Obsessive compulsive disorder - OCD treatment and therapy from NOCD

When to push and when not to push your kid’s OCD?

By Danielle Cohen, LMFT3 min read

Do you find yourself asking, where do I draw the line with removing accommodations from my child’s OCD? Of course you do. It goes against every natural inclination as a parent not to help your child when they are distressed. We at NOCD understand how difficult this is for parents and we encourage you to think about this process as your own ERP exercise. It will be tough, but you and your children are tougher! To help you through the process of removing accommodations, this article details a few helpful tips and tricks.

Tip #1

Work with your child’s ERP clinician. In treatment, your child’s clinician will assist you in making a list of accommodations you typically provide for your child’s OCD. This will be a collaborative process between your child, the clinician, and yourselves as parents. The clinician will help your child rate the level of distress they would experience if each accommodation were to be removed. This information will be organized into a hierarchy, with each accommodation and corresponding distress level listed in ascending order. The clinician will inform you to begin removing the accommodations that are at the lowest level of distress. Over time, you will gradually work your way up the hierarchy. 

Therefore, if you are wondering if you should or should not accommodate your child’s OCD, ask yourself:

  • Is this accommodation on the hierarchy?
  • Have we begun removing this accommodation?

If the accommodation in question is accounted for on the hierarchy, and has been assigned as homework to remove, then you would want to resist the urge to provide the accommodation. If the accommodation in question is not on the hierarchy, or is at a distress level that is higher than those currently being tackled in treatment, go ahead and accommodate, so as not to overwhelm your child. 

It is best to wait to speak to your child’s clinician before removing an accommodation independently. However, if you feel you must remove the accommodation, ask yourself, does this accommodation’s distress level match that of the current accommodation homework?

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Tip #2

It is important that your child is included in the process of accommodation removal. Excluding the child from this process would likely lead to negative feelings and loss of motivation to participate in treatment. If we collaborate with your child, they will understand the expectations being set for them and receive the message that they have control over their OCD symptoms and treatment process.

Tip #3

What about if your child is not motivated for ERP treatment? Is there still hope?

The answer is yes! Even if your child does not wish to participate in ERP treatment, there are options. 

But first, let’s explain a few things! ERP treatment would likely not be effective for a client who does not wish to be there, as this treatment requires clients to be active participants in creating and implementing exercises. Pushing your child to engage in treatment could lead to frustration and reduce the likelihood that they would participate in treatment later on in life when they are more motivated.

What’s the alternative, you ask? Parents have the option of working with ERP clinicians to target their child’s OCD symptoms without the child’s involvement. These sessions would focus on assisting parents in gradually removing accommodations that are typically provided. When only the parental accommodations are removed, progress does typically occur, as children are not provided with the reassurance or support they think they require in order to feel better. In other words, they will habituate, or “get used to,” the anxiety and distress they will feel when they are not afforded the relief that comes with being accommodated. This method can also help increase your child’s motivation for treatment, as when accommodations are removed, the child may realize that OCD has more control over them than they would like.

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Finding the right clinician for your children can be difficult. It is important that you feel comfortable with your choice of professionals and their associated treatment approach. We would be happy to answer any questions you may have about our clinicians and the ERP treatment we utilize for children and adolescents. If you are interested, please reach out to our CARE team by booking a free call on our website. We also offer community feeds and support groups to interact with others experiencing similar symptoms and situations. Ask about our many services and resources when you call in!

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Danielle Cohen, LMFT
WRITTEN BYDanielle Cohen, LMFT