Childhood Obsessive Compulsive Disorder (OCD): Symptoms and Treatment
Become confident in parenting your child with OCD.
Learn the best science-based methods to help your child.
Your child will learn to manage their symptoms and will feel joy again.
Understanding Childhood OCD
As a parent, watching your child struggle with overwhelming thoughts and compulsive behaviours can feel like navigating an emotional minefield. You may find yourself caught between wanting to protect your child and feeling helpless as they wrestle with intrusive thoughts. They may be engaging in rituals or anxiety-driven behaviours, and the visible distress can leave you worried about your child’s emotional well-being, social connections, and future.
You are not alone.
At Foundations for Emotional Wellness (FFEW), we understand the complex emotional landscape that families navigating OCD experience. We recognize that your child’s struggles are real, challenging, and deserve compassionate, specialized support. OCD is not a choice, not a failure of willpower, and certainly not a reflection of your parenting. It’s a complex condition that affects many children, and with the right approach, children can learn to manage their symptoms and reclaim their joy.
What OCD Looks Like in Children and Adolescents:
Repetitive Behaviours:
Your child might repeatedly check locks, light switches, or other items multiple times. This isn’t about being careful—it’s a way they’re trying to manage overwhelming anxiety. This is because OCD is an anxiety disorder. Children might spend a lot of time ensuring everything is “just right,” which can be emotionally exhausting for both you and your child. Continuous “checking” is one of the symptoms of OCD. These behaviours are a sign that your child is battling intense internal fears and uncertainties.
Rigid Routines and Rituals:
You may notice your child following extremely strict, inflexible routines that must be performed in a specific way. This could involve complex bedtime rituals, specific ways of organizing belongings, or precise patterns of movement. These routines aren’t simple preferences—they’re survival mechanisms your child uses to feel a sense of control and to manage the anxiety that comes with uncertainty. Rituals are common signs of OCD.
Intense Anxiety When Routines Are Disrupted:
When something interrupts their established routine, your child might become visibly distressed, anxious, or even have emotional outbursts. This isn’t intentional defiance, but a genuine response to feeling like their carefully constructed sense of safety has been threatened. The anxiety is real and overwhelming for them. They feel a lot of worry.
Persistent Unwanted Thoughts:
Your child might share or show signs of intrusive thoughts that cause significant distress. These could be fears about harm coming to loved ones, worries about contamination, or disturbing thoughts that seem to come out of nowhere. It’s crucial to understand that these thoughts are deeply upsetting to your child, and they’re not choosing to have them.
How OCD Impacts Children and Adolescents
The challenges of OCD go far beyond simple worry:
- Interference with Daily Functioning: OCD can make even simple tasks feel monumentally challenging. Getting ready for school, completing homework, or participating in social activities can become overwhelming. Mental compulsions interfere with daily life. Your child isn’t being difficult—they’re fighting an internal battle that requires immense emotional energy.
- Emotional Distress: The constant battle with intrusive thoughts and compulsive behaviours can lead to significant emotional exhaustion. Your child might feel shame, guilt, or frustration about their inability to “just stop” these thoughts and behaviours. They may feel different from their peers and struggle with self-esteem. This can significantly affect social lives of young children.
- Social Relationship Challenges: OCD can make forming and maintaining friendships difficult. Your child might feel embarrassed by their rituals or afraid of being judged. They might withdraw to avoid situations that trigger their anxiety, which can lead to isolation, further worsening their mental health symptoms.
- Academic Performance Impact: The mental energy spent managing OCD can make concentrating on schoolwork incredibly challenging. Your child isn’t lazy or unmotivated—their brain is constantly juggling intrusive thoughts and compulsive urges, which can make learning and focusing extremely difficult.
As a mental health provider based in Toronto, we work with parents and children both in person at our clinic and all over Ontario virtually. If you are not sure what mental health condition your child has, we will do an assessment. We can administer the OCD diagnosis if they have it as our team is made up of professional clinical psychologists and child psychiatrists.
