4 Steps for Supporting Children With OCD Without Providing Accommodation

As someone who grew up with obsessive-compulsive disorder (OCD), I often reflect back on what my childhood was like and all of the ways in which OCD impacted not only myself, but also my family. Through my childhood memories, I’m reminded that OCD doesn’t care who gets in its path; it can be destructive and life-altering for the entire family—particularly when family members end up inadvertently accommodating a child’s OCD symptoms.

Well-intended efforts to support a child with OCD enter the realm of family accommodation when they involve family members making adjustments to alleviate a child’s distress and anxiety or prevent negative outcomes related to their OCD symptoms. While accommodation may initially provide some relief, this relief will be short-lived and will only serve to reinforce a child’s compulsions, perpetuating the OCD cycle and increasing strain on family members.

Learning strategies to reduce accommodation and support children in managing their OCD symptoms can help parents and family members avoid these challenges.

1. Recognize your child is suffering

When a child is first diagnosed with OCD, their family members may be shocked to find out that the child meets the criteria for this condition. Up to this point, their understanding of OCD may have been shaped by society’s misguided views of the condition and narrow portrayals of OCD in the media. As a result, they may have no idea what their child is actually dealing with at this early stage in their journey.

If you are looking into family accommodation and how it can affect children with OCD, there’s a good chance you may have already done the very hard work of recognizing that something was going on with your loved one, learning more about how OCD can present in children, and taking steps to get a proper diagnosis and treatment for your child. You may be one of the many parents and caregivers who’ve spent years trying to get to the source of your child’s suffering, potentially struggling through misdiagnosis after misdiagnosis along the way.

Symptoms that may have presented in your child prior to you seeking help for them may have included the following examples:

• Temper tantrums, angry outbursts, or behavioral difficulties
• Spending time lost in thoughts or behaviors that seem repetitive or unusual
• Changes in sleep patterns or eating habits
• Excessive rearranging, ordering of items, or time spent washing
• Spending unusual amounts of time alone, particularly in the bathroom or shower
• Repeatedly asking questions, even after they’ve been answered
• Homework struggles
• Perfectionistic tendencies
• Extreme anxiety or fearfulness
• Frequently confessing thoughts and feelings
• Excessively checking to confirm if something is “normal”

Of course, the list could go on and on. We know that OCD can be very nuanced, and these are just a few of the many ways in which its symptoms can lurk in the lives of children and adolescents. One child may only exhibit some minor changes in behavior that become more obvious over time, while other children may exhibit extreme differences that seem to come on quite suddenly, causing a great deal of concern for their family members.

But no matter how OCD presents in your child, it has likely caused them a great deal of suffering. As you interact with your child, keep in mind that depending on their age, they may not understand what they’re experiencing or why they’re struggling with such intense emotions. Their fears can feel incredibly real, even if the outcomes they focus on seem unlikely to you. Recognizing where your child is coming from can help you approach OCD-related challenges with a mindset of empathy and compassion, allowing you to support them more effectively.

2. Recognize the impact OCD can have on the entire family system

Just as it’s essential to acknowledge the impact that OCD can have on your child, it’s equally essential to recognize the ways in which OCD can impact parents, siblings, and other family members. Probably the most overwhelming theme I’ve seen in my clinical work with families is that family members will often want to avoid causing the child with OCD any more pain and, as a result, will try desperately to appease the OCD. This response is often fueled by love and a genuine desire to help the child.

Sadly, when family members try to “help” by accommodating OCD’s outrageous demands, it can lead to more harm in the long term. Now I do not believe that anyone would intentionally make a child’s OCD symptoms worse, but without an idea of how to effectively respond to a child with OCD, loved ones can end up falling into this trap, only to find that the more they give, the more OCD takes. It’s like a thirst that cannot be quenched—nothing will ever be enough. 

The good news is that these habits can be replaced with behaviors that don’t perpetuate the OCD cycle. One of the first steps for loved ones looking to learn how they can more effectively support a child with OCD will be to look for ways in which the family might be unwittingly accommodating the child’s OCD.

Some examples of family accommodations can include:

• Providing excessive reassurance
• Helping the child to do things the OCD tells them that they “need” to do, in order to “lessen the load” for the child
• Engaging in the child’s rituals or compulsions, such as cleaning things in a particular way or performing certain behaviors as part of a morning or bedtime routine
• Changing schedules or routines to accommodate the child with OCD
• Helping the child avoid triggers
• Preparing separate meals or altering other tasks at the requests of the child with OCD

Please keep in mind that these are only a few of the ways that a family may be supporting a child’s OCD symptoms, and you may notice others in your family.

