Cognitive Behaviour Therapy (CBT)
Involves a detailed assessment of the problem, often starting with the child and family keeping a diary of the obsessions and compulsions. The aim of the treatment is to teach young people how to get control of the problem, by tackling it a little bit at a time. The young person designs the treatment programme with the therapist, so that little by little they can overcome their fear. Young people need to be actively involved in planning the treatment, because they need to know that they are not going to be made to do things that they do not want to do, or that they are not ready to do.

Sometimes parents or other family members get very involved in the OCD rituals. Families need to learn about OCD, and also about how to help their child fight back. Sometimes this means showing OCD that parents will resist getting roped in to carrying out annoying rituals with their child, by saying 'NO' to OCD !

One of the reasons that children keep doing the compulsions that they have (such as washing hands, or checking light switches) is because of worrying what will happen if they did not do it. Sometimes the compulsion is doing a special thing (a ritual), sometimes it is avoiding something, or sometimes it is asking for reassurance. Trying not to do the compulsion makes most people with OCD feel anxious. One of the most powerful ways of fighting OCD is learning how to confront this anxiety.

Medication
The medications that work with OCD all act on a brain chemical called serotonin. All the drugs used are well known antidepressants, but it is their special anti obsessional effect that makes them work in OCD. Most of the drugs used are ‘SSRIs’. That stands for selective serotonin reuptake inhibitors.

There are several anti-obsessional medications available. The drugs used in OCD treatment have been used in adults for quite a long time; they seem to be safe and useful for young people too. Although each has side-effects, most people only experience them as short-lived, minor irritations.

Only sertraline is currently (2002) licensed for use in children in the UK; this does not mean that the other medicines cannot be used. Ask your doctor to explain about licensing. Treatment will begin with a low dose, and build up gradually. Although some young people with OCD stay on medication for quite a long time, you shouldn't worry about this. Having bad OCD is more risky ! For further information, see the section on ‘Treatment of OCD’.

OCD Action can supply a CD-ROM information pack for young people called 'Why me ?' Please contact the OCD Action office for a copy or visit the OCD Shop page for details.

What causes OCD ?
Finally, although the cause of OCD is not known, research work has given some clues. Because the medication that works well in OCD acts on a specific chemical, serotonin, which we all have in our brains, it is possible that people who get OCD have an imbalance in serotonin. The tendency to develop OCD seems to run in families, as well as there often being other family members with OCD, there are sometimes people with involuntary jerky movements (tics) in the family. This has led to ideas that obsessive thoughts may be a bit like a 'tic' in the mind, something that just happens.

One of the main benefits of understanding that OCD is likely to be a neurobiological disorder, is that it helps young people and families realise that it is not their fault. Children and families do not cause OCD, but they can learn ways to fight back at it !

Source: OCD Action 2002