2nd try - I'm new and need advice

September 12, 2002

My 6 year old boy was just diagnosed with OCD. He has been getting

treatment from a child psychologist who we like very much. She is

doing CBT, but is not doing exposure and response prevention (E/RP).

From what I've read, E/RP is critical.

I plan to give our psychologist some information on the importance of

E/RP. I've also ordered a book ( Free Your Child From OCD)which

discusses E/RP. I plan to share the book with her. I hope she will

respond and work with us on this.

Can anyone recommend someone trained and experienced in the

Cleveland or Akron area?

Thanks

September 12, 2002

Hi! I believe the OCD Foundation can send you a list of qualified

therapists in your area. Their website address is

http://ocfoundation.org

Hopefully your current child psychologist will work with you on the

ERP. I believe I've read here where another parent(s) had done the

same thing - get OCD info to their child psych/therapist on how best

to treat OCD (CBT and ERP). And the relationship your child has with

the therapist is really important too, so hope the current one works

out well for you! Keep us posted.

What type OCD behaviors does your son have?

> My 6 year old boy was just diagnosed with OCD. He has been

getting

>

> treatment from a child psychologist who we like very much. She

is

>

> doing CBT, but is not doing exposure and response prevention

(E/RP).

>

> From what I've read, E/RP is critical.

>

> I plan to give our psychologist some information on the importance

of

>

> E/RP. I've also ordered a book ( Free Your Child From OCD)

which

> discusses E/RP. I plan to share the book with her. I hope she

will

>

> respond and work with us on this.

>

> Can anyone recommend someone trained and experienced in

the

>

> Cleveland or Akron area?

>

> Thanks

September 12, 2002

Hi there, I did see your first post but didn't respond since I can't recommend

someone in Cleveland or Akron. My daughter is eight now but was four when she

experienced an abrupt onset of severe OCD. It's been my experience that

therapists shy away from using ERP techniques with young children because they

are difficult and aversive (others won't do the cognitive parts because they

believe a young child won't be able to understand.) They also may think a child

won't cooperate with therapy if it becomes hard, won't tolerate even mild

anxiety provoked on purpose, etc. But you are absolutely right, exposure to the

feared things in a controlled and gradual fashion is key to reducing OCD

symptoms.

I like your idea of sharing Dr. Chansky's book with the therapist. To have

found a therapist who is familiar with CBT/ERP for OCD is really a godsend in

some areas, and that you and your son already have a relationship with and like

her is valuable, something worth keeping if she is open to doing the ERP

component of therapy. I would have been thrilled to have found a therapist for

my daughter who even knew what CBT/ERP was, much less actually practice it with

children! :-)

My daughter did very well with ERP at ages six and seven with only me as her

coach, since I couldn't find anyone appropriate who would treat her due to her

age, and I felt the clock was ticking. I relied on the March manual and the

guidance of those on this list. (Now at age 8, she sees a great therapist and I

have " retired " as her counselor!!) I just told her, as nutty as it sounded, the

way to make OCD leave her alone was to do exactly what " he " was telling her

*not* to do. I also told her doing this would give her the " bad feelings " (her

word for anxiety) but not too bad, and it would go away soon on its own. These

young kids will surprise us once given the tools and support to boss OCD into a

corner. Successfully using ERP techniques was at least as important to her

recovery as the SSRI she was taking, and the two together pulled her OCD from

the severe to the mild category. Most importantly she *knows* what to do, and

knows she can win, no matter what stupid thought or compulsion OCD comes up

with. This sense of being in charge rather than being at OCD's mercy is,

needless to say, very empowering for her.

OK, off my soapbox! Your son is very lucky to have a Mom so determined to give

him the right and effective type of therapy for his OCD right out of the

starting gate. Write again and let us know how things go.

Take care,

Kathy R. in Indiana

----- Original Message -----

From: keuper

My 6 year old boy was just diagnosed with OCD. He has been getting

treatment from a child psychologist who we like very much. She is

doing CBT, but is not doing exposure and response prevention (E/RP).

From what I've read, E/RP is critical.

I plan to give our psychologist some information on the importance of

E/RP. I've also ordered a book ( Free Your Child From OCD)which

discusses E/RP. I plan to share the book with her. I hope she will

respond and work with us on this.

Can anyone recommend someone trained and experienced in the

Cleveland or Akron area?

September 12, 2002

Kathy and

Thanks for your responses. I forgot to sign my original message. My

name is Joe B.

I believe my son has Mild OCD, but I have not seen a rating system.

Can anyone refer me to one? The only recent symptom that he has had

is fear of getting germs on stuff like his books. No repeated hand

washing, but he was asking his mom about his fear several times a day.

Kathy, we will try your advice on how to handle it at home - just tell

him that if he wants the thought to leave him alone, he needs to touch

the book...will get the bad feeling and then will go away. Right?

Since we believe his symptoms are mild, we have not yet explored

medication. My hope is that it will not be necessary.

Kathy, you mentioned the March Manual - do I need it in addition to

the book I have ordered (Free Your Child From ODC)? If so, what is

the full name.

