“What I tell parents is trust your radar,” he said. “If your child seems off emotionally, or raw or fragile in a way you wouldn’t expect, or significantly different than peers or siblings, then you won’t regret bringing a professional into the situation.”
The most effective approach for those with mild to moderate O.C.D. is cognitive behavioral therapy with exposure response prevention, which involves gradually introducing a person to the thing that scares them without giving in to rituals, Dr. Storch said. And the good news, he said, is that this treatment is effective at reducing symptoms more than 75 percent of the time. In more extreme cases, these therapies can be paired with medication.
Lara Koelliker, who is 18 and has been treated for O.C.D. since age 8, said she had severe symptoms for three years before finding a therapist who specialized in exposure therapy. The treatment helped her manage her symptoms by giving her coping mechanisms, she said.
“I’ve learned how to sit with my uncomfortable feelings, and I don’t give in to my compulsions,” she said. “Now the part of me that has been equipped with all these strategies jumps in.”
Therapy on Zoom
Many therapists are using video calls to treat patients now. And being inside a patient’s house, virtually speaking, can be useful for exposure treatment, as home is often “where O.C.D. lives,” Dr. Freeman said. Some kids, for example, have fears involving contamination from pets, family members, or parts of their house.
“On Zoom, I can say, ‘Can you show me that room? Can you show me that couch? Do you think you can sit on that couch? Can we do it together?’”
Beyond therapy, parents’ top priority needs to be listening to their kids, Dr. Freeman said.
“Validate, validate, validate what the kids are feeling,” she said. “And be willing to have difficult conversations that stir up anxious distress in all of us. It’s really important not to tell a child they shouldn’t be sad, anxious or upset. That invalidates the emotions they’re feeling.”