Obsessive Compulsive Disorder (OCD) is an anxiety-related condition where the child or young person (CYP) experiences frequent unwanted intrusive thoughts commonly referred to as obsessions. Obsessions are very distressing and the CYP carries out repetitive behaviours or rituals to neutralise the perceived harm or worry the preceding obsessions focus on. These repetitive behaviours are known as compulsions and can include ‘overt behaviours’ like excessive hand washing and/or cleaning, checking, tapping, avoiding people, places or objects and constant reassurance seeking as well as hidden mental behaviours like counting, praying, repeating a phrase.
Compulsions temporarily reduce the distress caused by the intrusive thoughts. However, in the long-term compulsions reinforce the CYP’s original obsession and need to carry out compulsions. This can lead to a gradual worsening cycle of OCD symptoms.
OCD is often associated with significant disruption and impairment in family, social and academic life and can have adverse impacts on psychosocial development.
Developmental Considerations
Most children have routines and exhibit normal age-dependent obsessive-compulsive behaviours. These behaviours are often transient and can be understood in terms of development issues involving mastery and control (like ordering and categorising) or as magical thinking and ritualistic behaviours (avoid stepping on cracks).
Understanding the motivation behind the CYP’s behaviours can help recognise if they are OCD-related or just part of normal development. OCD related compulsions are driven by anxiety and distress rather than preference.
OCD that is left unchecked and untreated will likely continue to grow. It is therefore recommended patients and families seek professional advice and support as soon as possible. The most effective treatment for treating OCD is Cognitive behavioural Therapy (CBT).
Young people and parents/carers may want to access online and other resources to learn more about OCD and its treatment options – please see Resources and Links for detail.
In addition to arranging help for the child and young person, and as anxiety is a feature of OCD, parents and carers may be helped by the cCBT module on anxiety, for use by themselves.
GK & CM 16/1/26
OCD can be episodic, and symptoms can be random and change over time with no clear pattern. This can make initial identification difficult. It is important to be aware of the possible co-existing presence of OCD within autistic CYP as it frequently missed.
Who to refer
A referral to a specialist should be considered where:
- The CYP experiences recurrent and persistent intrusive thoughts that are often experienced as unwanted and cause marked anxiety and distress. The CYP attempts to suppress or ignore the intrusive thoughts or neutralise them with a compulsive behaviour.
- Obsessions and compulsions are time consuming and cause significant disruption and impairment in family, social and academic life.
- Symptoms are present for a period of time and have a pattern of continual worsening.
Online Resources for Parents and Carers
- OCD-UK: https://www.ocduk.org/
- OCD-UK’s Parent Project: https://www.ocduk.org/parents/
- Online Support Groups (Themed Support Groups – Parents Support Group): https://www.ocduk.org/support-groups/online/
- Helping your Child with Obsessive Compulsive Disorder A Parent / Carer Self Help Guide –
- https://www.anxietyuk.org.uk/wp-content/uploads/2010/06/Helpling-your-child-with-Obsessive-Compulsive-Disorder.pdf
Online Resources for Young People
- OCD-UK: Pocket sized guide for young people –https://www.ocduk.org/teens/
- OCD-UK: To the recently diagnosed- A video offering hope and inspiration – https://www.ocduk.org/ocdukya/to-the-recently-diagnosed/
- Online Support Groups (Themed Support Groups – Young People Support Group): https://www.ocduk.org/support-groups/online/
Self-help Books
- Breaking Free from OCD: A CBT Guide for Young People and Their Families by Derisley
- What to Do When Your Brain Gets Stuck: A Kid’s Guide to Overcoming OCD (What-to-Do Guides for Kids) by Huebner and Matthews
- Break free from OCD by Challacombe, Bream-Oldfield, Salkovskis
