OCD in Teens & Preteens

7 parent questions ▼
Archived Q&A and reviews ▼

Parent Q&A

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  • Starting a 13YO on Sertraline (Zoloft) vs Fluoxetine (Prozac)

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    May 18, 2023

    We’re considering starting our soon to be 13 yo on medication and wanted to get input from other parents who’ve tried

    …fluoxetine (Prozac) or 
    …sertraline (Zoloft) 

    for their child.  It’s mainly for OCD, but our preteen also has general anxiety, probably social anxiety, ADHD-combined (… ASD1 isn’t ruled out - even after a recent neuropsych eval).  

    We know one size doesn’t fit all, but we are wondering how these two meds compare.  Does one have more side effects than the other?  If both parents haven’t had side effects, does that mean the child will tolerate the medication better? We would really appreciate any other insight/useful info to consider as we consider this big step.  Thank-you!

    May 18, 2023

    Hi,

    I'm a retired primary care doc.  Yes there are important differences.  Prozac (fluoxitine) tends to be more energizing while sertraline is more calming.  I don't have statistics but there were reports of teen suicides with Prozac many years ago.  They may not have proved statistically significant.  You can probably find out about that by Googling Prozac and teen suicide.  In terms of adults, sertraline tends to have greater positive results for depression, but as you say, it has to be individualized.  As far as OCD, my own choice is, as much as it may dismay you, marijuana.  You can Google Dr. Mike Alcalay (now deceased) who was the expert in the field of medical marijuana and for OCD.  Under his name you may (hopefully) find a segment on 60 minutes with Mike where a very young child with OCD was so unmanageable that he could not be kept in school.  On marijuana that his mom cooked into brownies every day he became almost instantly calmed and returned to school and was integrated well when the report was done (maybe 20 years ago).  I don't know how much weight the poor child put on and I don't have any follow up into his teen years.  He took a high dose.  My choice of anti-depressants in elders has long been sertraline.  Taken before bed it can also help them sleep.  Medicating a 13 old with psychoactive drugs requires close monitoring (hopefully by a counselor).

    Marc Sapir MD, MPH  

    May 22, 2023

    I cannot speak to comparing the 2 medications but here is how to avoid any side effects with either med. Instead of starting say at a dose of 10mg of Fluoxetine, ask the Pharmacist for tablets in stead of capsules. Then you can cut them into quarters. Start off at 2.5mg for 2 weeks, then every 2 weeks increase by 2.5 mg. This will do 2 things: 1) There will be zero side effects with this gradual build up, and 2) it will help you titrate exactly how much medication is needed  so your child will not take more than is needed to control their symptoms.  You will know when an adequate dose is reached and it may be 7.5mg rather than 10mg, or 12.5 rather than 20mg for example. 

    May 22, 2023

    Hi!  I would recommend treating the ADHD first- once this is treated other things fall into place.  I have lifelong experience with this.  The longer the ADHD is treated, you have positive experiences to build self esteem.  When the adhd treatment (medication) isn’t there it’s like riding a bike without glasses.  

    May 22, 2023

    Hello! I’m so glad you are considering medication treatment for your child! I’m a family med doc who prescribes SSRIs for a range of ages and conditions. Also, my son took Zoloft for 3 years for depression and I have friends whose dtr has responded really excellently to Zoloft for OCD

    Everyone responds differently to different SSRIs but the 2 main differences are that Prozac is more energizing (which can be a pro or a con) and also Prozac has a longer half life so if your child is likely to miss doses (due to all kinds of individual and family-related factors) then the effect of the Prozac will be steady even in the face of erratic dosing. 
     

    good luck to you and your family 

    May 23, 2023

  • OCD teen

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    Mar 13, 2023

    Hi guys, I am looking for a psychiatrist for my 13 year old daughter with OCD. She is already taking therapy sessions. But it’s not enough, unfortunately. I guess we are ready to try some meds. It is really hard to find a good psychiatrist for a teenager. Any recommendations? Thank you in advance!

    Mar 13, 2023

    Our 17 year old daughter was in a similar situation. She had been in therapy for over a year but was still struggling. She started with Psychiatric Nurse Practitioner Cris Bisonnette at Berkeley Therapy Institute about 6 months ago and it has made all the difference. I wish we would have done this earlier. The number for Berkeley Therapy Institute is 510-841-8484

    Mar 15, 2023

    So sorry your daughter is struggling. My daughter really struggled with OCD in her early teen years..... medication was helpful in getting her to a place where she could engage fully in the therapy. There is a specific type of therapy that is key to OCD treatment.... ERP (Exposure and Response Prevention). Be sure your daughter is seeing a CBT therapist who is experienced in ERP.

    I can highly recommend Brad Engwall as a psychiatrist for teenagers, though I am not sure if he's accepting new patients (sadly that is a common theme in the world of mental health these days).

