Obsessive-Compulsive Disorder (OCD) is a chronic mental health condition characterized by persistent, unwanted thoughts (obsession) and repetitive behaviors (compulsions). These obsessions and compulsions can interfere significantly with daily activities and cause distress.

I’ve had parents come to me saying they feel hopeless as their child’s condition has been straining their life as a family and individually for years. When you’ve explored it all – medication, diet, special education, and more – and nothing seems to work permanently, it can be discouraging to continue the fight and give in to the negative atmosphere OCD can bring to your family.  

From my years of experience helping kids and guiding families deal with OCD, believe me when I say that the turmoil you are in now doesn’t have to be your “normal”. Treating OCD in children is a journey, but not forever.

Feeding Obsessive Compulsive Disorder

An essential, often overlooked part of treating Obsessive Compulsive Disorder (OCD) in children and teens is helping families understand what OCD is and how it affects the brain—both for the child and their parents. This includes recognizing how OCD shapes a child’s behavior and how easy it can be for parents, despite good intentions, to unknowingly reinforce their child’s obsessions and compulsions.

Sometimes, parents may offer too much comfort or say things that unintentionally fuel their child’s intrusive thoughts and repetitive behaviors, rather than helping to reduce them. This pattern, called “accommodation,” essentially feeds the “OCD monster.”

OCD Treatment Involves Everyone 

Living with someone who constantly seeks reassurance—sometimes for hours a day—can be exhausting. You need guidance on what to say and do to help their child break this cycle. Family support is crucial in treating OCD in children or in making meaningful progress because OCD will not just go away in a snap.

Natural and Therapy-Based OCD Treatments for Children

Natural and therapy-based treatments for OCD in children focus on managing symptoms without medication, using proven therapeutic techniques and lifestyle adjustments to support mental well-being.

Cognitive-Behavioral Therapy (CBT):

1. Exposure and Response Prevention(ERP):
   ERP is a specific type of CBT that is considered the gold standard for OCD treatment. It involves gradually exposing individuals to situations that trigger their obsessions and feared situations while helping them to refrain from engaging in their compulsive behaviors. Over time, this helps reduce the anxiety associated with the obsession and the need to perform compulsions.
2. Cognitive Therapy:
   This focuses on identifying and challenging irrational or maladaptive thoughts that contribute to OCD symptoms. It helps individuals develop healthier thinking patterns and reduce the intensity of their obsessions and compulsions.
3. Acceptance and Commitment Therapy (ACT)
   ACT is a form of psychotherapy that encourages individuals to accept their thoughts and feelings rather than fighting or feeling guilty about them. Commitment therapy also involves commitment to behavioral changes aligned with personal values.
4. Mindfulness-Based Cognitive Therapy (MBCT)
   MBCT combines cognitive therapy techniques with mindfulness strategies to help individuals become more aware of their thoughts and feelings and manage them without getting overwhelmed.
5. Family Therapy
   Family therapy can be beneficial, especially for children and adolescents with OCD. It helps the members of the family understand the disorder and learn how to support their loved one without enabling compulsive behavior.

Relaxation Techniques for OCD symptoms

Relaxation techniques can be beneficial for managing the anxiety and stress associated with Obsessive-Compulsive Disorder (OCD). These techniques help calm the mind and body, reducing the intensity of obsessive thoughts and compulsive urges. Here are several effective relaxation techniques you can incorporate anytime when treating OCD in children:

1.Deep Breathing Exercises:

• Diaphragmatic Breathing: Also known as “belly breathing,” this technique involves taking slow, deep breaths, expanding the diaphragm rather than shallow chest breathing. It helps activate the body's relaxation response.
• 4-7-8 Breathing: Inhale for a count of 4, hold your breath for a count of 7, and exhale slowly for a count of 8. Repeat several times.

2.Progressive Muscle Relaxation (PMR):

• PMR involves tensing and then relaxing different muscle groups in the body systematically. Start from your toes and work your way up to your head, focusing on the sensations of tension and relaxation.

3. Mindfulness Meditation:

• Body Scan: Focus on each part of your body, from toes to head, noticing any sensations without judgment.
• Focused Attention: Concentrate on your breath, a mantra, or a specific object, gently bringing your mind back to the present whenever it wanders.

4. Visualization and Guided Imagery:

• Imagine yourself in a peaceful, calming place (e.g., a beach, forest, or meadow). Visualize detailed aspects of this environment, engaging all your senses.

5. Yoga and Tai Chi:

• These practices combine physical movement, controlled breathing, and mindfulness to promote relaxation and reduce stress. Gentle yoga poses and Tai Chi movements can help calm the mind and improve overall well-being.

How to Address Treatment-Resistant OCD

When a child doesn’t seem to respond to treatment, it can feel discouraging. However,  there are ways to tackle it. Start by stepping back to really understand what’s happening. A detailed assessment can provide a clearer view of the whole picture, making it easier to find the most effective approach.

