Parents can impact the success of their child’s
OCD treatment
What is OCD and how many kids struggle with OCD?
Before you can help your child through their treatment, you must first understand what OCD is.
Obsessive-Compulsive Disorder (OCD) is a brain-based anxiety-related disorder that causes considerable suffering and can interfere with all areas of life. OCD has many symptom profiles, also called OCD subtypes or OCD symptom dimensions.
OCD affects between 1 and 200 children and teens around the world (stats from IOCDF website). On average it can take eleven years to receive an OCD diagnosis and seventeen years to receive the proper treatment. (Stats from advanced interventions UK)
OCD consists of anxiety inducing intrusive thoughts or images, that can only be relieved by completing a compulsion, also known as a ritual.
Compulsions can be somatic (physical): needing to breathe a certain number of times, needing to wash their hands a certain way, needing to check to see if they really did lock the door, or needing to brush their hair a certain way. Somatic compulsions are not limited to this list, somatic compulsions can be anything.
Compulsions can also be entirely mental (sometimes called “pure-O””). These Pure-O compulsions can be much harder to identify, as the person experiencing them is experiencing them internally. They may be silently praying repeatedly, they may be mentally reviewing past events to find evidence that their intrusive thoughts are true, they may be reassuring themselves that they are good, or that their thoughts aren’t true.
How is OCD treated?
The gold standard treatment is a type of cognitive behavior therapy called Exposure, Response, Prevention (ERP)
ERP works by having people with OCD face their fears/intrusive thoughts.
OCD thrives on uncertainty, which is often why people with OCD ask seek reassurance from friends and family.
In ERP therapy, the person will be given various tasks to do, for example:
- If they are anxious/uncomfortable touching a doorknob, their therapist may have them touch the door knob a once a day.
- If they seek reassurance, their therapist may tell them they are no longer allowed to ask for reassurance.
- If they have intrusive thoughts “am I bad?” they may be told to respond to the thoughts with “am I bad? Maybe I am! Who care!”
- If they need to wash their hands, their therapist may tell them not to wash their hands anymore, or to delay washing their hands for as long as possible.
An experienced OCD professional will never start with exposure treatments that cause too much anxiety.
They will determine which exposures to start with based on the severity of anxiety relating to OCD compulsions.
Your OCD expert should determine which obsession and compulsions is the least stressful and the most stressful and then start with the least stressful, gradually working their way up to the most stressful over time, and only when the patient is ready.
How can a parents role make or break the success of ERP treatment?
ERP tasks will not only be completed during therapy sessions – the therapist will also assign ERP homework.
Parents come into the treatment equation when it comes to ERP homework. The success of ERP treatment is contingent on how much the patient adheres to ERP homework assignments in between therapy sessions.
For treatment to be successful, the parents, siblings, extended family, and close friends, all need to be aware and on board with the homework that their loved one has been assigned.
ERP can be very difficult emotionally for both the parent and child. It is hard witnessing your child struggle, but it is often necessary.
Parents can inhibit the treatment process by:
- Offering reassurance when their child asks for it
- Carrying out rituals and compulsions for their children/teens (for example, opening a door for their child that the child thinks is contaminated)
- Purchasing special handwashing supplies and making handwashing stations to prevent hands from becoming dry and cracking – don’t supply these things!
- Changing family schedules and living arrangements for their children
- Allowing their child to stay home from school because they want to stay home
- Allowing them to avoid siblings because they feel they are “contaminated”
- Tolerating delays due ritual completion (being late for school because your child needs to brush their hair just right, etc.)
- Decontaminating clothing or living spaces
- Trying to rationalize their OCD or apply logic and reasoning to their OCD
- Negotiating with them
- Questioning their child’s OCD expert and their approach to ERP – your child’s therapist wants to help
It can be hard for parents to know the difference between enabling their child’s OCD and offering comfort. It is important that parents listen to their child’s OCD expert and follow through on the homework assignments no matter what.
A child’s anxiety may get worse before it gets better – but parents must buckle down and persevere through it.
