Finding a therapist who can diagnose and effectively treat OCD in kids and teens is a challenge for many parents and families. Some estimates indicate that it can take up to 14–17 years from the onset of symptoms to getting an appropriate diagnosis and effective treatment for OCD.
Why the delay?
- Hiding symptoms: Some children may choose to hide their symptoms, often in fear of embarrassment or because they just don’t understand what is happening. This can cause many kids, teens, and even adults with OCD to not ask for help until many years after symptoms begin.
- Lack of proper training in health professionals: Children with OCD can sometimes get the wrong initial diagnosis from health professionals and may wind up seeing many doctors and therapists over the course of several years before finally getting the right diagnosis. ADHD and autism spectrum disorders can have similar symptoms, but require very different treatments than OCD.
- Difficulty finding local therapists who can effectively treat OCD in children and adolescents.
- Not being able to afford proper treatment.
The 2013 APA Practice Guideline for the Treatment of Patients with Obsessive Compulsive Disorder recommends beginning treatment with a type of cognitive behavior therapy (CBT) called exposure and response prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD. Below are some tips and guidelines for finding a good ERP therapist.
Tips for Finding the Right Therapist
When you search for a therapist in the Resource Directory, you may get more than one result for your area. There are many factors to now consider when choosing the right therapist for your child. In addition to practical matters such as whether they accept your insurance, how convenient their office is for you, and so on, you also need to make sure that the therapist is someone who you and your child will feel comfortable working with. Below are some tips to helping you find the best possible treatment for your child.
Remember that some therapists are better at treating OCD in kids and teens than others. It is important to interview therapists to find out if they know how to do exposure and response prevention (ERP) therapy well. Their responses to your questions are a good guide to what you want to know about a new therapist. Your initial consultation may be done over the phone or in person, but either way, remember:
- You have the right to ask questions. This is your child’s life and health!
- If the therapist is guarded, withholds information, or becomes angry at your requests for information, you should probably look elsewhere.
- If the therapist appreciates how important a decision this is for you and your family and is open, friendly, and knowledgeable, you may have a gem of a therapist!
- Your child’s relationship with the therapist is important, especially since he or she will potentially be asking your child to do things that your child may find scary at first.
Here are some good questions to ask as you consider whether the therapist is a good fit:
“What techniques do you use to treat OCD?”
If the therapist is vague or does not mention cognitive behavior therapy (CBT) or exposure and response prevention (ERP), use caution.
“Do you use exposure and response prevention to treat OCD?”
Be cautious of therapists who say they use CBT but won’t be more specific.
“What is your training and background in treating OCD?”
If the therapist says he or she went to a CBT psychology graduate program or did a post-doctoral fellowship in CBT, it is a good sign. Another positive is if a therapist says he or she is a member of the International OCD Foundation (IOCDF) or the Association of Behavioral and Cognitive Therapists (ABCT). Also look for therapists who say they have attended specialized workshops or trainings offered by the IOCDF, like the Behavior Therapy Training Institute (BTTI), Pediatric BTTI, or Annual OCD Conference.
“Are you trained to work with children and/or teens with OCD?”
“How much of your practice currently involves anxiety disorders?”
A good answer would be over 25%.
“Do you feel that you have been effective in your treatment of OCD?”
This should be an unqualified, “Yes.”
“Are you willing to leave your office if needed to do behavior therapy?”
It is sometimes necessary to go out of the office to do effective ERP.
“Do you include families in any of the treatment?”
OCD can be very isolating and is unique in that obsessions and rituals can sometimes involve members of the family. Parents and caretakers (and even siblings sometimes) are an important part of a child’s OCD treatment, and should be involved in many ways. Your therapist should be open to including family members as part of the treatment plan.
These tips have been adapted from “How to Choose a Behavior Therapist” by Michael Jenike, MD