Review Question - QID 108998

A 25-year-old male medical student presents to the student health clinic with a chief complaint of picking at his skin. He states that at times he has urges to pick his skin that he struggles to suppress. Typically, he will participate in the act during finals or when he has "too many assignments to do." The patient states that he knows that his behavior is not helping his situation and is causing him harm; however, he has trouble stopping. He will often ruminate over all his responsibilities which makes his symptoms even worse. The patient has a past medical history of surgical repair of his ACL 2 years ago. His current medications include melatonin. His temperature is 98.6°F (37°C), blood pressure is 112/67 mmHg, pulse is 92/min, and respirations are 14/min. On physical exam, you note a healthy young man with scars on his arms and face. His neurological exam is within normal limits. Which of the following is the most appropriate initial step in management?