A randomized controlled trial looked at treating obsessive compulsive disorder in young people who haven't responded well to previous treatments. They found that when these kids received specialized therapy, like CBT, with or without medication changes, their symptoms got a lot better. But they also discovered that many kids hadn't been getting the right kind of therapy before, which made their OCD worse. The study suggests that giving the proper treatment can help kids with OCD feel better (Krebs et al., 2014).

I once worked with a remarkable young girl named Emily, who had been battling OCD for years. Despite trying different medications and therapies, she felt like she was hitting a wall. This is true for most treatment resistant patients. But you know what? We didn't give up. We looked closely at her treatment plan, considered all the puzzle pieces, and decided to try something new.

We treated her OCD by incorporating ERP therapy into her sessions. Exposure therapy might sound intimidating, but consider it taking small steps outside your comfort zone, one at a time. Giving parents the tools to not accommodate the OCD is critical and making them understand the treatment plan in its entirety helps. 

For Emily, it meant gradually facing her fears, whether it was touching a “contaminated” object or resisting the urge to perform her rituals. Over time, those small victories added up. She began to reclaim control over her life, one brave step at a time.

What is OCD Therapy Like?

When I work with children and teens using Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) for OCD, I focus on helping both the child and their parents understand why OCD thoughts and compulsions form a neurological habit. We dive into how the brain works, so they can learn to “talk back” to OCD using the principles of neuroscience. 

Once they understand the negative reinforcement cycle, kids with OCD gain the power to break the pattern of compulsive behaviors. They start to take control of their OCD instead of letting OCD control them. 

OCD doesn’t typically develop overnight, although it can suddenly appear in cases like PANS/PANDAS/AE. Most of the time, it takes several weeks or even months to get intrusive thoughts and compulsive behaviors to a more manageable level or back within a normal range.

What is the Best Treatment for OCD in Children and Teens? 

At my clinic in Ridgefield, CT, I use a combination of two evidence-based approaches—Exposure and Response Prevention (ERP) therapy and neurofeedback—both for in-person and virtual clients. ERP, in particular, has been extensively proven to be effective in treating OCD. It provides clients with the education and skills to take control of the thoughts and sensations that have hijacked their minds.

Unlike traditional talk therapy, which often focuses on emotions, ERP teaches clients how to manage those overwhelming thoughts. Many kids (and adults) with severe OCD have found ERP invaluable for breaking free from intrusive thinking and learning not to connect to their feelings first.

In one pediatric study involving 112 kids, researchers found that those with milder OCD symptoms showed the most improvement with any treatment, whether they took medication, saw a therapist, or did both. These kids tended to understand their condition better, had fewer behavioral issues, and received less support from their families. However, if a child had a family member with OCD, therapy alone wasn't as effective. This suggests that children may need a combination of treatments, and it highlights the importance of considering family history when developing a treatment plan (Garcia et al., 2010).

Response Prevention Therapy for Obsessive Compulsive Disorder

Exposure and Response Prevention (ERP) is a highly researched and effective approach that can help reduce, and even eliminate, OCD symptoms. But here’s the thing—ERP isn’t just about the child. It requires a lot of support from parents, who play a key role in helping their child break the OCD cycle at home.

What that means is teaching your child how to cope with anxiety, intrusive thoughts, and compulsions in a healthier way. It’s all about knowing what to say and do—because sometimes, without realizing it, we might accidentally reinforce the very behaviors we’re trying to stop. 

When you combine therapy like ERP with calming techniques for the nervous system, it’s possible for kids to make real progress. Unfortunately, we don’t hear enough about OCD success stories, but at my clinic in Ridgefield, CT, I see kids, teens, and families overcome OCD every day. 

I work closely with parents, guiding them on how to respond to OCD-driven behaviors and what to say to their child. I know how hard it can be to see your child in distress, and many parents are unsure of the right approach. But once you learn these tools, it’s truly a game-changer. 

Neurofeedback for OCD in Children and Adolescents

When your child’s nervous system is in a constant state of stress, it becomes nearly impossible for them to think clearly, focus, or take action in a way that helps stop their OCD. Instead, their brain gets stuck in a never-ending loop of obsessive thoughts and compulsive behaviors. That’s where neurofeedback for OCD can be a game-changer. Along with ERP, it works by calming the nervous system at a deep, subconscious level, helping a child get out of that “fight or flight” mode.

By helping the nervous system shift into a more relaxed state, neurofeedback allows the brain the space it needs to think and respond differently. When this happens, your child has the mental clarity and emotional bandwidth to act in healthier ways, breaking free from the OCD cycle.

We use brain-based therapies like this to help kids manage their stress and respond to life’s challenges in a more balanced way. This leads to fewer obsessive thoughts, reduced compulsions, and less irritability or anger. Instead, kids experience more calm thinking, positive behaviors, and the ability to engage with the world around them without getting stuck.

Alongside neurofeedback, there are also natural treatments for OCD, including supplements, herbs, and of course, ERP. If you're interested in exploring natural solutions in treating OCD in children, I invite you to download The Natural OCD Thought Tamer Kit for more helpful resources.