Treating OCD in Children & Teens
Treating OCD in Children & Teens: Exposure and Response Prevention
Exposure and response prevention (ERP) is the gold standard, evidence-based treatment for Obsessive Compulsive Disorder (OCD). ERP is a form of Cognitive Behavioral Therapy (CBT) that teaches youth to face their fears (exposures) without doing compulsions (response prevention). Over time, the brain learns that the feared outcome doesn’t happen, and anxiety decreases. So, instead of providing temporary relief (like compulsions do), ERP helps youth build confidence in managing their anxiety.
What is OCD?
OCD is characterized by unwanted, distressing thoughts, images, or urges which lead to repetitive behaviors or mental acts that temporarily relieve anxiety. Over time, the cycle of obsessions and compulsions can become more intense, leading to significant interference in daily functioning. Individuals with OCD may recognize that their obsessions and compulsions are irrational, yet they feel powerless to control them.
OCD often requires treatment, such as Exposure and Response Prevention (ERP), and sometimes medication to help manage symptoms.
Assessment & Understanding
The therapist will help your child understand their OCD, including the specific obsessions and compulsions that are part of their experience. This involves identifying situations, thoughts, or triggers that lead to anxiety and compulsive behaviors. During this process, a therapist may ask a child to rank their anxiety caused to various objects or experiences.
Psychoeducation
The therapist will explain to your child the OCD cycle—how obsessions lead to compulsions that temporarily reduce anxiety, but in the long run, reinforce the OCD pattern. The therapist will help them understand that it’s okay to experience discomfort without acting on the compulsions.
Gradual Exposure and Response Prevention
The therapist will guide your child through feared situations, starting with the least anxiety-provoking. Gradually, they will confront more challenging situations. A key part of ERP is preventing compulsive behaviors in response to anxiety, allowing your child to tolerate the distress and gradually break the cycle of reinforcing OCD.
Repetition & Lasting Change
Repetition and gradual improvement involve consistently practicing exposure exercises to reduce anxiety over time, with the therapist reviewing progress and adjusting the exposure levels as needed. Clients continue practicing independently, using coping strategies to resist compulsions, and preparing for relapse prevention. Long-term strategies, such as mindfulness and coping skills, help young people strengthen their confidence and manage anxiety effectively outside of therapy.
Common OCD Challenges
Too many young people struggle with mental health challenges and cannot access effective care. We exist to expand access to quality, evidence-based mental health care for children, teens, young adults, and their families.
Contamination Fears
Contamination fears in kids and teens with OCD involve intense anxiety about germs or dirt, leading to repetitive behaviors like excessive handwashing or cleaning. These fears can disrupt daily life, affecting school, friendships, and overall well-being. Teens may also avoid certain places or situations to reduce anxiety.
Ordering
The ordering subtype of OCD in kids and teens involves a need for things to be arranged in a specific way. This can lead to anxiety if things aren’t "just right" and may disrupt daily activities like school, socializing, and completing tasks. The need for symmetry can interfere with overall well-being
Checking Behaviors
Checking behaviors in kids and teens with OCD involve repeatedly checking things, like locks or lights, to prevent harm or disaster. This can cause significant anxiety if they don’t check repeatedly, disrupting daily routines, school work, and social interactions. These behaviors can become timeconsuming and interfere with overall functioning.
Intrusive Thoughts
Intrusive thoughts in kids and teens with OCD are unwanted, disturbing thoughts that cause anxiety. These thoughts may involve fears of harm or doing something inappropriate, leading to rituals to neutralize the thoughts. They can be overwhelming, affecting focus, relationships, and daily activities.
What Can You Do At Home?
Start by gently reducing reassurance and accommodations.
Reassurance, like saying “Everything is fine, ” may ease anxiety short-term, but it feeds OCD long-term. Instead, acknowledge their feelings without trying to fix them. Try: “I know this is hard, and I believe you can handle it. ”
Accommodations, like helping with rituals or avoiding things that might trigger OCD, also keep OCD going. Begin stepping back while offering calm support. The SPACE program can guide you through this. Your steady presence at home is a powerful part of your child’s recovery
Caring for a child or teen struggling with their mental health can be a terrifying and isolating experience— CCAMH is here to help.
CCAMH accepts Central California Alliance for Health Medi-Cal, provides superbills for insurance reimbursement, and offers a generous sliding scale.
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