The American Academy of Child and Adolescent Psychiatry (AACAP) states that OCD is found in as many as 1 in 200 children and adolescents. The behaviors of OCD severely impact their ability to successfully function in school and at home, and they interfere with socialization. Medication may help, but therapeutic activities are the key to treating OCD.
Symptoms
Obsessions are persistent anxiety-causing thoughts or images. Compulsions are repetitive behaviors related to the obsession. These behaviors turn into rituals that must be completed before the child can move on to do anything else. Common obsessions for children revolve around fears of being harmed, fear of a parent dying and fears about illness or germs. A related compulsive behavior might be constantly washing their hands to be rid of the germs. Other common rituals revolve around arranging toys or objects in a specific way and hoarding items. These behaviors can't be controlled and they consume time and attention, leaving children unable to focus or complete tasks.
Therapy Factors
The child's age can create challenges to implementing therapy. Depending on their level of development, children may not be able to make the connection between obsessions and compulsions. Younger children may also have a hard time describing their fears and may not understand why they perform compulsive rituals. At any age, they are less motivated to engage in work now for a future benefit that they don't fully comprehend, and their potential anxiety over entering treatment may render them less able to participate. Still, therapeutic activities are critical. The AACAP states, "The younger the child, the more one would first attempt a non-pharmacological treatment such as cognitive-behavioral treatment."
Cognitive Behavioral Therapy
Cognitive behavioral therapy uses structured activities such as a workbook, daily or weekly activity sheets, maintenance of a diary, and specific assignments. The goal is to record anxiety-producing thoughts, feelings and behaviors so that the information can be reviewed later with the therapist. In this way children learn to recognize the negative obsessions and compulsions and can begin to learn to replace them with positive thoughts and behaviors.