Thanks again.

Joe B

> Hi there, I did see your first post but didn't respond since I can't

recommend someone in Cleveland or Akron. My daughter is eight now but

was four when she experienced an abrupt onset of severe OCD. It's

been my experience that therapists shy away from using ERP techniques

with young children because they are difficult and aversive (others

won't do the cognitive parts because they believe a young child won't

be able to understand.) They also may think a child won't cooperate

with therapy if it becomes hard, won't tolerate even mild anxiety

provoked on purpose, etc. But you are absolutely right, exposure to

the feared things in a controlled and gradual fashion is key to

reducing OCD symptoms.

>

> I like your idea of sharing Dr. Chansky's book with the therapist.

To have found a therapist who is familiar with CBT/ERP for OCD is

really a godsend in some areas, and that you and your son already have

a relationship with and like her is valuable, something worth keeping

if she is open to doing the ERP component of therapy. I would have

been thrilled to have found a therapist for my daughter who even knew

what CBT/ERP was, much less actually practice it with children! :-)

>

> My daughter did very well with ERP at ages six and seven with only

me as her coach, since I couldn't find anyone appropriate who would

treat her due to her age, and I felt the clock was ticking. I relied

on the March manual and the guidance of those on this list. (Now at

age 8, she sees a great therapist and I have " retired " as her

counselor!!) I just told her, as nutty as it sounded, the way to make

OCD leave her alone was to do exactly what " he " was telling her *not*

to do. I also told her doing this would give her the " bad feelings "

(her word for anxiety) but not too bad, and it would go away soon on

its own. These young kids will surprise us once given the tools and

support to boss OCD into a corner. Successfully using ERP techniques

was at least as important to her recovery as the SSRI she was taking,

and the two together pulled her OCD from the severe to the mild

category. Most importantly she *knows* what to do, and knows she can

win, no matter what stupid thought or compulsion OCD comes up with.

This sense of being in charge rather than being at OCD's mercy is,

needless to say, very empowering for her.

>

> OK, off my soapbox! Your son is very lucky to have a Mom so

determined to give him the right and effective type of therapy for his

OCD right out of the starting gate. Write again and let us know how

things go.

>

> Take care,

> Kathy R. in Indiana

> ----- Original Message -----

> From: keuper

>

> My 6 year old boy was just diagnosed with OCD. He has been getting

>

> treatment from a child psychologist who we like very much. She is

>

> doing CBT, but is not doing exposure and response prevention

(E/RP).

>

> From what I've read, E/RP is critical.

>

> I plan to give our psychologist some information on the importance

of

>

> E/RP. I've also ordered a book ( Free Your Child From OCD)which

> discusses E/RP. I plan to share the book with her. I hope she will

>

> respond and work with us on this.

>

> Can anyone recommend someone trained and experienced in the

>

> Cleveland or Akron area?

>

September 12, 2002

Hi Joe, I read two symptoms in your last post: the worry that the books are

germy, and the compulsive, repetitive reassurance-seeking that they are not.

Don't be too surprised if there are others that you have not noticed yet, my

child has had innumerable compulsions that looked " normal " such as bike-riding,

roller-blading, jumping on the trampoline, etc. etc. that all had a compulsive

element of " do it a certain number of times " or " do it right " (all these had an

obsession behind them, that some terrible thing could happen to herself or her

family if she didn't.) Needless to say, these normal and age-appropriate

activities aren't any fun when you have a gun to your head so to speak. Some

kids, mine included, also have difficult-to-notice mental compulsions such as

counting that take up lots of their time and attention.

The book I mentioned is a manual intended for therapists and is considered the

CBT 'bible': " OCD in Children and Adolescents " by Dr. March and

Mulle. I bought it when I wanted to learn about CBT/ERP to do this with my

child at ages 5 and 6 before I could find a qualified therapist for her. Though

it's intended for professionals it is very easy-to-read and follow. Dr.

Chansky's book was not yet available when I bought Dr. March's. You might see

if you can find a copy at a library, to decide if this book would also be of use

to you.

Re encouraging your son to touch the germy books: you could make sort of a game

of it, after explaining that this is how you get OCD (or whatever your son calls

it) to back off. Can you touch the book while I count to 10? etc. etc. Can you

give it a big hug? I made liberal use of rewards (cookie, TV, toy, special

outing, whatever) to motivate my child, and her therapist has us do this still

at age 8.

Lots of parents are entangled in their child's rituals, this comes very

naturally to us of course, to provide reassurance and a sense of safety. But

when OCD is present, answering the repeated bids for reassurance strengthens the

OCD. Your wife could begin to limit the number of times she answers whether the

book is germy, after explaining that answering OCD's questions just help keep

" him " strong.

You want to start small and slow to make sure your child " wins " (resists the

compulsion, feels some anxiety which will diminish without doing the compulsion,

but isn't overwhelmed with anxiety.) Delaying doing the compulsion can be very

helpful too. Timing can help, pick a time when your son is not overtired or

overstressed or trying to watch his favorite TV show. :-)

Hope I helped,