4 Tips to Help Your Child or Teen With OCD
When your child or teen has OCD, it can be hard to know how to help. You may find yourself answering the same questions over and over, participating in rituals, changing family routines, or trying to reassure your child—only to find that the anxiety keeps coming back.
Parents can play an important role in helping a child respond differently to OCD. Understanding what OCD is asking your child to do—and learning how to support them without unintentionally strengthening the OCD cycle—can make a meaningful difference.
Here are four ways you can begin supporting a child or teen who is struggling with OCD.
1. Understand How OCD Can Show Up in Children and Teens
What is OCD?
OCD generally involves obsessions and compulsions.
Obsessions are unwanted thoughts, images, urges, or fears that create distress or uncertainty.
Compulsions are behaviors or mental acts a child feels driven to do in response to those obsessions. Compulsions may include things like checking, repeating, asking for reassurance, confessing, mentally reviewing, or avoiding certain situations.
Sometimes compulsions are obvious. Other times, they can be easy to miss—especially when they happen entirely in your child's mind.
What can OCD look like in children and teens?
OCD doesn't always look like excessive handwashing or checking. In children and teens, it can show up in many different ways, and sometimes parents don't immediately recognize that a behavior is connected to OCD.
Some common OCD themes include:
Contamination fears — fears about germs, illness, or things feeling contaminated
Harm-related fears — intrusive thoughts or fears about accidentally harming themselves or someone else
“Just right” OCD — needing things to feel, look, sound, or be done a certain way
Scrupulosity — excessive fears about morality, religion, doing something wrong, or being a “bad” person
Intrusive thoughts — unwanted thoughts, images, or urges that can feel frightening or upsetting
Perfectionism-related OCD — feeling compelled to redo, check, or repeat something because it doesn't feel correct or good enough
Want help recognizing the different ways OCD can show up?
OCD can take many forms, and some are much easier to recognize than others. I created a free OCD Themes Checklist to help parents understand some of the different ways OCD may show up in children and teens.
Get the Free OCD Themes Checklist →
2. Help Your Child or Teen Recognize When OCD Is Showing Up
Learning to recognize OCD can help children and teens begin to separate themselves from what OCD is telling them to do.
You might help your child notice:
What kinds of thoughts or situations tend to trigger their OCD
What OCD urges them to do when they feel anxious or uncertain
Whether they are avoiding certain people, places, objects, or situations because of OCD
When they are looking to you for reassurance or certainty
Some younger children find it helpful to give OCD a name or imagine it as something separate from themselves. Older children and teens may prefer simply learning to recognize, “That's OCD asking me for certainty again.”
The goal isn't to constantly point out your child's OCD or get into an argument about whether a thought is “real.” Instead, you're helping them gradually become more aware of the pattern between an obsession, the discomfort or uncertainty it creates, and the compulsion that follows.
This can also help you as a parent recognize when OCD—not your child—is driving a particular behavior.
3. Help Your Child Practice Responding Differently to OCD
When OCD creates anxiety or uncertainty, performing a compulsion often provides temporary relief. Unfortunately, that relief can reinforce the OCD cycle by teaching the brain that the compulsion was necessary.
This is why simply telling a child, “There's nothing to worry about,” often doesn't help for very long. OCD tends to come back looking for more certainty.
With appropriate support, children and teens can gradually learn to experience uncomfortable thoughts, feelings, or uncertainty without immediately responding with a compulsion.
Depending on the child, this might mean:
Waiting before asking a reassurance question
Resisting the urge to check something again
Leaving something feeling “not quite right”
Gradually approaching something they have been avoiding because of OCD
Allowing uncertainty to be present without trying to resolve it immediately
These are some of the principles used in Exposure and Response Prevention (ERP), an evidence-based treatment for OCD.
Parents don't need to create an ERP treatment plan on their own. When OCD is significantly affecting a child's life, working with a therapist who has specific training in pediatric OCD and ERP can help ensure that treatment is individualized and appropriately paced.
What If Your Child Has PANDAS or PANS?
If your child's OCD symptoms are occurring in the context of PANDAS or PANS, treatment may need additional consideration.
PANDAS/PANS can involve a sudden or dramatic onset of OCD along with other neuropsychiatric symptoms. A child may also be experiencing significant anxiety, rage, separation anxiety, sensory sensitivities, eating restrictions, cognitive changes, school avoidance, or other symptoms at the same time.
