Questions to the Therapist: Children with OCD

Answering Questions about Children with OCD


Do you have a child with OCD? I recently received a question asking about information for children with OCD. In particular, "are there any special diets, medications or tools you would

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suggest."


First, I would like to assure any of you who have children exhibiting OCD type symptoms that you are not alone.


OCD symptoms in children consist of repetitive thoughts or images (obsessions) with ritual behaviors repeated again and again to manage those thoughts (compulsions).


Some obsessive thoughts that children may have include: preoccupation with dirt/illness, repeated doubts, thoughts of family getting hurt, needing order, excessive attention to detail, excessive worry or aggressive thoughts and urges. Some examples of compulsive behaviors may include: washing hands excessively, repeated checking and rechecking of things, excessive counting and recounting, repeatedly asking the same questions or repeating words, sounds or numbers.


Regarding medications or diets I would suggest consulting with a nutritionist or doctor as these interventions are not in my scope of practice. However tools that may be helpful should concentrate on use of effective coping skills and communication. Ultimately the child's compulsive behaviors are used to neutralize the feelings associated with the negative thoughts or images. By working with your child on coping skills and relaxation techniques they are able to access more healthy coping strategies to manage the negative thoughts and feelings. It is also important to talk calmly with your child exploring the thoughts that are resulting in these feelings/ behaviors. Sometimes by allowing the child to externalize these thoughts in a safe way assists in reducing the negative feelings/ behaviors. These thoughts can also be filled with distortions or inaccuracies so by examining them and attempting to restructure the thoughts with your child you begin to see a reduction in the compulsions.


If the problem persists therapy can be helpful in addressing OCD symptoms. Family therapy has shown to have good outcomes with focusing less on the child with OCD and more on the family unit by developing healthy coping strategies and resolution skills. Exposure Response Prevention Therapy has been effective in developing coping skills and gradually exposing the child to the triggers/anxiety. With gradual exposure, while continuing to focus on use of effective coping skills the child begins to feel less anxiety and develop new strategies for managing the feelings effectively. Cognitive therapy has also been shown to be helpful by examining the thoughts associated with the compulsions and challenging and restructuring those thoughts to create new feelings which results in more healthy behaviors.


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