Treatment for Obsessive Compulsive Disorder (OCD)

What will therapy with CAMHS involve?

Following your assessment, you and your assessment clinician agreed that treatment for Obsessive Compulsive Disorder (OCD) would be most helpful for you.

You will have been offered Exposure and Response Prevention (ERP) which is a type of Cognitive Behavioural Therapy (CBT).

Cognitive Behavioural Therapy (CBT) for OCD

CBT (Cognitive Behavioural Therapy) is a talking therapy which helps you to understand how your thoughts, behaviour and feelings are connected. It will help you to learn how to think and act in ways that will improve how you feel.

How many sessions will I have?

You will have up to 20 sessions.
These will be one-to-one sessions.
Your sessions may be in-person or online.
Sessions will be adapted to suit your age and needs.
Your parents and carers may join some or all sessions.

Working with your clinician

CBT involves working collaboratively with your clinician. This work may involve experiments to challenge your thinking and behaviours and testing these out both in sessions and between sessions. You will have regular reviews with your clinician to make sure this approach is working for you.

British Association for Behavioural and Cognitive Psychotherapies - What is CBT?

This video explains what CBT is and how it can help you. This video is 1 minute.

Mental Health Center Kids - What is CBT? CBT Tools - Catch, Check, Change

This video explains what CBT is and how it can help you. Younger children may find this helpful. This video is 4 minutes 31 seconds.

Mental Health Center Kids - Cognitive Behavioural Therapy for Kids, Thoughts Feelings, Actions

This video explains what CBT is and how it can help you. Younger children may find this helpful. This video is 4 minutes 7 seconds.

What is Exposure and Response Prevention (ERP)?

ERP might help you to face the situation/object that triggers your obsessions by breaking the cycle of OCD.

This may feel scary, but your therapy is collaborative so you won’t be forced to do something you don’t want to do or that you aren’t ready to do. It will be built up slowly at your pace.

The cycle of OCD

The cycle of OCD shows how your obsessions, compulsions and anxiety are linked. Everyone experiences OCD differently.

Trigger
Obsession
Anxiety
Compulsions
Relief

Trigger: Someone sneezes near you

Obsession: "I am going to get ill" "I am going to die"

Anxiety caused by the obsession

Compulsion: Wash your hands 10 times to make sure no germs are on our hands

Relief as the anxiety has been countered by washing your hands

Consequence: Dry and sore hands from excessive handwashing

Trigger: You forgot to clear up some water on the floor in the kitchen before you left for school

Obsession: "Someone will slip on that and break their neck" "They might die"

Anxiety caused by the obsession

Compulsion: Count to 10 in your head 10 times to make sure no one slips on the water

Relief as the anxiety has been countered by counting to 10 in your head

Consequence: Distracted from your lesson at school and don't understand what the teacher is talking about

Trigger:

Obsession: "X" "X"

Anxiety caused by the obsession

Compulsion:

Relief as the anxiety has been countered by

Consequence:

ERP and the cycle of OCD

You will practice challenging your compulsions. Reading this, you may experience some worries or concerns around challenging your compulsions. This is normal and okay. You can talk to your therapists about this.

You might avoid certain things, seek reassurance or distract yourself. These help you feel relief from your obsessions, but can make your OCD worse in the long term. Below are some examples of compulsions. You may do some, all or none of these, that is okay, everyone experiences OCD differently.

Your parents, carers and anyone you trust can help you to practice challenging your compulsions.

Repeatedly doing certain things
Checking things over and over again
Mental rituals such as counting numbers in your mind

You may also experience avoiding certain objects or situations and asking your parents, carers or friends for reassurance.

You can read about a young person’s experience of CBT for OCD here.

The therapies we offer in CAMHS have been tested and proven to help. You have been offered CBT as this is the best way to know how to help children and young people who are experiencing OCD.

How do I tell my therapist how therapy is going?

We will keep checking together to make sure your therapy is helping you. These are called review sessions, we will do a review session after every 6 therapy sessions.

If you feel it’s not working, you can tell your clinician in your review sessions. But you can also do this any other time that you would like to.

Your parents and carers might join these sessions, if you and your clinician think that is a good idea. You can tell your clinician if you don't want your parents and carers in your review sessions.

During your review sessions, you and your clinician will think about:

How therapy is going
Your goals and if therapy is helping you work towards these goals
If you need support from other services. This could be services within CAMHS or outside of CAMHS.

Together you will:

Update your care and/or safety plans
Update your risk assessment
Complete questionnaires to track your progress, you can read more about this on our Tracking Your Progress page
Plan next steps e.g. for therapy, starting to a different therapy, moving on from CAMHS.

Sometimes reviewing how your therapy is going involves your clinician talking to other clinicians in their team. This will happen in Multi-Disciplinary Team (MDT) meetings.

MDT meetings help your clinician think about you and your difficulties in different ways and what your next step might be. Your clinician will always share what was discussed in MDT meetings with you and use this to plan your next steps with you.

Requesting reasonable adjustments

We encourage you or your parents and carers to talk to your clinician about adjustments you may need. We will make adaptations to support you to engage with the therapy we offer. Below are some examples of adjustments you could ask for: