OCD in Children and Teens

Proven, family-centered help for intrusive thoughts and rituals.

What we treat

When worries get stuck and rituals take over

Obsessive-compulsive disorder (OCD) is a common and very treatable condition in children and teens. It traps kids in a cycle of unwanted, upsetting thoughts (obsessions) and the things they feel they must do to make those thoughts go away (compulsions). With the right help, most children learn to break that cycle and get back to the things they love.

How commonAbout 1 to 2 in 100 children and teens

Typical onsetOften begins in childhood, around age 10

First-line treatmentCBT with exposure and response prevention (ERP)

FormatIn person or telehealth

Understanding OCD

What OCD looks like in kids

Every child has quirks, habits, and passing worries. OCD is different: the thoughts feel intrusive and frightening, the rituals take up a lot of time, and trying to stop them causes intense distress. Children often know their fears don't fully make sense, but they feel unable to resist. Many kids also hide their symptoms because they feel embarrassed or worry that something is wrong with them.

Common obsessions

Fear of germs, illness, or contamination. Worry that something bad will happen to a parent. Needing things to feel "just right." Upsetting thoughts about hurting someone or doing something wrong. Fears about being a bad person.

Common compulsions

Excessive handwashing or cleaning. Checking locks, doors, or homework again and again. Repeating, counting, or redoing actions. Arranging items until they feel right. Asking the same reassurance questions over and over.

Signs parents notice

Long bedtime or morning routines. Meltdowns when a ritual is interrupted. Avoiding certain places, objects, or people. Needing parents to answer, check, or do things a certain way. Slower schoolwork from rereading or erasing.

When to reach out

Thoughts or rituals take up more than an hour a day
Your child is very distressed when routines are interrupted
Family life has started to revolve around the symptoms
OCD is affecting school, friendships, sleep, or mood
Your child avoids things they used to enjoy
Symptoms appeared suddenly or have been getting worse

Why families get pulled in

OCD often asks parents to help: answering the same question again, washing extra laundry, or taking a longer route to avoid a feared place. This is called family accommodation, and it comes from love. Research shows it is very common and is linked to more severe symptoms over time^[4].

Part of our work is helping parents step back from accommodation gradually, in a way that is supportive and planned, so your child can learn they can handle the anxiety on their own.

How we treat it

Our approach to OCD

We use cognitive behavioral therapy with exposure and response prevention (ERP), the treatment recommended first for children and teens with OCD by the American Academy of Child and Adolescent Psychiatry^[1]. ERP helps children face their fears in small, planned steps without doing the ritual, until the anxiety fades and OCD loses its power.

A thorough evaluation. We use standardized measures such as the CY-BOCS to understand your child's specific obsessions, compulsions, and how much they interfere with daily life.
Understanding OCD. Children learn to see OCD as a "bully" that is separate from who they are, which makes it easier to talk about and fight back.
Building a fear ladder. Together we list feared situations from easiest to hardest, so your child always knows what is coming next.
Brave practice. Step by step, your child faces each fear and resists the ritual, with support in session and practice at home.
Coaching parents. We show parents how to reduce accommodation and respond to OCD in ways that help rather than feed it.
Keeping gains. We plan for setbacks and teach your child to spot and handle new OCD tricks on their own.

The evidence

What the research says

ERP-based CBT is one of the best-studied treatments in child mental health. Large, well-designed trials show that it helps most children with OCD, including young children when parents are closely involved.

1 to 2%

of children and adolescents are affected by OCD, making it one of the more common mental health conditions in young people.

Geller & March, 2012 [1]

39% vs 4%

of children and teens reached remission with CBT/ERP alone, compared with pill placebo, in the POTS trial (ages 7 to 17).

POTS Team, 2004 [2]

72% vs 41%

of children ages 5 to 8 responded to family-based ERP, compared with a family-based relaxation program.

Freeman et al., 2014 [3]

The AACAP practice parameter recommends CBT with ERP as the first-line treatment for mild to moderate pediatric OCD^[1].
In POTS Jr, children as young as 5 improved substantially when parents were trained as coaches in ERP^[3].
Studies consistently find that family accommodation is present in most families of children with OCD, and that reducing it is linked to better treatment outcomes^[4].

Research results describe averages across groups of children. Every child is different, and we track your child's progress with standardized measures throughout treatment.

Common questions

Is this OCD, or just a phase?

Many young children go through phases of liking routines or things done a certain way. OCD is more likely when the thoughts are upsetting, the rituals take up a lot of time, your child gets very distressed if they can't complete them, or daily life is affected. An evaluation can help sort out what is going on.

Should I keep reassuring my child?

Reassurance is a natural response, but with OCD it often brings only brief relief and the questions come back stronger. Rather than stopping suddenly, we help you plan supportive ways to respond that build your child's confidence over time.

Can young children be treated for OCD?

Yes. Children as young as 5 can benefit from ERP, especially when parents are closely involved as coaches. We adapt the approach with games, stories, and rewards so it fits your child's age.

Will ERP make my child more anxious?

Exposures bring up some anxiety on purpose, but they are always planned together, start small, and never happen by surprise. Most children are surprised by how quickly their fear drops and how proud they feel.

Can treatment be done over telehealth?

Yes. ERP works well over video, and it can be especially useful because we can practice exposures right where OCD shows up, in your home.

References

Geller, D. A., & March, J. (2012). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(1), 98–113. <View study
Freeman, J., Sapyta, J., Garcia, A., et al. (2014). Family-based treatment of early childhood obsessive-compulsive disorder: The Pediatric OCD Treatment Study for Young Children (POTS Jr). JAMA Psychiatry, 71(6), 689–698. View study
Lebowitz, E. R., Panza, K. E., & Bloch, M. H. (2016). Family accommodation in obsessive-compulsive and anxiety disorders: A five-year update. Expert Review of Neurotherapeutics, 16(1), 45–53. View study