Treatment of OCD
OCD responds really well to therapy so that is always our first step. If necessary, we will discuss medication management—selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed to help manage OCD symptoms. OCD treatment significantly improves the quality of life of the individual.
Our Tailored Approach to Anxiety Treatment in Children and Adolescents
At FFEW, we recommend that parents and children actively participate in treatment as this generally leads to quick and long-lasting change for children and adolescents. Here’s a detailed description of the options for working with your family:
In-person and Virtual Therapy for Childhood OCD
Individual Therapy with a Skilled Therapist
OCD treatment offers real hope for children and adolescents struggling with intrusive thoughts and compulsive behaviours. We understand that each child is unique, and our goal is to develop a personalized strategy that provides immediate relief and long-term management skills.
What is response prevention therapy?
Our primary treatment approach is Exposure Response Prevention (ERP), a specialized form of Cognitive Behavioral Therapy (CBT) specifically adapted for children and adolescents. This evidence-based method is carefully tailored to your child’s developmental stage and individual needs.
ERP works by helping your child identify the specific triggers that spark their intrusive thoughts and compulsive behaviours, then gradually expose them to these triggers in a safe, controlled, and supportive environment.
Building resilience when faced with common compulsions
During therapy sessions, our skilled therapists create a compassionate and collaborative space where your child feels heard and supported. We work closely with them to understand their comfort levels, slowly guiding them to face their fears and manage their anxiety. The process is gentle and incremental, designed to build confidence and resilience. As your child learns to sit with discomfort and resist compulsive behaviours, they develop powerful coping mechanisms that can transform their relationship with OCD.
ERP coping strategies
The skills learned through ERP are designed to be lifelong tools. Your child will learn how to recognize intrusive thoughts without judgment, develop healthier thought patterns, and resist engaging in compulsive behaviours. We’re not just treating symptoms; we’re empowering your child with the skills to manage OCD independently. Our ultimate goal is to help your child build confidence, reduce anxiety, and reclaim their sense of control.
Parent Coaching for Childhood OCD
We use SPACE (Supportive Parenting for Anxious Childhood Emotions) when working with parents. SPACE is an evidence-based, treatment approach designed for parents of children and adolescents who struggle with anxiety or Obsessive Compulsive Disorder (OCD) developed by Dr. Eli Lebowitz at Yale University.
This approach begins by acknowledging the interpersonal nature of child/adolescent anxiety and how this can impact parenting styles. It then focuses on small but meaningful adjustments that parents can make in HOW they respond to their children’s anxiety. This is especially important if there is a family history of OCD. We also coach parents to employ CBT strategies by creating and finding ways to help children face their fears.
OPTION A
One-on-One Parent
Coaching Sessions
The focus of parent coaching is to lay the foundation for understanding how parental responses can influence a child’s anxiety. We teach parents to adapt their behaviours towards their child’s anxiety so they can engage in a manner that ultimately enhances the child’s ability to cope with anxious thoughts and feelings.
Individual parent coaching involves working one-on-one with a skilled therapist to develop strategies and skills to support the child. This approach helps parents to:
- Gain confidence in parenting their anxious child
- Develop the tools to address their child’s anxiety effectively
- Enhance your child’s ability to cope with OCD thoughts
OPTION B
Parenting your Anxious Children:
Group Therapy for Parents
Our Parenting Anxious Children group intervention has been running for several years and is highly sought after. This program offers a supportive environment where caregivers can learn valuable skills to optimize healthy outcomes in anxious children. Through didactic teaching, skill-building exercises, and peer support, participants will gain insights into understanding anxiety in children. This group:
- Uses a SPACE and CBT approach to supportive parenting with evidence-based strategies to help their child.
- Provides a framework for understanding the interpersonal nature of anxiety and a roadmap for what parents can do to support their children.
- Provides a supportive group environment where parents can share experiences, receive feedback, and learn from each other.