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Health Tips for Parents
Does my child have OCD?
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Few children are without certain worries or fears, but for the estimated 1 to 2 percent of children with obsessive-compulsive disorder (OCD), these thoughts and behaviors become so intense they can be both greatly distressing and disruptive of the child’s ability to function.
Children with OCD are plagued by uncontrollable obsessions (persistent, irrational thoughts and fears) and compulsions (repetitive behaviors or rituals meant to prevent or correct a dreaded event) that can significantly impair their everyday functioning. Obsessions associated with OCD commonly involve germs or contamination, but they can also include such fears as throwing away something that might be important or violating religious or moral codes. Frequently seen compulsions include excessive hand washing, ritually checking objects and repeating mantras.
For children and adolescents, compulsions can often hinder schoolwork: The need, for example, to have numbers and letters look just right may lead students to constantly erase until there are holes in the paper and the assignment is never completed.
“Though OCD is often portrayed as a fear of contamination or the need to be orderly,” states R. Lindsey Bergman, Ph.D., director, UCLA Pediatric OCD Intensive Outpatient Program, “the severity and types of symptoms exhibited by children with OCD vary greatly.”
Treatment Research has provided evidence for two effective OCD treatments, Dr. Bergman says. One is medication, most commonly in the form of prescribed selective serotonin re-uptake inhibitors. The other — often used in combination with the medication — is a particular form of cognitive behavioral therapy called exposure and response prevention. “The child is exposed to the feared thought while resisting engaging in the compulsive behavior, in a graduated fashion — practicing at first with something that’s just a little bit scary,” Dr. Bergman explains. A reward system is used to reinforce the child’s attempts at engaging in exposure activities regardless of their success in resisting compulsions. Over time, and with follow-up at home, compulsive behaviors are extinguished as the exposures demonstrate that negative consequences do not result when the compulsive behavior or ritual is resisted.
Group Therapy
Proves Helpful “Children with OCD often feel very alone in that many of them haven’t met peers with the disorder,” Dr. Bergman notes. “Getting them in group settings and allowing them to share their experiences and work together can be incredibly helpful.” As patients near the end of their time in the program, the treatment team works to ensure a continuity of care to help reduce the risk of relapse.
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