Child & Adolescent OCD Treatment

Obsessive-compulsive disorder (OCD) symptoms can manifest at any time, but many people first experience symptoms between ages 8-12 years old. It’s estimated that about 500,000 children and adolescents in the United States have OCD, although this isn’t an exact statistic.

Childhood  & Adolescent OCD symptoms can range from mildly frustrating to downright debilitating. It’s especially important for loved ones to know the warning signs and how to access treatment.

Child & Adolescent OCD Symptoms

OCD is a specific type of anxiety disorder characterized by obsessive, unwanted thoughts and compulsive behaviors. While many children experience anxiety, an OCD diagnosis specifically focuses on the presence of both obsessions and compulsions.

It can be easy for parents to overlook OCD because they assume that certain symptoms are just part of normal childhood development. While it’s true that many children prefer engaging in specific rituals or get upset when things don’t go their way, child OCD symptoms are time-consuming, compulsive, and associated with tension and irritability.

Children and adolescents with OCD may exhibit the following obsessions:

  • Need for symmetry or order
  • Fear of dirt or germs
  • Religious or spiritual obsessions
  • Lucky (or unlucky) numbers or patterns
  • Fear of contracting illness
  • Fear of harming oneself or others

Children and adolescents may exhibit the following compulsions:

  • Repeating certain behavioral rituals (i.e. needing to touch a doorknob in a specific way)
  • Grooming rituals (showering, brushing teeth, washing hands)
  • Checking rituals
  • Organizing and rearranging rituals
  • Cleaning rituals
  • Seeking ongoing reassurance from others
  • Excessive praying
  • Counting and recounting rituals
  • Collecting and hoarding items that seem insignificant

How OCD Affects Childhood Development and Temperament

Children with OCD may present as defiant. They can become obsessive at home and they might get upset if parents or other family members defy their normal routines. If something isn’t done “just right,” they may feel the need to start over until it feels perfect.

In young children, compulsive rituals act as a way to self-soothe in a scary and chaotic world. Parents may note that their child seems particularly reactive to changes in routine. They might also notice the early stages of compulsive rituals (i.e. wanting to do something a certain number of times or refusing to touch a certain item).

Unfortunately, parents or teachers might also dismiss the presence of OCD and simply assume that the child is being difficult, attention-seeking, or “dramatic.” Such conflict can exacerbate stress, which can worsen OCD symptoms (and intensify a child’s sense of shame).

Unlike young children, teenagers who develop OCD may try to hide their obsessions or compulsions. However, parents might notice their teenager struggling with certain tasks (like getting to school on time or finishing their homework). Some teenagers may also turn to disordered eating or substance use to cope with their intrusive thoughts.

It’s important to note that a child or adolescent can’t control whether or not they have OCD. In addition, someone with OCD is likely to experience co-occurring mental health disorders, including major depression, other anxiety disorders, body dysmorphic disorder, and eating disorders, all of which can exacerbate OCD symptoms.

Child and Adolescent OCD Treatment

Children and adolescent OCD can worsen progressively. Without treatment, symptoms can seriously compromise someone’s academic performance, relationships, self-esteem, and overall emotional well-being.

Treatment focuses on helping children become desensitized to their intense fears. It also helps them interrupt and, ultimately, stop engaging in their compulsive rituals. Over time, this allows the child to regain a sense of control over their lives. Even if they still have some anxiety, they can recognize their fears as heightened or irrational and cope with their stress productively.

How Parents Can Support Their Child’s OCD Treatment

If you suspect your child or adolescent may have OCD, it’s important to seek support. There’s nothing wrong with your child, and OCD is treatable. Even if you feel scared, try not to panic. Treatment can help your child manage their symptoms and improve their mental health.

A child psychiatrist or qualified mental health therapist can diagnose OCD after evaluating your child. Some clinicians prefer to interview both the child and parent during the assessment phase. It’s normal if you feel upset or concerned about a diagnosis. Remember that an accurate diagnosis can ensure proper treatment and recovery.

Stay Involved In Your Child’s Care

The best way to support children with OCD is by supporting their treatment efforts. Your child’s care team is there to help your child reduce their symptoms and regain a sense of control over their life.

If you need clarification about something, ask questions. But try to also let the professionals do their jobs. Remember that your child’s team has their best interest at heart, even if some of the techniques may seem uncomfortable or unfamiliar.

Reinforce Treatment Efforts at Home

The most effective OCD treatment requires that parents reinforce CBT and other exposure and response prevention techniques at home. During treatment, children will be given various homework assignments. Family involvement can help build confidence and maintain treatment strides.

Remember that your child needs you to believe in their resilience and capabilities. They also need to know that they are so much more than any mental health disorder or presenting set of symptoms.

Believe that they are more than any mental health disorder or presenting symptoms.

Avoid Constant Reassurance

Children with OCD often struggle to tolerate uncertainty or anxiety, and they may turn to their parents for reassurance. For example, they might ask, “Will I do well on my test?” even if they have studied the content extensively or if the parent has answered many times.

Parents must work with the child’s treatment team to avoid accommodating OCD or feeding anxiety. Children can and should rely on support from loved ones, but they also need to ultimately learn how to soothe themselves.

Look at Big Picture Progress

It’s easy for individuals and loved ones to get discouraged if a relapse occurs. A child’s symptoms can ebb and flow, and stress may cause old problems to resurface. It’s important to be mindful that progress generally isn’t linear. Slips happen, but each day presents a new opportunity for trying again. Getting stuck in all-or-nothing thinking often only makes everyone feel worse.

Try to validate baby steps. Even small gains are incredibly significant, and family members need to recognize all types of progress. This can encourage children to keep taking care of themselves, even if they feel discouraged.

Practice Your Own Self-Care

It’s crucial for loved ones to avoid consuming themselves in their child’s OCD. No matter what’s going on with your family, it is still important to set limits and focus on your own needs. Looking after your mental health can also help you feel like a more attentive and calm parent.

Final Thoughts on Childhood OCD

It is imperative that family members recognize the early warning signs of childhood and adolescent OCD. If there’s a family history of OCD or other anxiety disorders, a child may be more susceptible to developing OCD symptoms.

In almost all cases, OCD doesn’t go away on its own. Symptoms require ongoing management and attentiveness. It’s important that children receive the professional support and care they need during this vulnerable time.