OCD is an anxiety disorder marked by intrusive thoughts (obsessions) and repetitive behaviours (compulsions) that children feel compelled to perform. These obsessions can lead to significant anxiety, and the compulsions are attempts to neutralise or reduce this anxiety.

Children with OCD often recognise that their obsessive thoughts and compulsions are illogical, yet they struggle to ignore or control them. This is why treatment for child OCD is so crucial in helping children learn how to manage their thoughts and behaviours effectively.

Common Obsessions and Compulsions in Child OCD

Obsessions (repetitive, intrusive thoughts) can include:

• Fear of germs, dirt, or bodily fluids
• Worrying about contracting a disease or illness
• Thoughts of harm coming to themselves or loved ones
• Religious or superstitious concerns

Compulsions (repetitive actions) often seen in children with OCD are:

• Excessive hand washing or cleaning
• Counting or touching things in specific ways
• Checking items repeatedly, such as locks or appliances
• Seeking constant reassurance from others

Understanding these patterns is key to providing effective treatment for child OCD, which can help the child gain control over their compulsions and improve daily functioning.

Cognitive-Behavioural Therapy (CBT) for OCD Treatment

Research consistently shows that Cognitive-Behavioural Therapy (CBT) is an effective treatment for child OCD. CBT helps children learn to challenge their obsessive thoughts and resist the urge to perform compulsions. The process involves several key strategies:

Stress Management

OCD symptoms often worsen during stressful times. Teaching children stress management techniques can help reduce anxiety and prevent the escalation of obsessive thoughts and compulsions.

Relaxation Skills

Learning relaxation techniques, such as deep breathing, helps to reduce physical tension and anxiety, which can be especially useful when confronting OCD triggers.

Cognitive Therapy

This approach involves examining the irrationality of obsessive thoughts and replacing them with more realistic thinking patterns. By combining cognitive therapy with exposure and response prevention (ERP), children can gradually reduce their compulsions and the anxiety they cause.

Exposure and Response Prevention (ERP)

Exposure and Response Prevention is the gold-standard behavioural strategy used in treatment for child OCD. In ERP, children are gradually exposed to the situations or objects that trigger their obsessive thoughts while being encouraged to resist performing their usual compulsive actions. Over time, this process helps the child realise that the feared consequences rarely come true, and that their anxiety will naturally decrease over time without the need for compulsions.

For example, a child who fears contamination from germs may start by using a public toilet but only washing their hands a limited number of times. Each time they face their fear, the anxiety lessens, and they gain the confidence to confront increasingly challenging situations.