It Takes a Team: What to Expect from Exposure and Response Prevention for Pediatric Obsessive-Compulsive Disorder

When you have a child with obsessive-compulsive disorder (OCD), the road to finding the best treatment options can be confusing and daunting.

Soon after diagnosis, parents may hear about exposure and response prevention (ERP). This form of treatment has proven to be particularly effective for pediatric OCD, and it uses a team approach to help the child manage the symptoms. During ERP, “exposures” refer to having the child face their feared situations in a systematic, gradual manner. The “response prevention” portion encourages the child to refrain from doing their OCD-related compulsions and rituals. For example, a child with germ-related worries about door handles may be asked to touch a door handle (exposure), and refrain from washing their hands afterwards (response prevention). By practicing these tasks over and over, with increasing difficulty, the child learns to break the link between their fears and their need to do their rituals.

It takes a team (therapist, child, and parent) to help your child successfully manage his/her OCD through ERP.

Team Member: Therapist

Role:

  • Helps develop the specific roadmap for treatment
  • Creates and models how to conduct exposures
  • Assigns ERP home exercises (i.e., exposures assignments at home)
  • Teaches skills to help better manage anxiety/discomfort in everyday life
  • Supports and rewards child’s efforts
  • Acts as a coach (e.g., skill development and practice, encouragement)

Team Member: Child

Role:

  • Works together with the provider to customize the treatment plan and ERP assignments
  • Completes exposures in session and at home as assigned
  • Practices better ways to manage the anxiety/discomfort that were taught in session

Team Member: Parent

Role:

  • Serves as a coach at home (and in-session, as needed)
  • Helps carry out home assignments in between therapy sessions (e.g., facilitating exposures)
  • Models calm behaviors for the child
  • Tries out new ways to disengage from the child’s OCD that were taught in session
  • Supports and rewards child’s efforts

Each team member has a unique and equally important role in helping the child manage his/her OCD symptoms. By working together, the team approach will ensure that the child is getting the support needed to conquer their OCD.

Written by:

Monica S. Wu, PhD

CARES Staff Psychologist