In addition to reviewing the SCAMP domains of the ComB Model, this chapter is focused on awareness – awareness of the specific BFRB domains while asking the reader to notice relevant BFRB patterns and encouraging them to become aware of their body and mind at any given moment. The Awareness Form is introduced to the reader. Readers are asked to practice mindfulness exercises daily, to fill out the Awareness Form each day, and to begin to notice important aspects of their behavior that will be critical to formulation of an intervention plan.

Detailed description of ComB treatment begins in this chapter. The importance of establishing a strong therapist/client relationship is emphasized as a basis for productive, targeted treatment for the BFRB, but also for its potential impact on common, secondary issues such as shame, interpersonal problems, and diminished self-confidence. Specific recommendations and examples are provided for maximizing effective communication with the client about basic information about BFRBs, their treatment, and addressing common obstacles that may impede effective treatment, such as unrealistic expectations for treatment, ambivalence about recovery, perfectionism, frustration, and low motivation for treatment. Also presented are recommended approaches for introducing the five categories of variables relevant to Comb conceptualization and treatment (sensory, cognitive, affective, motor, and place – the anagram “SCAMP” is suggested as a memory facilitator). The remainder of the chapter describes the five phases of ComB treatment that are detailed in later chapters.