Loom is an integrated wearable device and mobile app that
helps parents of children with Trichotillomania maintain their condition over time.


September, 2019 - December, 2019 (12 weeks)


Double diamond process model; Figma, Principle,
Photoshop, inVision


UX Designer
Visual Designer
3D modeling


Alex Krzyzosiak
Zoe Rathbun
Yating Zhang


Trichotillomania is an impulse control disorder that involves pulling out one's hair. The typical onset age of Trichotillomania is 10-13. We noticed through our research that there is a lack of understanding around Trichotillomania. Children with Trichotillomania tend to blame themselves, and their parents are under a lot of pressure to take care of them. The family's openness is essential for their wellbeing, but parents usually do not know how to talk to their children about Trichotillomania.

Our solution, Loom, weaves a system of support for primary caregivers to help maintain their child's Trichotillomania over time. It provides visibility and a sense of control by visualizing maintenance using wearable technology. Loom also can help caregivers and children to identify and log triggers and create a dialog between primary caregivers and children by delivering relevant and contextual activities.


Research, Insights, Ideation, and Prototypes

As a team, we need to solve problems for people with mental health issues. We have about 12 weeks to finish this project from problem setting to high-fidelity product design. When we did this project, we followed the double diamond design process model. 

Research Goal

Throughout the research, we wish we can:

(1) Broaden our understanding and knowledge about Trichotillomania,
(2) Get insights on their current situation and walk-arounds, and finally,
(3) Explore opportunity spaces on how we can help parents of children with Trichotillomania.


What is Trichotillomania?

Trichotillomania(trick-o-<ll-o-may-nee-uh) (TTM or “trich”) is a body-focused repetitive behavior classified as an impulse control disorder which involves pulling out one's hair. Hair pulling may occur in any region of the body in which hair grows but the most common sites are the scalp, eyebrows, and eyelids.

  • 1 to 2% of the population has Trichotillomania.
  • The typical age at onset of Trichotillomania is usually 10–13 years old.
  • Trichotillomania is more common in women than men. 


In order to get an in-depth view on  Trichotillomania, we conducted culture probe and follow-up interviews with:

  • Primary caregivers of children living with Trichotillomania.
  • Adults who developed Trichotillomania as children and who still have it.
  • Adults who developed Trichotillomania past childhood.

We got 4 responses of the culture probe and get chance to talk with 3 of our participants. Then we leveraged affinitization to analyze and make sense of the data we collected. 

Insight #1:

Trichotillomania isn’t something that people “can just stop”, it’s just a part of people’s lives.
It is important to keep in mind that Trichotillomania is a lifelong condition, and people need to learn to live with it. The lack of knowledge around Trichotillomania makes people think this is just a bad habit, which is not true.

Insight #2:

Trust and openness between someone who has Trichotillomania and their family is important to their wellbeing.
One of our participants mentioned that the open relationship between her daughter and her is the most successful tool that they currently have. Among our interviews, not all of the participants have an as supportive family as they do. They all wish their parents can be more understanding and supportive when they are in the beginning stage of Trichotillomania.

Insight #3:

Those with Trichotillomania tend to blame themselves and hide their behaviors which can negatively impact how they feel about their Trich.
“She tries to hide the pulling by kind of sinking down in the couch and will wrap herself up in blankets so I can’t see her behind the couch.” Saying by one of our participants who is a mom of a daughter with Trichotillomania. Hiding behaviors or shame may give further stress to children. Not only that, but they might miss the chance to go to see the therapist or start medication.

Insight #4:

Primary caregivers are under a lot of pressure to care for their child.
Primary caregivers always need to keep an eye on their children’s behavior to understand their children’s behavior and keep track of their Trichotillomania. One of our participants has to take her daughter homeschooling. On the other hand, it takes a lot of money to see therapists.


I took the lead on creating two personas based on our interviewees’ real story and feeling to emphasize their emotional frustrations to help us better understand their frustrations and build empathy.

Design Challenge

How might we reduce stigma while increasing awareness, understanding, and dialogue around Trichotillomania for children who are often ashamed and primary caregivers who are unsure how to help?


We came up with and sketched more than 90 ideas in total based on the accumulation of the research and insights. Then we started to group ideas that share some similarities.


After grouping our ideas that had similar attributes and themes, we identified that most our ideas primarily fell into the areas of:

(1) Individual/low tech - fidget toys, parent-child game
(2) Individual/high tech
(3) Public/lower tech

Design principle

We identified four Design principles to help us to do further down-selection.

Create a feeling of control.
A solution will make sense of the complexity that is Trichotillomania and all of its triggers while providing actionable steps to reduce pulling behavior.