Getting Help for Your Child’s OCD When Parents are Divorced
Conflict between parents can harm the healing process. Working together is the key to success.
Obsessive-compulsive disorder (OCD) is a brain-based anxiety-related condition that causes considerable suffering and impairment.
- Both parents need to be on the same page in your child’s treatment
- Don’t play the blame game and put your child in the middle
- Keep communication with your co-parent clear and simple
- Sit down with your child together and explain to them that they have OCD
- Keep daily routines consistent in both homes
Obsessive-compulsive disorder (OCD) is a serious condition that can affect people of any age, including children. When your child has OCD, it affects the whole family. Relationships with parents, siblings, and daily routines are often disrupted. This is all made more complicated when parents are divorced or separated, and the child with OCD goes back and forth between homes, particularly in high-conflict situations. In these situations, it’s important to learn how to set your adult feelings aside and focus on your child.
Here are 7 things you and your co-parent can do to help support your child in getting well and staying well after being treated for OCD.
1. You both need to be on the same page when it comes to your child’s treatment.
Exposure and Response/Ritual Prevention (ERP) is the gold-standard treatment for OCD, and this is the treatment your child should receive first. Medication should be a secondary option, especially in young developing children.
ERP is hard work and requires the involvement of caregivers. Both parents need to be involved and kept in the loop regarding ERP homework, OCD symptoms and compulsions, and how to handle when your child is in distress and stuck doing rituals. The response and support in these situations need to be consistent in both homes.
2. Don’t play the blame game and put your child in the middle.
OCD is caused by a mix of genetic predisposition and environmental factors.
This is not the fault of your child or your co-parent. Don’t use the child’s condition to inflict emotional harm on the other parent. OCD should never be used as a weapon. Your child needs love and support from both parents.
3. Give your co-parent the benefit of the doubt. They want your child to get better as much as you do.
The other parent will be willing to put the time and work into helping your child, too. It is natural to worry about your child, especially when they are not well. You need to trust that your ex will have the best interest of the child in mind and follow the treatment plan.
4. Remember that people recover from OCD at different rates.
If your child is taking longer to recover then you think they should, this is not anyone’s fault. Ask the child’s therapist what you can do to help your child get better faster. (Don’t ask the therapist what your ex should do!)
Remind your child that you love them and will support them through their treatment no matter what.
5. Keep communication with your co-parent clear and simple.
Make sure you communicate with each other about therapist and doctor appointments, attend them together, and are willing to hear your co-parent when they offer suggestions for treatment and therapists.
By keeping both parents involved in treatment and on the same page, you are giving your child the best chance to overcome their OCD. Do not turn your child’s appointments into opportunities to attack the other parent.
6. Sit down with your child together and explain to them that they have OCD.
Your child should know that they have OCD.
They should be told what their treatment plan will be, that they need support from both parents, and that they will have love and support from the whole family throughout their treatment.
7. Keep daily routines consistent in both homes.
Children thrive on routine and predictability. Keeping bedtime, wake up times, and mealtimes consistent for your children in both homes can be very beneficial for your child.
It’s not easy.
When someone in the home has OCD, it is stressful for everyone. People are often not their best selves when they are stressed. It is natural to feel angry about your child’s condition. It is natural to want to assign blame, but conflict between parents will only make the child’s condition worse.
When you are co-parenting a child with OCD, make sure that the therapist knows how to treat OCD and also has experience working with couples and families. It would be important to request someone with expertise in both OCD and family therapy. If you are not able to engage in conflict-free co-parenting, consider separate family therapy with your ex to enable both of you to work together for the sake of your child to be better co-parents.
The Impact of OCD
How Can BWC Help?
Our group of caring clinicians can offer the Gold Standard in treating OCD, Exposure and Response Prevention (ERP). Reach out to one of our client intake coordinators to learn more about how this may help you!
Lasting Relief
At the Behavioral Wellness Clinic, our approach is simple: to provide strategies which can be used lifelong. This means that after your initial treatment, we will continue to provide follow-up care, but will also strive for you to be empowered within your own care and life.