Obsessive-Compulsive Disorder (OCD) is characterized by both obsessions (recurrent or intrusive thoughts or images) and compulsions (ritualized behaviors that have to be done a certain way or a certain number of times). Obsessions and compulsions vary widely from person to person. The most common obsessions are fear of contamination, fear of being harmed, fear of harming others, and fear of making mistakes; the most common compulsions are cleaning, washing, checking, and hoarding. For children with OCD, these thoughts and behaviors significantly interfere with their daily functioning and can also be quite distressing and embarrassing. OCD occurs in about 2% of adults and more than half of all who develop OCD do so by age 19 as it often emerges in childhood or early adolescence. Due to embarrassment and fear that they are ‘going crazy' many children try to be secretive of these rituals and thoughts. It is not surprising that there are often many years between the time that symptoms appear and treatment is initiated.
How Do You Treat OCD?
Historically, people with OCD were treated with psychodynamic (Freudian) therapy. This was with the - flawed - reasoning that these symptoms represent an impaired way of dealing with past, unconscious experiences. Research has disproven this, and we now understand that OCD represents a disorder of brain functioning. Recent research on childhood OCD suggests that the recommended course of treatment for youth with mild to moderate OCD is to begin with Cognitive Behavior Therapy (CBT) and add medication if needed. The recommended treatment for those with moderate to severe OCD is to begin with both CBT and psychopharmacology. While CBT is recommended for all anxiety disorders, a particular type of CBT called Exposure and Response Prevention (ERP), is most effective for OCD. As part of ERP, once a child has learned the basic CBT tools of recognizing anxious thoughts, developing coping thoughts, and managing the physical symptoms of anxiety, he/ she works with the therapist to gradually face fears and engage in the behaviors that OCD had previously prohibited.
Our Clinical Services
The NYU Child Study Center offers both psychological and psychopharmacological treatments for OCD. Following an initial evaluation, recommendations will be made by the evaluating clinician as to whether the child should begin with ERP, medication, or a combination. ERP is generally conducted individually on a weekly basis. More intense treatment (multiple sessions per week or a one-week intensive program) may also be available on a case-by-case basis. For younger children with OCD, parental involvement is extremely important and parents may be required to attend all sessions with their child. For older children, teens, and young adults, parental involvement may be more varied. While most sessions will occur on site at the NYU Child Study Center, for some children it may be necessary to hold ERP sessions in their home, school, or community.
For more information or to schedule an appointment please contact an intake coordinator at (646) 754-5000 or e-mail us at firstname.lastname@example.org.
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