Reduce the load.
A solution will minimize the emotional and cognitive load that primary caregivers often feel as a result of constantly caring and monitoring their child.

Deliver encouragement,
not shame

A solution will consider the shame children and blame primary caregivers already feel, providing interventions that will focus on the positive during and following pulling episodes.

Provide ongoing support.
A solution will foster a long lasting and reliable support network between primary caregivers of children with Trichotillomania.

3 Ideas &

Using our fourdesign principles to assess how each of our ideas most embodied the principles, we were able to down-select to three clusters:

  • Parent to parent support
  • Encouragement
  • Provide users a sense of control

A mobile app that allows primary caregivers to match with others local to them who also have a child living with Trich to help primary caregivers create a long lasting and sustainable support network with other primary caregivers who have similar experiences.

⭕️ Create a feeling of control.
✅ Reduce the load
⭕️ Deliver encouragement, not shame
✅ Provide ongoing support

A stick-on VUI device that can be adhered on a toy or object of the child’s choice to deliver conversational, non-threatening accessible CBT interventions in the home.

Create a feeling of control.
✅ Reduce the load
✅ Deliver encouragement, not shame
⭕️ Provide ongoing support

An integrated wearable device and mobile app that helps caregivers better support their child by enabling visibility of pulling triggers and patterns while providing a way of opening the dialogue with their child to help them reduce conscious/subconscious pulling without shaming.

✅  Create a feeling of control.
✅ Reduce the load
✅ Deliver encouragement, not shame
✅ Provide ongoing support

The last one can approach all of our design principles. After careful consideration, we all agreed that this one with most potential and feasibility, we decided to go with this idea.


After we settled down with one idea, I translated the idea into a storyboard so that we could better explain our concept and help us better understand the user scenarios.

Paper Prototype

The first iteration is a paper prototype. We divided the application into three user flows: the onboarding process, data review, and conversation facilitation process.

User flow 1: On boarding key features

  • Frame as a team effort.
  • A customized experience by entering information of users.
  • Calibration to increase the accuracy of the bracelet.

User flow 2: Data review&identify triggers

  • Daily report about child’s pulling behaviors.
  • Data of child’s pulling behaviors at a glance.
  • Log triggers & identify patterns of behaviors.
  • Over time, users are able to see an overview of triggers. 

User flow 3: Conversation facilitation

  • Facilitate conversation between primary caregivers and children.
  • The conversation helps parents figure out triggers of children’s pulling behavior.

Users Assessment

We did user tests based on this paper prototype. The paper prototype is easy to make and can provide us a lot of insights to move forward.

Insight #1:

While vibration was the most effective haptic feedback method for notifying users, they perceived these interactions as more negative than positive.  

“If I kept feeling this each time I pulled my hair I would feel like I’m being punished.”
(Participant E)


We decided to get rid of any forms of haptic feedback and instead we wanted it to play more of a retrospective and information gathering role.

Insight #2:

During the onboarding process, the part that requires children to put on the bracelet and do the gesture that they usually pulling their hair with might be obtrusive.

“Imagine that situation, as a family we sit down together and try to set things up. Am I going to say ‘do your pose that you always pull’? That is very disrespectful and can create further shame on my daughter.”(Participant B)


We want to deliver encouragement instead of shame. Therefore, we want to redesign the onboarding flow and ideate on new ways of calibration.

Insight #3:

Participants mentioned they do not like “daily report.” A daily report can make their children feel like they are taking an exam every day, which will put further stress and pressure on them.

"I'm not loving the connotation of having a daily report. As parents of children with Trichotillomania, I don't want to make children feel they do anything wrong. I don't want to control them or fix them, because they didn't do anything wrong. The current design of the graph makes me feel very stressed." (Participant A)

Parents don’t need to know every time their child has pulled - often, there is nothing they can do about it at the moment, which can cause extra stress.

“I would have had a total breakdown at work if I had been getting these messages every single time my daughter was pulling her hair.”(Participant C)

Providing parents with an overview of their child’s pulling and triggers is helpful in understanding what actionable steps they can take to help in the future.

“If I need to go to see therapist with my daughter, those data can be very helpful.”(Participant A)
“I am curious about my Triggers, so next time I can have a fidget toy with me”(Participant D)


We want to deliver encouragement instead of shame. Therefore, we want to redesign the onboarding flow and ideate on new ways of calibration.

  • We decided to get rid of the connotation of “daily report,” but leveraged visual representation of in-bounds and out-of-bounds to provide users some information about their recent pulling behavior while avoiding the feeling of clinical.
  • We decided to remove constant messages or notifications.

