Acceptance and commitment therapy (ACT)-enhanced behavior therapy (A-EBT) is the most empirically supported treatment of trichotillomania. Support for A-EBT for excoriation disorder is budding. In this article, we review the A-EBT model, including support for targeting psychological inflexibility, as well as the use of traditional behavioral procedures to reduce non-focused behaviors. To date there are 17 studies investigating A-EBT for trichotillomania and skin picking across ages and treatment delivery methods (individual, group, telehealth, and asynchronous web-based delivery). The work has occurred by multiple research teams. Data on processes of change are reviewed. Future directions and limitations are discussed.