Obsessive-Compulsive Disorder (OCD)

Obsessions are unwelcome or intrusive thoughts, worries, feelings, images, urges or doubts. Everyone’s obsessions are different, but they can include:

• worrying about something bad happening, like their home burning down or someone they love dying
• worrying that they are going to harm someone else, or have already harmed someone else
• worrying about becoming contaminated – for example with germs, viruses, infections, dirt or dangerous chemicals
• intrusive sexual thoughts or images
• intrusive violent thoughts or images
• having a general feeling or sense that something is wrong, or that something bad is going to happen

CBT is a type of talking therapy that focuses on changing the way we think and behave. Over time, a CBT therapist can help your child to develop a different relationship with their thoughts and how they feel about them. They can also support them to try out new ways of responding or behaving when they’re experiencing obsessions.

NICE recommends that CBT therapy for OCD should include Exposure and Response Prevention (ERP) techniques. ERP involves purposefully letting obsessive thoughts come up without using compulsions to deal with them. This can help your child to realise that they can manage the anxiety without compulsions.

If your child is under 18, NICE recommends that you, or their other parent or carer, should be involved in the CBT so that you can support them with the techniques at home.

Your child may have online, in-person, group or individual CBT. NICE guidelines state that they should have a choice about which they would feel most comfortable with.

Find out from your child what support they'd like from you when they’re struggling. Sometimes this could be offering a distraction like going for a walk or doing something creative together. At other times, it might be listening and providing emotional support. Your child can use OCD-UK’s booklet to let you know what kind of help they’d like from you, and you can use their parent guide to support you to respond.

If your child finds it difficult to tell you when they’re struggling with thoughts, try and find other ways of communicating. Some young people say they find it easier to agree a code word with their parent or carer. They can then say or text this word to them when they’re struggling with their thoughts and compulsions. This means they don’t need to voice what’s going on aloud, but can still alert you to the fact that they need support. Your child can also use OCD-UK’s booklet, in which they can write down the thoughts they’re having and circle the types of support they’d like from you.

Regularly doing activities that help them feel relaxed and soothed can help. Find out what works for them. It could be things like:

• colouring or drawing while listening to music or podcasts
• mindfulness and breathing exercises or meditation
• doing exercise like running, walking, playing sport or yoga
• finding ways to wind down in the evening
• doing activities that give them something to do with their hands, such as doodling, sewing, knitting or making something

You can also help your child to do the daily things that support your wellbeing. These include getting enough sleep, eating regular meals, doing some exercise and spending quality time with friends and family. They might sound simple, but they do have an effect on our mood.

When you’re stuck in a cycle of obsessions and compulsions, it can feel like there’s no way out. Let your child know that getting the right professional support can make a huge difference and that, with help, it won’t be like this forever.

Your child or young person’s thoughts might sometimes feel shocking to hear about. If your child is experiencing violent or sexual thoughts, or worrying about harming someone, remember that people with OCD are very unlikely to act on their thoughts. Some young people say their intrusive thoughts are the opposite of who they are. Worrying constantly about these things can show just how much they don’t want to cause harm to other people.