Residential Treatment Program Application for Dermatillomania

Comprehensive Residential Treatment for Dermatillomania

Dermatillomania, also known as excoriation disorder or skin-picking disorder, affects millions of people worldwide. If you or a loved one struggles with compulsive skin-picking and are ready to take the next step toward recovery, our residential treatment program offers specialized, evidence-based care in a supportive environment.

What Makes Our Program Different

Our residential treatment approach combines proven therapeutic interventions specifically designed for body-focused repetitive behaviors (BFRBs). We understand that dermatillomania is more than just a habit—it's often deeply connected to anxiety, stress, and underlying emotional challenges that require professional support.

Our multidisciplinary team provides:

• Habit Reversal Training (HRT) to help you identify triggers and develop healthier coping mechanisms
• Competing Response Training to replace skin-picking behaviors with alternative actions
• Cognitive Behavioral Therapy (CBT) to address thought patterns that contribute to the behavior
• Anxiety and stress management through evidence-based therapeutic approaches
• 24/7 supportive residential environment where you can focus entirely on healing
• Individual and group therapy sessions to build community and shared understanding
• Holistic wellness activities including mindfulness, meditation, and body awareness

Who Should Apply

This residential program is designed for individuals who:

• Experience compulsive skin-picking that interferes with daily life
• Have tried outpatient treatment without sustained success
• Are ready to commit to intensive, focused recovery work
• Need a structured environment away from daily triggers
• Want to address underlying anxiety, trauma, or emotional regulation challenges

Why Use Paperform for Your Application

Applying for residential treatment is an important step, and we've made the process as straightforward and supportive as possible. This application form, built with Paperform, allows you to:

• Complete the application at your own pace in a secure, confidential environment
• Save your progress and return to complete sections when you're ready
• Upload required documents directly within the form
• Communicate sensitive information knowing your data is protected with SOC 2 Type II compliance
• Receive immediate confirmation once your application is submitted

For treatment centers and mental health facilities managing applications, Paperform streamlines the entire intake process. You can automatically route applications to the appropriate clinicians, trigger follow-up workflows using Stepper to schedule intake calls or send welcome packets, and maintain organized records without juggling emails and paper forms.

Healthcare administrators can also use Papersign to securely collect required consent forms, HIPAA authorizations, and treatment agreements electronically, keeping everything connected to the original application for a complete client record.

Taking the First Step Toward Recovery

Seeking help for dermatillomania takes courage, and completing this application is a powerful step toward healing. Our team reviews every application with care and compassion, and we're committed to supporting you throughout the admissions process.

Whether you're a mental health professional looking for streamlined client intake, a residential treatment facility needing compliant application workflows, or someone personally seeking treatment, Paperform provides the flexibility and security you need for sensitive healthcare applications.

Ready to begin your journey? Complete this confidential application to take the first step toward specialized residential treatment for dermatillomania and start your path to recovery.

Note: This form template is designed for behavioral health residential programs. Paperform is not HIPAA compliant and should be used in accordance with your organization's privacy and compliance requirements.