Insight #4:

Users do not like the type of conversation when there is a clear purpose.

One of the participants said they do not want their children to have a sense of they are being policed, but what they really want is to open up a conversation and make their children willing to talk to them.
“I don’t want my child feel like I am trying to be a spy and try to get something out of her.”(Participant A) 

Informal story facilitation was perceived as a positive way to discuss feelings with a child.

Frequent conversations between parent and child are helpful in building supportive relationships.
“The idea of focusing on how to make you feel good and to self-soothe is good.” (Participant A)


  • We decided to simplify the goal of the conversation. Instead of trying to find out their triggers through conversation, we want it to be a chance to talk to each other and focusing on self-soothing.
  • We thought about these activities on a spectrum of the types of conversations primary caregivers will have with their children. We decided to provide multiple activities and tie specific to how the child is doing (whether they are pulling a lot or whether they’re within their typical pulling range) that consider the broader context of how the child might be feeling.

Final Outcome

The Loom Bracelet

The bracelet can detect geolocation and time, and the app helps the child and parent add triggers by leveraging information collected to help them think retrospectively.


The process of creating an account and ordering the bracelet is framed as a team process such that the child is present and is involved in the decision making to get the Loom bracelet, so they don’t feel policed or monitored.

It’s also framed as a lifelong journey, and that the primary caregiver needs to be an ally in helping their children manage Trichotillomania. They can personalize their experience together, so it’s ready to use when she gets it.

Once users receive their Loom bracelet, they could start to use the Loom app. The system learns about the child’s pulling behavior and typical pulling range over a few weeks as they go about their daily lives.

Users will receive a notification saying that the Loom finishes learning about you. They can go back to the Loom app, walk through a few tips of using Loom.

Add Triggers

With information about when pulling has occurred, the app will provide instances of pulling behavior for the child and primary caregiver to add triggers to. It allows them to log what activities they were doing and how they were feeling at the time to help them understand potential external and internal cues - “triggers” that occur before pulling.

Over time, Loom will provide patterns that they can learn from in an approachable manner, providing a sense of control and help them maintain their Trich. For example, if they know that tests are triggers, they can make sure that the child has a fidget with them when they have a test.

Provide ongoing support

As children will become adults one day, and Trichotillomania is something that will never go away, supporting children in learning to maintain their Trichotillomania on their own is the eventual goal of our app.

Our app focuses on building healthy and positive perceptions through parents so that as children grow older, they can see themselves and their Trichotillomania in a positive light, reducing stigma for both parents and children. In this way, we hope to support long-term emotional well-being. Loom allows parents to “pass” the Loom app and account over to their child when they are ready to maintain it on their own.

Visual Design/
Branding etc

We came up with four main brand values: supportive, encouraging, approachable, and reassuring, to help inform the emotional connection that our target users will have with Loom.

Color palette
Based on our research of the target user group, we ideated and created a color palette for Loom that could represent our four brand values. I led on the design system and finished the whole.

 🎨  Click to see the full version of design system


“I think you are creating something that can truly help achieve this, So amazing!”

We emailed the demonstration of our final prototype to the participants of our interviews. They said they were very excited and they wanted to try it out. Feedback from a mom of a child with Trichotillomania, “Parents need to learn that there is so much they can do to help their child without trying to control or fix them. And they need to empower their children to feel in control and never “broken.” I think you are creating something that can truly help achieve this. So amazing. You should be proud.”


User Testings are important
“Daily report” is widely used in health-related areas as well as mental health-related issues. Therefore, when designing this, we didn’t notice that this may create further stress for users. I feel the importance of user assessment once again because it really can help you find out problems in the early stage.

Being flexible and caring during interview
This project was the very first time for me to focus on mental health-related issues. I value this experience a lot. During the usability testing, one of the participants, the mother of a child with Trichotillomania, feels very stressed and sad because of the “daily report.” She kept saying this is so intense, and we decided to stop the usability testing immediately. I learned from this experience of being flexible during the interview. Besides, when doing interviews, the interviewer should not only focus on their goals but also need to be caring about the emotions and feelings of participants.

Future Vision

We kept the concept of a minimum viable product in the head when we were trying to design Loom. Therefore, although we thought about many possible functions, we did not include them in there. In this session, I want to introduce some of the features that we thought might be good for future implementation.

As more and more caregivers of children with Trichotillomania start to use Loom, we want to create a sense of community. Users can explore and find others' experiences, what worked well for others, etc. For example, add data-based features like 40% of Loom users found or said a particular tool is useful. Users can also search by triggers to look for what other people might doing during a specific situation. For example, they can click on TV to get ideas for what helped others in this particular situation.

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