Obsessive compulsive disorder (OCD) is characterized by recurrent, persistent, and intrusive thoughts, images, or impulses (obsessions), which increase anxiety and discomfort, and repetitive, purposeful behaviors or thoughts intended to prevent or reduce anxiety and discomfort (compulsions). Children and adolescents with OCD may believe that the compulsions (also called rituals) will prevent obsessive thoughts or make them go away, but doing compulsions provides only temporary and short-lived anxiety reduction. Anxiety and discomfort return often with increased intensity once the obsessive thought reoccurs. This results in a vicious cycle of obsessions and compulsions, which causes escalating anxiety.
OCD occurs in about 2-3% of children and teens. Specific obsessions and compulsions can vary greatly from person to person, but there is a common theme of discomfort with uncertainty. Some typical symptoms can include contamination fears, repetitive and unwanted thoughts, images or impulses, perfectionism, and fear of harming oneself or others. Common rituals in children can include compulsive washing, repeated checking, repetitive behaviors, perfectionism with schoolwork, excessive reassurance seeking and mental rituals. For children and adolescents, OCD may cause stress in the family, problems at school, difficulties with friends and may interfere with participation in activities.
Treatment for OCD:
AATC offers the first-line, scientifically-based treatment for OCD—Exposure and Response Prevention (also called E/RP). E/RP is a specialized form of Cognitive Behavioral therapy. Children and adolescents learn cognitive tools to address their anxiety. Then, through gradual exposure, they learn to confront feared thoughts, images, objects and situations. Response prevention teaches them to resist performing compulsive rituals. The natural drop in anxiety that happens when a person stays “exposed” and “prevents” the “response” is called habituation. By doing this, the person “retrains their brain” to extinguish the fear. Once treatment goals are achieved, maintenance and relapse prevention training is an important part of the treatment plan. Parents will be informed of the tools the child is learning so they can reinforce progress at home.
Because OCD may affect a child’s daily life, there is also a supportive component to therapy where the child can discuss life stressors and concerns. In some cases, family sessions can be helpful to address the impact of OCD on the family. With parent permission, our therapists will work with a child’s school, pediatrician, psychiatrist and other community providers as needed.
Our focus is on treating the “whole child,” so issues other than anxiety may also be addressed in treatment.
An Important Note: Some people get very stressed about the prospect of completing E/RP and may be anxious about treatment. This is most common prior to starting treatment and quickly fades once the individual begins practicing regular exposure. Keep in mind that this is common, and our therapists are used to working with children and teens who may be resistant to treatment. Our therapists will work collaboratively with clients to develop treatment goals and work at a pace that is agreeable to the client.
For more information regarding treatment for children and adolescents, or to schedule an initial evaluation for your child, please contact Dr. Lori Kasmen at (610) 667-6490 ext 21 or email@example.com
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