grants
They award grants for BFRB studies. Areas of focus have included:
- Neurobiology and genetics of BFRBs
- Treatment development and testing
- Epidemiological research
- Digital intervention development
- Pediatric BFRB treatment
While individual grants are modest compared to NIH funding, they often support pilot studies that generate data for larger federal grant applications. Several major BFRB studies were seeded by TLC Foundation grants.
Research Registry
The TLC Foundation maintains a registry of people willing to participate in research studies. Researchers can recruit participants, and people with BFRBs can find studies to join.
This is particularly valuable because BFRB research has historically struggled with recruitment. Having a centralized registry accelerates the research pipeline.
Research Summaries
For non-researchers, the TLC Foundation translates study findings into accessible language. Their website and newsletter regularly feature plain-language summaries of new BFRB research.
Advocacy
The TLC Foundation engages in advocacy on several fronts:
- Insurance coverage: Advocating for better insurance coverage of BFRB-specific treatments. Many people have been denied coverage for HRT or ComB because their insurer doesn’t recognize BFRBs as billable conditions.
- Clinical recognition: Pushing for BFRBs to be included in clinical training programs. The more therapists who learn about BFRBs in school, the less gap there is between prevalence and available treatment.
- Public awareness: Campaigns like BFRB Awareness Week (held annually in October) aim to reduce stigma and increase public understanding.
- Research funding: Advocating for increased NIH and NIMH funding for BFRB research, which has historically been underfunded relative to prevalence.
How to Get Started with TLC Foundation Resources
Here’s a practical order of operations:
- Visit bfrb.org: Browse educational content about your specific BFRB
- Sign up for the newsletter: Free, and it’ll keep you informed about events and research
- Search the therapist directory: Whether you’re ready for treatment or just want to know your options
- Consider a support group: Even one session can significantly reduce the isolation many people feel
- Look into the conference: If you can attend, it’s worth the investment. If not, watch for virtual programming and archived content
- Join the research registry: Contributing to research helps the entire community
Other Organizations Worth Knowing
While the TLC Foundation is the largest BFRB-specific organization, a few others deserve mention:
- Canadian BFRB Support Network: Resources and support for Canadians with BFRBs
- Picking Me Foundation: Focused specifically on excoriation disorder (skin picking)
- International OCD Foundation: Covers OCD-spectrum conditions including BFRBs
- BFRB Peer Support Community: Various online communities on Reddit, Facebook, and Discord
The TLC Foundation remains the most comprehensive single resource for anyone affected by a BFRB—whether you’re just learning what BFRBs are or you’ve been managing one for decades.