Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is often misunderstood as simply being “overly clean” or “particular.” In reality, OCD is a complex anxiety-related condition characterized by unwanted intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) aimed at reducing anxiety. These compulsions may provide temporary relief, but they ultimately reinforce the anxiety, creating a vicious cycle that can dominate a child’s daily life.

OCD can present in many forms, including fears of contamination, excessive checking, needing things to feel “just right,” or intrusive thoughts about harm or inappropriate topics. For children, OCD is often confusing and frightening, as they may not understand why their minds produce these distressing thoughts, leading to shame or secrecy.

Leading researchers such as Dr. Jonathan Grayson, Dr. Edna Foa, and Dr. Aureen Pinto Wagner emphasize that OCD is driven by a faulty alarm system in the brain, causing the individual to overestimate danger and feel an urgent need to neutralize perceived threats. Dr. Jeffrey Schwartz, in his influential work on neuroplasticity, highlighted that targeted treatment can actually change brain chemistry over time, empowering individuals to reclaim control from their OCD.

Our Treatment Approach At Moroz Child Psychology Group, we understand the unique challenges OCD presents to both children and their families. Successfully managing OCD requires a treatment approach built on trust, knowledge, and courage. Children must feel safe with their therapist, understand what is happening in their brain, and gradually face their fears to experience freedom from the grip of OCD.

Key Areas of Focus in Treatment:

• Building Understanding & Trust: We begin by normalizing the intrusive thoughts that accompany OCD. We help children and parents understand that everyone has strange or unwanted thoughts, but OCD magnifies their significance. We teach that the problem is not the thoughts themselves, but the compulsions and the meaning assigned to those thoughts.
• Changing the Brain (Neuroplasticity): Drawing on Dr. Jeffrey Schwartz’s work, we emphasize that exposure therapy, when done correctly, actually rewires the brain’s alarm system. Children are taught that by resisting compulsions and allowing anxiety to decrease naturally, they are weakening the faulty brain circuits that fuel OCD.
• Exposure and Response Prevention (ERP): Grounded in the work of Dr. Edna Foa, ERP is the gold-standard treatment for OCD. We guide children in gradually facing their fears without resorting to compulsions. Together, we create a fear hierarchy, breaking down anxieties into manageable steps. Children learn that the anxiety will naturally decrease over time (habituation) and that they can survive the discomfort without giving in to OCD’s demands.
• Combining Exposure with Cognitive Flexibility: We help children challenge the rigid, catastrophic thinking patterns that OCD often produces. Inspired by Dr. Jonathan Grayson’s work, we teach that the goal is not to achieve certainty, but to learn to tolerate uncertainty. This shift in mindset is key to long-term success.
• Externalizing OCD (“Boss Back” Approach): Drawing from Dr. Aureen Pinto Wagner’s book “Up and Down the Worry Hill,” we help younger children view OCD as an external bully or “boss” that tries to control their actions. We empower children to “talk back” to OCD and regain their sense of choice and autonomy.
• Parent Collaboration: OCD often affects the entire family, with parents unintentionally accommodating rituals to reduce their child’s distress. We work with parents to set boundaries around compulsions, support exposure work, and reduce reassurance-seeking behaviors while maintaining compassion and support.
• Tailoring to Each Child: While ERP is the foundation, we recognize that every child is different. For younger children or those with severe anxiety, we may start with more gradual exposures, play-based techniques, or parent-focused coaching to build readiness.

Our goal is to help children understand their OCD, confront their fears, and reclaim their lives. Through evidence-based interventions and a trusting therapeutic relationship, we guide children toward lasting freedom from the cycle of obsessions and compulsions.