OCD Chicago

Your Child Can Get Better With Effective Treatment
Information for Parents

OCD Treatment Challenges

Don’t be discouraged by some set-backs along the way.  Learn about common barriers to success so you can have an action plan to keep improvement on-track.

Getting appropriate treatment for OCD and committing to a treatment plan are key to achieving relief from OCD for your child.  Even when your child’s behavior improves, you may experience set-backs as it’s difficult to consistently sustain improvement.  Knowledge is a powerful tool that is linked to success in treating OCD—and understanding barriers will help you recognize and overcome difficulties such as:

Under-Diagnosis and Under-Treatment

Even though OCD is a relatively common illness and effective treatment is available, OCD is often under-diagnosed and under-treated.  And sometimes treatment can fail.  There are a number of reasons why:

  • Hiding symptoms: Some children can be very secretive and hide their symptoms.  At first, you may not notice the symptoms.  Once OCD is diagnosed and they undergo treatment, they may hide their symptoms to avoid having to do the Exposure and Response Prevention (ERP) therapy exercises at home.
  • Avoidance:  You may not notice (at first) that your child is avoiding certain places, activities or people.  It’s natural for children to form opinions and preferences, so of course you will notice that your child gravitates toward some places, activities and people more than others.  But extreme avoidance can signal that the child is trying to make irrational fears (the obsessions) go away—their compulsion may be avoidance.  For example, a child who has contamination obsessions such as an extreme fear of germs may avoid public restrooms (or not want to use the school restroom), avoids drinking from water fountains and may decline invitations to play or sleep over at friends’ homes.
  • Physician Diagnosis:  Not all physicians know how to diagnose and treat OCD, especially in children and young adults.  At routine check-ups, some doctors do not ask questions about a child’s mental health.  Others may only want to prescribe medication because they aren’t aware that cognitive behavior therapy is the treatment of choice.
  • Treatment Provider Education:  Some psychologists and psychiatrists still rely on unproven, ineffective theories about treating OCD.  Psychoanalytic therapy and therapy that focuses on family dynamics, early childhood trauma or issues of self-esteem are not effective treatments for OCD.  As the parent of a child who suffers from OCD, you can look for a doctor who is trained in treating OCD in children, and seek help and advice from other sources (OCD Chicago and resources listed in the More Resources section of this web site).  If your doctor is not familiar with OCD and cognitive behavior therapy, keep looking for help elsewhere.  Your child’s future depends on it.
  • Misdiagnosis:  Common but less familiar symptoms of OCD in children may not be easily recognized.  The disorder can take many forms and is not limited to familiar or obvious types such as compulsive washing or checking door locks.  Examples of symptoms that can go unrecognized as OCD include:
    • Procrastination
    • Difficulty making decisions or inability to make a decision
    • Asking repetitive questions
    • Continual reassurance-seeking
    • Avoidance of people, places, objects or events

Recovery Avoidance

Even with the right diagnosis and parental enthusiasm for effective treatment, sometimes children have a difficult time committing to treatment and doing their exposure homework exercises at home.  There are many variables, but some of the most common barriers to success are:

  • Recovery Avoidance:  Some children find the OCD treatment sessions to be very difficult, and may also find the ERP homework exercises to be stressful and, in some cases, overwhelming.  Successful treatment depends on your child’s therapist being able to plan and construct a challenging but not impossibly difficult program and designing a manageable schedule for your child’s particular situation and tolerance level.
  • Fear of Change:  Change can be difficult.  It takes courage to make changes and face fears, particularly if the obsessions and compulsions have existed for many years.  Some children or young adults with OCD are afraid to begin treatment, but living with untreated OCD is vastly more painful than any discomfort associated with treatment.  They must learn to overcome and manage their obsessions and compulsions to be able to have a more normal childhood, teenage experience and adult life.
  • Embarrassment: Some older children or teens may feel some concern or embarrassment about “having to go to therapy” or “having to go to the doctor” weekly (or more often, depending on the schedule determined by the therapist).  Peer pressure to “fit in” may already be putting pressure on your child, and being perceived as “different” or “mentally ill” can increase stress—and stress can sometimes increase OCD symptoms. If you believe this is causing your child to falter in treatment or is the reason they may not want to attend sessions or do ERP homework, talk with the therapist to find a way to encourage your child to not give up and to commit to the treatment.

When Money is a Problem

Treatment for OCD is usually not available free of charge, so you may need to be creative about how you plan to pay for CBT therapy (and medication, if your child’s doctor prescribes medication).

Some people who have OCD are not able to afford treatment for their child.  Those without health insurance, or whose insurance policies do not fully cover mental health care, sometimes struggle to get the treatment they need.  Some cognitive behavior therapists offer fees on a sliding scale to low-income clients, making it more affordable.

If your child’s cognitive behavior therapist recommends the use of medication in conjunction with therapy, you may be able to obtain drugs at a reduced price.  A number of resources offer information about prescription assistance, including:

  • Partnership for Prescription Assistance 1-888-4PPA-NOW or www.pparx.org
  • Needy Meds: www.needymeds.com

Learn more about treatment resistance or failure

Back to Helping A Child Who Has OCD