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Behavioral and Cognitive Therapy for OCD in Children and Adolescents

Obsessive-compulsive disorder (OCD) is an anxiety disorder. It causes obsessive thoughts and compulsive behaviors that can interfere with everyday activities. OCD can vary in intensity and habits from person to person. Some compulsive habits, called rituals, may include checking locks, counting, over-organizing, or washing hands. The condition can develop at any age but is common in late adolescence and early adulthood. Treatment options include antidepressant medicine or behavioral/cognitive therapy.

A Cochrane review combined the results of several studies on the benefits of therapy. This large review found that behavioral/cognitive therapy alone appears to be an effective treatment for adolescents and children.

About the Study

The systematic review examined eight randomized trials that had evaluated treatments for OCD in children under 18 years old. These studies included 343 participants. Behavioral therapy or cognitive therapy were compared to a placebo pill, medicine, attention control, or wait list. In trials that compared behavioral therapy or cognitive therapy to placebo or wait-list, therapy patients had:

  • Lower severity of OCD after treatment
  • Significant reduction in risk of OCD continuing

In trials that only compared therapy vs. medicine, there were no significant differences in effectiveness of treatment comparing therapy and medicine in three trials.

In two trials comparing therapy plus medicine vs. medicine alone, the combination of therapy with medicine was better than medicine alone.

How Does This Affect You?    TOP

This systematic review highlights which treatments may be most effective in treating OCD for adolescents and children. The cognitive/behavioral therapy sessions appear to be as effective in reducing OCD symptoms as medicine and more effective than no treatment. Keep in mind that medicine used to treat OCD (most commonly antidepressants) may have serious side effects. Side effects can range from headaches and sleep problems to suicidal thoughts and depression. In therapy sessions, counselors will help you identify negative patterns and develop healthier habits. Therapy session may be done as individual or group therapy, and the length of treatment will depend on your specific case.

The degree and and management of OCD can vary greatly from one person to the next. It may take time to develop an effective program. Work with your doctor and therapists to find the treatment method that works best for you.


National Institute of Mental Health National Institutes of Health
Obsessive-Compulsive Foundation


O'Kearney RT, Anstey K, von Sanden C, Hunt A. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents. Cochrane Database of Systematic Reviews. 2006, Issue 4.
Last reviewed 4/6/2010 by Brian P. Randall, MD

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