Behavioral treatments for pica: A review of empirical studies

Behavioral treatments for the eating disorder pica are reviewed. An extensive search of the literature yielded five previous reviews, 45 articles, and 3 dissertations. Interventions designed to reduce pica are described, including self-protective devices, over correction, water mist and aromatic ammonia, brief restraint, differential reinforcement, discrimination training, patient self-report, and ecological modifications. Many interventions were associated with reductions or eliminations of pica and required few hours of intensive therapist or staff involvement. Methodological problems with the published database on pica are assessed. Suggestions for further primary research and reviews are included.