When a child is in an acute flare or experiencing significant inflammation and dysregulation, they may not have the same capacity to participate in traditional ERP that they might have when they are more medically and emotionally stable.
This doesn't mean ERP can never be helpful for a child with PANDAS/PANS. Timing, pacing, and the child's current medical and emotional state matter.
During more acute periods, families may need to focus first on appropriate medical care, psychoeducation, reducing demands when needed, supporting regulation, and helping the family understand what is happening. As symptoms stabilize, therapeutic work can be introduced or adjusted based on what the child is able to tolerate.
For parents, this can be particularly confusing. You may receive standard OCD advice about immediately challenging avoidance, reducing reassurance, or stopping accommodations. While those strategies can be important in OCD treatment, how and when they are implemented may need to look different when a child is severely dysregulated or medically unwell.
If your child has PANDAS/PANS, it can be helpful to work with providers who understand both OCD and the complexities of PANDAS/PANS, rather than assuming that the same therapeutic approach is appropriate at every stage of illness.
4. Pay Attention to Family Accommodation
When your child is distressed, your instinct may naturally be to do whatever you can to make things easier.
With OCD, however, families can sometimes unintentionally become part of the OCD cycle. This is known as family accommodation.
Family accommodation might include:
Repeatedly answering reassurance questions
Participating in your child's rituals
Changing family routines because of OCD
Doing things for your child that OCD prevents them from doing
Helping your child avoid situations that trigger anxiety
Providing certainty when OCD is demanding an answer
If you've been doing these things, it doesn't mean you've done something wrong. Most parents accommodate OCD because they are trying to help a distressed child.
Reducing accommodation is usually a gradual process, particularly when OCD is severe or when medical, developmental, or neuropsychiatric factors affect what a child can tolerate.
Rather than suddenly refusing all reassurance or stopping every accommodation at once, parents can learn how to respond in ways that support their child without continuing to reinforce the OCD cycle.
And if your child has PANDAS/PANS, this is another area where pacing matters. What your child can tolerate during a period of relative stability may be very different from what they can manage during a significant flare.
When Should You Seek Professional Help for Your Child's OCD?
You don't need to wait until your family is completely overwhelmed before seeking help.
If OCD is interfering with your child's daily life, relationships, school, sleep, activities, or ability to function, an evaluation by a professional experienced in treating OCD can help you understand what may be happening and what kind of support is appropriate.
Exposure and Response Prevention (ERP) is considered a first-line psychological treatment for OCD. ERP helps children and teens gradually face feared thoughts, situations, or uncertainty while learning not to rely on compulsions for relief.
Treatment can also include significant work with parents, particularly when reassurance, avoidance, or family accommodation has become part of the OCD cycle.
If PANDAS/PANS is suspected or already diagnosed, treatment planning may also require coordination with appropriate medical providers and consideration of where the child is medically and emotionally.
A Final Thought for Parents
Watching your child struggle with OCD can be difficult. It's understandable to want to take away their anxiety, answer the question one more time, or change something so they can feel better.
One of the most helpful shifts parents can make is learning how to support their child without always having to help OCD feel certain or safe.
That doesn't happen perfectly or overnight.
And when OCD is part of PANDAS/PANS, parenting can become even more complicated. You may be trying to determine what is OCD, what is a flare, when to push, when to step back, and whether you're making the right decisions—all while watching your child struggle.
Parents need support in this process, too.
If you're parenting a child, teen, or young adult with PANS/PANDAS, you may also be carrying the effects of what your family has been through. You can learn more about my PANS/PANDAS therapy and parent support here.
I provide virtual therapy in New York, Connecticut, and Delaware. If you'd like to explore whether working together might be a good fit, you can schedule a free 15-minute consultation by clicking the button below.
Julie Cox, LCSW is a licensed therapist with 25 years of experience supporting children, teens, young adults, parents, and adults in New York, Connecticut, and Delaware.
She specializes in working with families navigating PANDAS/PANS and has extensive experience supporting children and families affected by anxiety and OCD. Her approach is individualized and may include ERP, CBT, ACT, nervous system-informed approaches, and parent support, depending on a child's needs and where they are medically and emotionally.
Julie also works closely with PANDAS/PANS parents, helping them navigate the emotional impact of caring for a child with a complex neuroimmune condition.
Therapy for OCD
Therapy for PANDAS/PANS
Trauma Therapy and EMDR