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Nail biting in high school

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Presenting Behavior:
Please describe the behavior:
Nail biting

How old is the student?
Late High school

Where and when does the behavior occur?
Through out the day without a specific location

Frequency and duration of behavior?
Varies

What happens before and after behavior?
There do not seem to be any definite antecedants

What does the student get from engaging in the behavior?
Not sure?

What is the emotional state of the student during the behavior?
Calm

Who is the behavior directed at?
Self?

Is the behavior intentional or involuntary?
Possibly involuntary, habit

Relevant health and mental health conditions?
None

Medication side effects?
None

Student strengths and interests?
Good academics, likely college bound

Have you noticed any patterns?
No

Possible Interventions:
Nail biting is a behavior that can have numerous root causes. That's really what is most important to first determine before targeting an intervention at the behavior. For example, some people nail bite due to stress, anxiety, fear, boredom, etc. And some people just do it out of habit or to self soothe, which does not really require any intervention unless the nails are bleeding and it is severe.

Regardless of the reason for the biting, I would think that after you determine the root cause, the intervention would likely need to include some kind of replacement behavior that is more productive/less harmful/less socially stigmatizing. If the nail biting is not severe and not destructive though, it may be that the nail biting is already a good or the best coping strategy for that student and there is no need to do anything.

If the biting is severe, or there seems to be severe or significant emotions and feelings behind the biting, then it could be helpful to give the student some additional or alternative coping strategies. You could even sit down with the student for a few minutes and have the student write down a list of alternatives to use when they catch themself biting their nails. they could keep the list in their pocket or in a folder and just choose an alternative on the list to do at that moment.

Some alternative coping strategies might include:
- listen to music
- take deep breaths
- write in a journal
- think about something relaxing or positive
- doodle
- draw
- stretch arms and hands
- feel something that has a stimulating texture, like a piece of VELCRO® brand hook and loop fastener, silky or smooth material, surface, etc (rubbing your nails can be soothing as they are smooth or rubbing hand on the desk top or a text book if it is smooth)
- get up and get a drink
- go to the bathroom as a way to get up and take a break
- open and close hands several times
- stretch or roll neck, shoulders, or back (rolling the neck can be very refreshing and releiving as many people tend to be tense in the neck area when anxious, nervous, uptight, etc.)
- close and rub eyes
- tap foot or pencil (this could be distracting to others if done too loudly. Tap pencil on arm or soft surface to avoid this)
- look out the window or around the room for a moment
- rest head on hands so the hands are covering the ears and blocking out sound, then breath in and out slowly, steadily, and deeply. Then imagine ocean waves coming in and out on a tropical beach. The slow steady breathing while covering your ears can sound like waves coming and going, which can be relaxing and soothing.

Strategies, like those above, could be put on a list and the student use that list on their own. Or if the biting really is a big problem, you may consider, in addition to the alternative strategy list, having the student and the student's teachers develop a secret signal, cue, gesture, or sign. When the teacher gives the student this sign or signal, like a tap on their shoulder or desk or something, the student knows this means the teacher has noticed they are biting their nails and they need to take out their list and use one of the alternative strategies.

If the student has serious anxiety or other emotional issues, you should refer them to the school counselor or meet with the student and their parent(s) to recommend or discuss how outside counseling may be helpful.

If emotional issues are not a factor and the student's nail biting is not severe/harmful/destructive, I would likely not do anything. Nail biting is not a horrible coping or soothing strategy when it is not severe, and any strategy that may replace it could be worse and more destructive. If it is indeed the case that the student does not have emotional problems and is just biting nails out of habit or to self soothe, I would likely still recommend to the student they use an alternative due to the fact that nail biting, when observed by others, can seem unsanitary or unprofessional, especially at the secondary and collegiate levels. You could frame it to the student that because they are older and the next step is college, they need to stop biting their nails as college is a professional setting where this will be looked down upon by fellow students and professors. Additionally, if there are job recruiters and other potential employers they have contact with at college, they will also look down upon this bad habit of nail biting. I would think the student would be very open and receptive to this approach as they are old enough to understand it.

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