Obsessive-compulsive disorder (OCD) not only affects your child, but the entire family. While your child’s struggles with OCD can unintentionally strain family life, consistent support from you and other family members can have a significant impact on their treatment and recovery.
Exposure and response prevention (ERP) therapy is a highly effective treatment for children with OCD, but it works best when the whole family is involved.
Continue reading to learn how to help a child with OCD at home.
Learn about OCD and ERP together
A starting point for practicing family ERP is to get a better understanding of the condition your child lives with. OCD involves a cycle of obsessions and compulsions. Obsessions are intrusive thoughts, images, urges, feelings, and sensations that can cause distress. Compulsions are physical or mental acts performed to relieve distress or prevent perceived danger. Your child may feel stuck in a never-ending cycle of ‘what-ifs’ that disrupts their daily life.
OCD can also directly affect families, as you or others may unintentionally accommodate your child’s symptoms—which we’ll cover in a later section. When you give OCD what it wants, it only gets worse, which leads to more distress for your child and strain on the family.
It’s also important to understand how ERP for kids works. During ERP, a therapist helps your child face their fears gradually, often through playful or creative exercises that feel manageable to them. As they practice resisting the urge to do the things OCD tells them they have to do, they learn to handle the uncomfortable feelings and thoughts without giving in.
ERP is not a quick fix–-it requires time and patience to see long-term changes. But over time, it helps your child feel braver, more confident, and in more control of their life instead of allowing OCD to take the lead.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Create a shared plan and open communication
You’re not expected to be an expert on how to deal with OCD—that’s what the OCD specialist is there for. They can guide your family through best practices for supporting your child’s OCD at home and help you navigate what can be an emotionally challenging process.
It can be beneficial for the whole family to discuss how OCD may be impacting the family’s goals or day-to-day life. During this conversation, you can try framing OCD as a “bully” and explain that everyone in the family will be responsible for standing up to it. This approach can make it clear to your child that they are a valuable part of the entire process.
As you start implementing these strategies, make sure that your child doesn’t view them as punishment. Remind them that the new way of responding is geared towards their OCD, not them, and encourage a sense of self-compassion throughout the process.
To encourage your child to talk openly about OCD, use age-appropriate and supportive language. The following tools can help build shared understanding and reinforce the idea that you’re on the same team:
- Metaphors (“My OCD feels like…”)
- Characterization (“My OCD monster likes/dislikes when I…”)
- Externalization (OCD is something separate from your child)
- Repetition to reinforce understanding and confidence
Avoid accommodations to support progress
As a family unit, you want to ensure that no one is providing accommodations to your child. While no one intentionally wants to make a child’s OCD symptoms worse, without knowing how to respond effectively, loved ones can end up falling into OCD’s trap.
Below are some subtle family accommodations in OCD:
- Modifying routines to accommodate the child’s OCD.
- Unknowingly participating in OCD rituals or compulsions.
- Avoiding anything that you think might cause your child to have an anxiety attack or frustrate them.
- Appeasing your child by allowing them to engage in their compulsions while turning a blind eye.
- Allowing OCD to worsen by giving in to the belief that your child’s symptoms will never get better.
These are just a few examples of accomodations—your family may spot others over time.
How to lovingly detach from your child’s OCD and anxiety
The key to stopping family accommodations at home is to work toward detaching from your child’s OCD and anxiety.
Here’s how you can do that:
- Understand that detachment is not indifference. Detaching doesn’t mean you don’t care about your child—it means that you don’t want to make their symptoms worse. Allow them to experience and manage their anxiety on their own, which is essential for their growth and coping skills.
- Separate empathy from reassurance. You can empathize with their discomfort without offering reassurance. For example, if your child is questioning whether their peers accept them, you may say something like, “It’s natural to wonder what others think, but since we can’t know for sure, it’s more helpful to focus on being ourselves.”
- Manage your emotional responses. Keep your emotions in check. Responding with intense emotions can validate your child’s fears. Instead, stay neutral to show that uncertainty can be tolerated without distress.
Practice redirection. When your child is stuck in an endless loop of intrusive thoughts or compulsions, gently redirect their attention to something else. Doing so can help break the cycle and teach them how to shift away from anxiety-inducing thoughts.