When family members first learn about accommodation and how their actions may have unintentionally impacted a child’s OCD symptoms over time, some feel sadness, guilt, or shame. If you notice these emotions in yourself, it is so important that you give yourself compassion. You’ve been struggling with something that you didn’t choose and may not have fully understood prior to this point. You have always done the best you could with the knowledge you had. The only way to approach things different in the future is by learning more, which you’re already doing.

3. Make a plan to support the child—and the whole family—without accommodating the OCD

Now that you have an awareness of the behaviors that might be accommodating a child’s OCD symptoms, you can begin to make changes and develop a plan for managing accommodation within the family. This is best done with the help of an OCD specialist, who will have the expertise to help you navigate what can be an emotionally-charged process.

During this process, it will be incredibly important to help the child who is struggling with OCD understand that these changes are not in any way intended to be a punishment for them. The child may already be consumed with guilt and shame about their symptoms, so we want to make it clear that this new way of responding is geared towards their condition, not them, and encourage them to maintain an attitude of self-compassion.

As a starting point, it may be helpful for the entire family to get together and discuss all of the ways in which OCD may be interfering with the family’s goals or day-to-day life. During this conversation, you can frame OCD as a “bully” and explain that everyone in the family will be responsible for doing their part to stand up to this bully. This approach can make it clear to the child with OCD that they are a valuable part of the entire process, and that their family members are on their team.

Here are some tips to help you get started with responding to the OCD differently:

• Explain to the child with OCD that you’ve learned some new information that could be helpful in fighting the “bully” that is their OCD. Let them know that you would like to have a family meeting to discuss this.
• Ensure the child understands that they are not in trouble and they have done nothing wrong—your primary goal is to help them and get the OCD bully out of the house.
• Sit down as a family and create a list of all of the behaviors within the family that might be making the OCD bully grow.
• Brainstorm as a family how each of you might respond differently (or not respond at all) in the future. This process can also be referred to as developing an accommodation reduction plan.
• Discuss how even though the family’s current responses to the child’s OCD symptoms may seem helpful at that moment, long-term, these actions are actually causing more harm to both the family and the child with OCD.
• Let the child know that you love them and support them, that you don’t want to see them in pain, and that you know this new approach will cause them less suffering in the long term, but that it will also take some time to adjust to, and that’s okay.

It might also be helpful to have conversations with other children in the family about how they are handling the stress and impact of their sibling’s OCD, and how their family relationships and daily routines may have been disrupted. While they, too, have likely watched their sibling suffer from this “thing,” it is important not to assume that they understand it. They may need education about what OCD is and what it entails.

The siblings of children with OCD may also, at times, feel lonely and unheard. To them, it may seem like the whole family is hyper-focused on one child, that the child with OCD is getting lots of extra attention, and that they are being left out. As parents change their approach to supporting the child with OCD, it will also be important for them to carve out time for the other children in the home that is focused on them and their needs.

Finally, parents will need to turn their attention toward their own self-care—because as the saying goes, “You can’t pour from an empty cup.” While parents tend to prioritize the needs of their children, carving out time for their own self-care is anything but self-serving. By tending to their own emotional needs, parents can enhance their ability to effectively care for and support their child.

4. Find effective OCD treatment for your child

Finally and most importantly, whether you think your child might be struggling with OCD or know for a fact that they are, you should seek out an OCD specialist who is trained in exposure and response prevention (ERP) therapy. Research has shown ERP to be the most effective therapy for people with OCD. Traditional talk therapy uses skills that may be helpful for many areas of mental health, but it is not the right treatment for OCD and can make it worse.

If your child is struggling with OCD and is hesitant to begin treatment, NOCD can help. Our licensed therapists deeply understand OCD and receive comprehensive training in treating OCD with ERP therapy, including specific training in treating children and adolescents. We work side-by-side with the OCD experts and researchers who designed some of the world’s top OCD treatment programs, ensuring the best care for our members.

Along with teaching your child how to manage their symptoms and the distress they cause, ERP therapy with NOCD can also have powerful benefits for other family members. Family members can take an active role in their loved one’s recovery by getting involved in treatment and incorporating ERP into the family’s lifestyle. NOCD Therapists can help family members become more aware of their personal responses to a child’s OCD symptoms and teach them strategies to more effectively support the child with OCD.

Remember that your child is not their OCD, and getting better is possible. You can book a free 15-minute call with our team to learn more about your child getting matched with one of our therapists and starting OCD treatment. If you’d like to learn more about the condition and how to best help your child, you can also ask about our support group sessions designed for parents, caregivers, and loved ones, which can help you learn ways to support your child as they work to manage their symptoms.