The Combined Approach to atopic eczema is not difficult to learn. No special expertise in psychology is required.
To begin with…
Before anything else, some introductory reading is recommended. As you are already reading this article, the introductory content on this website is easy to go to from here.
If you have already watched the slide presentation The Combined Approach, go next to the article “Behavioural dermatology – The Combined Approach to atopic eczema”, followed then by Atopic Skin Disease – the manual for practitioners, including its appendices!
“See one, Try one, Teach one”
Next, watch the video Live Without Eczema and, if possible, arrange sit in with a colleague who is using the approach.
You will then in a good position to start working with your first patient.
Prepare yourself:
- Review the appropriate recommended protocol in the practitioner’s manual: no short cuts!
- Obtain a hand tally counter, and two copies of the appropriate patient handbook: one is for your patient, the other is for yourself.
Add notes into your copy of the patient handbook from the protocol that seem likely to be useful for you to consider as you take your patient through each part of the handbook.
As soon as you have started to work with your first patient, arrange also to start talking about your experience with an interested colleague.
This classic method – See one, Try one, Teach one – works well when learning how to use this treatment programme.
As you become more experienced and confident, do not forget to always take any opportunity you get to teach others: by doing so, discover how you learn more.
Invite others to sit in with you when you are using the approach.
Finally, write about your experience: see for example Val Anderson’s 2017 Case History.
Workshops
If possible, attend a training workshop. In the UK at the University of Hertfordshire have Habit Reversal in Dermatology within their postgraduate dermatology courses.
For further information contact k.radley @ herts.ac.uk
Psychodermatology UK also offer group training in Habit Reversal in Dermatology.
For further information contact rebecca.ercole @ nhs.net
Here on this website there is a recording of a workshop that can be used for either individual or group training.
In the UK, from time to time as part of Continuing Professional Development for all disciplines ad hoc training sessions can be organised by local tutors.
Contact us if you need help in doing this.
TIP: To get the most out of attending, or watching, a workshop, ensure beforehand you complete the introductory reading recommended above.
Recommended Practice
The protocols for The Combined Approach set out in the appendix to the manual for practitioners are based on the original clinical practice which reported research has demonstrated as successful.
Since the publication of the manual we have accumulated on this website further advice from clinical experience on how to achieve the best outcomes, how to understand common difficulties and how to correct some common mistakes.
Local arrangements for clinical governance vary and need to be taken account of when introducing new treatment programmes. The main characteristic of The Combined Approach that needs allowing for is that it involves a series of appointments: it needs to be a treatment programme if it is to be successful.
Keeping a case register can enable review of clinical effectiveness and make it easier to discuss and compare your clinical outcomes with those of colleagues. The register should include initial assessment of severity, and of prognosis, together with assessment at follow-up. For such review to be meaningful, the measures used need to be standard and commonly used by others.
References and Further Reading
Finally, keep up to date. Check out the recommended references under Further Reading. Consider setting up a notification arrangement with Google Scholar Alert. When you find new interesting reviews or research papers that others might like to read, please let us know.
See also: Can habit reversal be used for other skin conditions?
Dr Christopher Bridgett, for Psychodermatology UK. October 2025