Encourage your child’s participation in therapy
Some parents may face difficulty getting their child to participate in ERP. To encourage your child’s participation in therapy, you and your family can set up positive and negative consequences.
Positive consequences can reinforce a desired behavior and are best to try first. For example, if your child does their homework every day, they can earn an extra hour of screen time. Negative consequences teach a child to make a good choice. If homework isn’t done, then they might lose their phone for a day. Consequences work well when children realize that they have more to gain by eliminating the negative behavior.
Below are some tips for giving effective consequences to your child with OCD:
Make consequences meaningful and timely
For consequences to be practical, they need to be significant enough to your child and happen soon after the behavior. That could mean removing something they care about, such as their phone or a toy. Take the time to find out what your child treasures and ask them what they think would be fair.
Younger children often respond well to smaller, more frequent rewards, such as earning a sticker for each ERP session or losing a toy briefly for not following through. With teens, you might need more time to think about what would work for them.
Be consistent
Children are most likely to engage in undesirable behaviors when parents give in or forget to follow through with a specific consequence. As a parent, this can be challenging because when you deliver consequences, you’re also emotionally impacted. However, resisting compulsions is key to overcoming OCD, even when it stirs up some heavy emotions for the entire family during the ERP process. Staying consistent when it feels uncomfortable to do so can help your child learn that they can face anxiety without leaning on OCD.
Consider the degree and size of consequences
When your child doesn’t comply, the consequence should be in proportion to the violation. For example, if your child doesn’t do their homework, they don’t earn a sticker or lose phone privileges for the day. If the consequence is to lose the phone for a month, your child may become frustrated and lose hope. Ensure that other family members in the household also deliver appropriate consequences to maintain consistency across the board.
Switch it up
Make sure you vary the consequences. If you’re always taking away their phone, your child might not care after a while. Mix it up.
While ERP can be very beneficial for your child, your family must know when and when not to push their OCD. If the consequences aren’t working, get in touch with their ERP therapist to discuss next steps. They may suggest targeting the child’s OCD symptoms without their involvement, such as learning how to gradually remove accommodations to reduce their distress and increase their motivation for treatment. This is because when accommodations are removed, your child may realize OCD has more control over them than they would like.
Use incentives to support treatment goals
The use of incentives or rewards can be effective during the therapy process to increase a child’s motivation to engage in exposures and feel independent throughout treatment.
Here are some guidelines for developing an incentive or reward program for ERP:
- Include the child as a stakeholder. All children are unique and have distinct motivations. Allowing your child to collaborate with you and their therapist gives them autonomy and shows them that they have a say and a sense of control in their treatment.
- Offer a variety of rewards. Create a range of incentives that align with your family’s budget, capabilities, and personal preferences. Include different categories of rewards, such as material, experiential, privilege, and social.
- Track incentives. Creating a system for tracking incentives and rewards can be a fun family project. At the beginning of therapy, it is beneficial for the child to earn incentives or rewards frequently, with the goal of gradually spreading them out over time and progressing to more challenging exercises.
- Allow for the occurrence of natural consequences. A bonus of utilizing an incentive or reward system is that it allows the child to be in control of earning the incentive. On the other hand, it allows natural consequences to occur when the child doesn’t engage in the exposure. This brings a key component of making a rewards system work: the incentive or reward occurs only after the agreed-upon exposure or “challenge” is completed.
Finding the right support for your child’s OCD
If you haven’t already, please seek out an OCD specialist who has specialty training in ERP and experience working with children. You can ask your child’s pediatrician for a referral to an OCD specialist or search through this directory of 650+ specialized ERP therapists. In the first session, the therapist will assess your child to confirm an OCD diagnosis. From there, they’ll create a personalized treatment plan to address your child’s symptoms.
Bottom line
ERP can help your child escape OCD’s grip, but it requires the involvement of the whole family. Family ERP can give your child the support they need to learn the tools to break from the OCD cycle.
Key takeaways
- Exposure and response prevention is most effective when the whole family understands OCD and works together to support treatment at home.
- Avoiding accommodations and practicing detachment can help your child build confidence in managing their anxiety.
- Open communication and a shared plan between family, children, and the therapist make ERP feel like a team effort.
- Motivation matters—using rewards, consequences, and consistent follow-through can help encourage your child’s participation in treatment.
