According to the International OCD Foundation, approximately 1 in 200 children and teenagers have OCD, or obsessive-compulsive disorder--a condition characterized by obsessive thoughts that drive compulsive behaviors. For example, a child may obsess about the number ten, fearing that if he touches anything less than ten times, he may die. To reduce his anxiety, he compulsively touches everything in his room ten times before he exits. Treatment for childhood OCD often involves a combination of approaches, and support from parents and teachers can be vital.
Cognitive Behavioral Therapy
Cognitive behavioral therapy is a type of treatment that helps children understand the connection between their obsessive or fearful thoughts and their compulsive, ritualistic behaviors. It also arms them with specific, behavioral strategies to face their fears and stop resorting to compulsive habits. The treatment of choice for childhood OCD is called "Exposure and Response Prevention", or ERP. The first step in this treatment--exposure--involves gradually exposing a child to his fear--for example, that if he steps on a crack, he will break someone's back. The second step--response prevention--involves preventing the child from removing his foot from the crack to prove to him that this action did not cause anyone's back to break. Repeated exposure and response prevention both in the therapist's office and at school and home can help to reduce or extinguish OCD-related thoughts and behaviors over time. According to KidsHealth.org, many children can be successful with therapy alone; however, some may do better with a combination of therapy and medication.
Medication
The Food and Drug Administration has approved four antidepressant medications for use in treating childhood obsessive-compulsive disorder. These drugs are the selective serotonin reuptake inhibitors (SSRIs) fluoxetine, fluvoxamine and sertraline, and the tricicyclic antidepressant clomipramine. According to the International OCD Foundation, children are usually treated with one of the SSRIs first as clomipramine is associated with greater risk of side effects.
Children are usually advised to take one of these medications for at least one year. Because these drugs do not cure OCD, symptoms usually return a short time after stopping the medication. For this reason, drug treatment is often combined with cognitive behavioral therapy so that, should the symptoms return, the child can apply learned skills to manage the obsessive thoughts and compulsive rituals on his own. The child may start taking the medication again if he needs continued help reducing his symptoms.
School and Family Involvement
According to the International OCD Foundation, the way a family responds to and supports a child with OCD can have a tremendous impact on treatment; therefore, the parents, siblings and/or other people in the child's everyday environment may become a part of the treatment. In particular, the family may receive education about OCD and feedback about how their own behaviors are enabling the child's disorder.
Though well intentioned, parents often enable their child to, for example, avoid germs by washing his dishes for him, opening doors for him so that he does not have to touch the door knob, and so on. Parents may receive specific instructions for how to respond to these situations in a more constructive way that supports the goals of treatment.
Cincinnati Children's Hospital notes that teachers may also become involved in treatment. In addition to education about the disorder, the teacher may also receive guidelines for how to respond if she sees the child engaging in rituals or other compulsions while at school.
References
- International OCD Foundation: Medication for OCD in Children and Teens
- Cincinnati Children's Hospital: Obsessive-Compulsive Disorder
- International OCD Foundation: Cognitive Behavior Therapy for Children and Teens
- KidsHealth.org: Obsessive-Compulsive Disorder
- International OCD Foundation: Information for the Family
