Anxiety in Children

Obsessive-Compulsive Disorder (OCD)

What is Obsessive Compulsive Disorder, or OCD?

Obsessive-Compulsive Disorder (OCD) is a disorder characterised by frequently occurring disturbing thoughts or images (obsessions) which lead to feelings of anxiety or distress, and engaging in repeated or special rituals in attempts to dispel or prevent the obsessions from eventuating (compulsions). While certain rituals can be a normal part of a child’s development (e.g., wanting bedtime rituals to be the same each night), if your child is experiencing unwanted thoughts and engages in compulsive behaviours which interferes in daily life, they might have OCD. Sometimes, children with OCD anxiety may not be able to articulate why they have to do something in a particular way, only recognising that they need to do it. OCD will not dissipate on its own, and sometimes children who experience OCD can go on to have other emotional difficulties later in life. It is therefore important to seek professional help for your child if you recognise that they have OCD.

Examples of common themes of obsessions children can experience can include:

  • Worrying about germs and dirt
  • Worrying about hurting a loved one
  • Worrying about having cheated on exams or assignments
  • Thoughts that they have to count up to a certain number
  • Worrying about what they may or may not have said to someone
  • Worrying that everything has to be neat and tidy (e.g. school desk)
  • Worry about something bad happening to a loved one

Examples of common compulsions children can engage in can include:

  • Washing hands or showering in a special way
  • Mentally counting or saying things/special phrases/prayers
  • Asking the same question over and over again or “did I hear that right”
  • Avoiding certain numbers when counting
  • Dressing in a certain way (pulling socks up and down)
  • Checking lights switches or plugs lots of times
  • Sitting or standing in certain ways
  • Tapping things a certain way or a special number of times
  • Superstitious behaviours (e.g., wearing the same pair of socks to a football game; using a specific pen for exams)

What Treatments are Recommended for OCD

Cognitive Behavioural Therapy (CBT) including Exposure and Response Prevention (ERP) has been found to be the most effective treatment for OCD anxiety in children and adolescents. CBT works by helping children identify and challenge their dysfunctional thoughts, behaviours and overwhelming emotions, by changing their thought processes, allowing them to think and act differently in relevant situations. During ERP, children are gradually exposed to their feared situations with the guidance of their psychologist. ERP teaches children how to face their fears while refraining from their compulsions. This allows children to learn that their obsessive fears do not eventuate, and that their anxiety is tolerable and will subside over time. As with all CBT for children and adolescents, parental involvements is an important component of treatment.

Sources and Useful Resources