A Better Way to Treat Obsessive-Compulsive Kids

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Obsessive compulsive disorder (OCD) can be a nasty enough condition when it strikes an adult. When it hits in childhood it’s far crueler. Not only are kids unequipped to understand what’s happening to them, they are also being denied what should be the best — or at least most worry-free — years of their lives.

That’s one of the reasons that attentive parents  move to treat the condition fast, and that often means drug therapy, which seems like the most direct — and certainly least expensive — way to get the job done. According to a recent study in the Journal of the American Medical Association, however, those parents are leaving a big component of effective treatment on the table — a component that could double the odds of their kids recovering.

OCD is an anxiety disorder — unlike, say, narcissism, which is a personality disorder — and that’s a very good thing. Anxiety disorders are extremely amenable to cognitive-behavioral therapy, particularly a kind known as exposure and response prevention (ERP). For OCD sufferers who fear contamination, for example, ERP might involve touching a feared object like a doorknob or a trash can and then resisting the urge to wash their hands for a fixed period of time. Over the course of weeks, that period of abstinence will grow longer and the category of newly touchable objects will grow bigger. In as little as three months, the condition may be in check.

The problem is, behavioral therapy is expensive and insurance companies may cover it only partially or not at all. What’s more, it’s time-consuming. Better just to pop any one of a number of types of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) — most of which are available in cheap, fully covered generics.

In order to determine how effective that pills-only strategy is, a group of researchers headed by psychologist Martin Franklin of the University of Pennsylvania School of Medicine recruited a sample group of 124 OCD patients aged 7 to 17 years and divided them into three subgroups. A third of them would begin a medication-only protocol; a third would get medication plus instructions in behavioral strategies; and a third would get medication plus in-person therapy sessions to teach and rehearse the behavioral tactics.

At the end of a 12-week period, the kids’ OCD symptoms were evaluated using what’s known as the Children’s Yale-Brown Obsessive Compulsive Scale. The Yale-Brown scale scores kids on a range of OCD metrics, including how much anxiety they’re experiencing, the kinds of rituals they’re performing and how much time those rituals take. The benchmark Franklin and his colleagues were looking for was a 30% reduction in OCD symptoms — a level of relief that may not be full recovery, but can be a life-altering improvement and make kids receptive to more treatment still.

In the medication-only group, just 30% of the kids exhibited the 30% improvement; for medication plus behavioral instructions it was a tick better — 34%. The kids who received both meds and therapy sessions more than doubled that, with 68.6% getting 30% better.

The good news for children with OCD is not so much that the results are so robust. ERP has long been known to be an extremely powerful tool, and for many therapists, it’s the main tool, with drugs used merely as an adjunct and only when needed. The true significance is that Franklin’s study is clinical proof of that accepted wisdom — a powerful, peer-reviewed cudgel that will make it harder for insurance companies to deny kids the treatment. The faster that suffering children get the care they need, the more years of genuine childhood they’ll have.


OCD has destroyed my life! It IS the most devastating problem of thought in my case that never ceases to assert evil thoughts in my mind. It has me for more than 20 years and I feel so sorry for people especially new victims because they will be troubled the most. Now I kind of control it though it still is bothersome. Guys whatever you do never come close to it or you will have the worst time of your life ever. somebody said OCdemon - that is exactly how it feels when your mind is swarmed with evil demonic thoughts. Thank God I am much better than before now. I found one guide online which can be of great help whoever is troubled with OCD: http://dess.me/OCDrescue


@tomy_thom I totally feel for you Tomy. It so horrible to have OCD. My brother has it and it's extreme! He's also high function autistic. His life is total hell! It's also hard to be the people around him because we have to learn to think like he does in order to lessen the stress for him. It only seem to get worse the older he gets. I hate OCD so much and he will never accept help in any form. I've got a son who's 7 and he's also high function autistic. I was praying that he would never get OCD but now it's starting to show. He's always been quite anxious but the last two weeks his anxiety is coming out in OCD and it seem to be everything that triggers. I'm so devastated because I'm now so worried about his future. He's only 7 and it's so early for a little soul to have to deal with this. I am not letting OCD take away his life and I am prepared to pay for the best therapist to tackle it. of course I know it's costly and I haven't actually got the money but I will have to find a way to make sure he doesn't get swallowed into this totally unfair condition. I really wish the very best for you Tomy. I hope you come out of it. No one should live with OCD. 


@LouiseAdolphsen   My son was 3 1/2 when he was diagnosed with high functioning autism. He is now 10 years old  and his OCD went from very mild to severe this year. We noticed the change this year and will probably put him on meds. We never done any form of medications for him but it's taking a toll for him and the family. Would really appreciate if you have any information to share with and I will do the same. He is going to see Neuropsychologist next month.