Kids and adults of all genders and ages can have OCD. The onset age of OCD is different for every individual, but we see the most common onset of symptoms during teenage or early adulthood years. Even so, no one can be “too young” or “too old” to be diagnosed with OCD, the primary factor in diagnosis is the presentation of symptoms and worries and whether they meet criteria at any age.
Those who have biological parents or family members with OCD can increase the risk of developing OCD for the individual. Experiencing stressful or traumatic events has also been connected to an increased risk of developing OCD. Ongoing research is still investigating how biology, genetics, and traumatic experiences influence the development of OCD, but we do know from research that treatment can help many people with OCD, even if they’re experiencing more severe symptoms.
A gold-standard behavioral treatment for OCD is called exposure and response prevention (ERP), which is a specific type of cognitive behavioral therapy. In cognitive behavioral therapy, mental health professionals can work to help individuals understand how emotions, thoughts, and behaviors all influence each other. In exposure and response prevention, individuals learn how to tolerate distressing thoughts, resist engaging in compulsions, and eventually decrease the influence of OCD over time. While in treatment, kids and teens are provided psychoeducation about OCD so that they can understand what their thoughts and compulsions mean and how they can combat them. With their clinician, in a safe environment, they will undertake a series of exposures to situations that typically trigger their obsessions. Once they are experiencing obsessive thoughts, the clinician will guide them through the process of resisting their compulsive behavior that normally follows. By resisting the compulsion, the kid or teen with OCD will learn that their fear doesn’t come to life if they don’t engage with the compulsive behavior.
For example, a child who obsesses over touching dirty objects with the associated fear of illness or contamination may usually engage in excessive handwashing or cleaning to relieve their anxiety. In ERP, the clinician may challenge the child to touch a doorknob to the office and encourage them to resist washing their hands for as long as they can. As the child gets used to the exposures, the difficulty will be leveled up. After a while, they might be touching sticky substances or dirty areas of a home and still be asked to resist engaging in compulsions.
The nature of OCD can be quite intrusive in a child’s life, and only doing practice exposures during session for one hour a week may not be enough to make effective progress. Often, in outpatient clinics, mental health professionals will help caregivers learn about OCD, exposures, and how to support their child in practice outside of session. Caregiver involvement and support is key to ensuring that treatment is effective for OCD as soon as possible.
Another skill that clinicians may help kids and teens learn is called cognitive diffusion. Cognitive diffusion is the idea that we are not our thoughts, and we can distance ourselves from them. By diminishing the attachment a person has to their thoughts, it can leave more space for recognizing intrusive thoughts as what they are, rather than as facts. Many mindfulness techniques can be useful for kids and teens to become aware of their thoughts and their functions in the day to day.
For some kids and teens, OCD can be hard to manage with behavioral treatments alone. Medication can be helpful in dialing down the intensity of anxiety and obsessive thoughts that come along with OCD. Often, engaging in behavioral therapy in addition to medication is most effective for facilitating long term improvements.
If you are concerned that your child might be experiencing symptoms of OCD, the best place to get guidance is through an evidence-based assessment with a licensed mental health professional. In the assessment, the clinician will determine if your child is an appropriate match for OCD treatment, and they will be able to discuss with you the next steps for a treatment plan. To learn more about assessments, check out our blog post.
Want to learn more?
- Watch our FREE OCD webinar
- Read Defining Obsessive-Compulsive Disorder: What Is It Really and What Does It Mean to Have OCD?
- Read Client Spotlight - Exposure and Response Prevention: Thinking about Knives
- Contact us