What To Do When Your Child Has Obsessive-Compulsive Disorder
First off, breathe. Your child is not alone, and treatment options are available. According to the International Obsessive Compulsive Disorder Foundation (IOCDF), Obsessive Compulsive Disorder occurs in 1/200 children and is defined as, “an anxiety disorder that consists of obsessions and compulsions. Obsessions are unwanted ideas, thoughts, images or urges that are unpleasant and may cause worry, guilt or shame. Compulsions, also called rituals, are behaviors the child feels he or she must perform repeatedly to reduce the upsetting feelings or prevent something bad from happening.
To be diagnosed as OCD, these behaviors must be time-consuming and interfere with the child’s daily life.” (1) Obsessions include, and are not limited to, fears of germs, dying (self or others), doing things correctly (perfectionism/just right) , bad situations occurring, religious/moral themes, becoming ill, or even thoughts of sexual nature (typically seen in older children/adolescence if it occurs.)
Compulsions and Rituals
Your child may feel compelled to perform rituals or abide by specific rules, to ensure that the “bad thought” will not occur. Rituals can be performed physically and mentally. Compulsion examples include, and are not limited to: washing/cleaning repeatedly or in a ritualistic way, repeating behaviors, re-reading/re-writing, seeking reassurance over and over again (to self or asking others the same questions repeatedly), avoiding things that may be contaminated/dirty, tapping/touching, and even ordering. At times, the child with OCD may appear defiant due to an obsession limiting them to continue with a daily task.
Please understand, this is not defiance. Your child is suffering from a debilitating disorder that is causing them to struggle with daily functioning. In 1990, the World Health Organization reported that OCD ranked 11th for non-fatal burdens globally; however, this number has dropped in recent years due to improved data on the prevalence of the disorder and how to treat it (2.)
You might ask yourself, “How did my child get OCD?” “Could I have prevented it?” or “How do I know that this is not just Autism, ADHD, or another anxiety disorder?” These are questions that several parents have asked me in my office. My answers are similar to how I treat OCD: Uncertainty. Researchers believe that OCD may be genetic; however, that is uncertain. No one knows for sure if OCD is preventable. Lastly, OCD “rarely walks alone,” meaning the chances that your child also has another disorder is high. Thankfully, psychology has come a far way, and a thorough diagnostic evaluation will rule these disorders out. However, psychology still has its uncertainty, and OCD, in particular, can be challenging to diagnose.
OCD is treatable. It is not curable. Read that again. This can be a complex statement for some parents to learn. The goal of OCD treatment is not for your child to stop their thoughts or even decrease their thoughts. The goal of treatment is for your child to face their fear and tolerate uncertainty. OCD wants to ensure your child that they will be safe and the “bad thoughts” will not happen. The reality is that bad things do happen, and most are outside of our control. To your child, OCD can appear like a peer who has their back and protects them from harm, but the truth is that OCD is a bully. Would you allow a bully at your child’s school to continue to bully them? Would you allow your child to continue to feel shame, danger, and intense anxiety from this bully? What if your child said they wanted to kill themselves due to the bullying? (By the way, children who have a history of being bullied have a high risk of dying by suicide, and those diagnosed with OCD are also at high risk of dying by suicide.) If you would not allow your child to be a victim of bullying, let’s talk about treatment options.
Treatment for OCD
Do a quick internet search for “Child Therapist for OCD” for your town. Click on their website/therapy profile, and see if they use Exposure and Response Prevention Therapy (ERP.) ERP is the key here. Multiple providers claim they treat OCD utilizing play therapy, EMDR, or basic CBT and the truth is that those interventions are not as effective as ERP. You can read more about it here.
Play therapy, EMDR, and basic CBT are all beautiful strategies, and they have their place. Their place is just not for OCD. If searching your area for an OCD provider and nothing comes up, check out NOCD, an online OCD treatment resource. ERP is hard work, and it requires parental participation. Treatment of OCD is a team effort, and your child needs you to be on their team.
Locating a trained therapist in OCD treatment is your best option for your child’s recovery.
Your child deserves recovery, and it is possible. So now you know what to do next, you can take another breath, hug your child, and contact a specialist. You got this!
- Obsessive Compulsive Disorder in Children and Teenagers. (2014).
- World Health Organization. (2006). Global burden of obsessive-compulsive disorder in the year 2000.
Krista Reed is the owner of A Peaceful Balance, LLC, Therapy and Kids Yoga. As someone who
has been diagnosed with OCD and Excoriation Disorder, Krista knows what it is like to be
misunderstood and treated improperly by professionals. Krista has attended several trainings for
OCD, BFRBs, and BDD and obtained a certification of Exposure and Response Prevention
Therapy through the Perelman School of Medicine at the University of Pennsylvania. Krista has
written children’s books on mindfulness and skin picking. Krista has also founded the ICT OCD