Psychotherapy for OCD
Cognitive behavioural therapy
Research has shown cognitive behavioural therapy (CBT) to be a very effective treatment for OCD. CBT is a type of therapy in which a person learns to:
- recognize how their thoughts, feelings and behaviours are connected
- challenge their worries or unrealistic thoughts
- replace their thoughts with more rational or realistic thoughts
With OCD, the person over-estimates the importance of an intrusive thought. This can then make them feel anxious. The rituals they create offer temporary relief from their anxiety, but they provide no real guarantee that the thought will not recur. As a result, the ritual is repeated, usually several times, until the person "feels right" or has repeated the actions a special number of times.
CBT helps to address the anxiety a child with OCD might feel, but another treatment, exposure response prevention (ERP), helps them to challenge their thoughts and learn relaxation techniques such as deep breathing and muscle relaxation.
Exposure response prevention (ERP)
As its name suggests, ERP consists of two major parts: exposure and response prevention.
- Exposure involves having your child confront the feared situation (for example touching an object they think is contaminated).
- Response prevention involves keeping the child from acting on their immediate compulsion (for example preventing them from washing their hands immediately).
- While parents may help stop the child completing the ritual, (for example by turning off the main water valve so there is no running water), the child eventually must be able to stop themselves independently.
ERP is designed to allow the child to tolerate the anxiety without following the ritual. At first, not following the ritual is the most difficult part of treatment for the child, but, over time, their anxiety naturally reduces and the link between the fear and ritual weakens.
If your child needs ERP, it is not unusual to have many sessions before they stop the ritual. Even still, this treatment remains the most effective way to treat OCD.