    Mar 16, 2023

  • Therapist and psychiatrist for 15yo with OCD

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    Dec 7, 2022

    Our 15-year old grandchild is experiencing anxiety and/or OCD. Our doctor has prescribed medication, but we still need someone for an accurate diagnosis.  We are looking for a recommendation for a therapist for assessment and treatment, preferably someone who does work with Cognitive Behavioral Therapy.  Also, need recommendation for a psychiatrist to prescribe/monitor medication.

    Dec 7, 2022

    We had trouble finding a psychiatrist who would see kids under 16 years old (our son was 15 at the time). We finally found Dr. Hessenthaler with Mindful Health Solutions (https://mindfulhealthsolutions.com/) in Oakland and have been very happy with him. 

    Dec 14, 2022

    I would check out the International Obsessive-Compulsive Disorder Foundation to find a pediatric psychiatrist: www. iocdf.org

    It was really heartbreaking to see our kiddo spend so many hours doing compulsions (washing hands), and it effected really... everything. 

    It's a journey - but if you can find a doctor who integrates CBT and medication management, that's the ideal.

    Dec 14, 2022

    I don't have a recommendation, but I posted on BPN seeking recs a few months ago, so maybe there's a response in the archives that might be useful to you and your grandchild. CBT/ERP, the go-to therapy for OCD, did not work for my niece, despite trying for a long time. Leaning into the obsessions seemed to make it worse. Stanford has a couple of clinical trials going on right now, so we are keeping an eye on those results. Unfortunately, there's no magic bullet and everyone's OCD is different. Good luck to your grandchild. OCD is so hard; patience and love are needed in big doses.

    Dec 19, 2022

    Please check iocdf website. Need therapist trained in OCD (or to rule it out). We wasted time with CBT (although of course it’s important for accompanying issues). 

    Dec 19, 2022

    We worked with Dr. Raymond Hearey (psychiatrist) in Orinda and found him to be knowledgeable about OCD and other anxiety-based disorders, and appropriate medication regimens for those disorders.  We liked him.  He doesn't do CBT, but will coordinate with another therapist in regards to the medication and CBT combination.  Very expensive and doesn't take insurance, but you can apply to your insurer to be reimbursed for his charges after the fact (all depends on what your insurance will pay for.)

    We have worked with Mark Balabanis in Oakland as a therapist and liked him.  He has a gentle approach, and is well informed about CBT and OCD issues.

    Dec 19, 2022

    My teen has been seeing ilyana romanovsky for OCD for a couple years. It has greatly improved the quality of our lives. 

    Dec 26, 2022

  • Need Therapist for Daughter with Compulsions

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    Jul 9, 2021

    Hi. My daughter is 11 years old-soon to be 12 and she has had numerous compulsions over the years. There was one point where she felt like to she had to do a nightly ritual before bed or else something would happen to her family. She's always been a very sensitive child and has had some challenges with anger over the years, especially toward her younger sibling. She used to come to me crying each night worrying about something happening to me or fearing she would be kidnapped. When this behavior was at its height (around age 8 or 9) she was in therapy for about a year, which seemed to help. She doesn't have a trauma history and has had a typical childhood. Most of the time she is happy, jovial, does well in school, and has friends. But she often goes to a really dark place, and it happens without much warning. She is also struggling with her self esteem which I know is typical for this age. I am the only one she goes to with her fears, angst and worry about her compulsions. She doesn't talk to her Dad about it, nor to friends or any other adult (since therapy ended a couple years ago). She seems to keep it bottled up and then she'll come to me and it'll just erupt.

    As of late she has come to me a couple times expressing deep anguish about a new compulsion. She says that when she hears someone else sneeze, she feels tingling in her genitals. She says she can't stop the feeling and she even confided in me that she had been watching Youtube videos of people sneezing. When we've talked about it, I listen, reassure her that she's ok, and tell her that I want her to feel better and that we will get through it together. But to be honest, I am in over my head with this one. I don't know how to help her, and I'm worried about mental health overall. 

    Can anyone recommend a therapist that specializes in helping adolescents overcome compulsive behaviors? 

    Jul 9, 2021

    Thank you for sharing so earnestly. I don’t have a therapist rec, but your story reminded me of this amazing episode of the podcast “bodies” that you might find to be a meaningful listen:

    https://pca.st/episode/42c4b9bd-ca6a-492a-be5b-3efb0b9cd8fb

    Jul 14, 2021

    I’m so sorry your daughter is struggling with compulsions. It is an awful thing to go through. It’s really good she’s talking to you about it, as it hopefully means she is open to help. The most important thing is to find a therapist who is trained/experienced in ERP therapy. It is considered the “gold standard” for obsessive compulsive disorders. Some, but not all, CBT therapists work with ERP.
    My daughter worked with a therapist, Ilyana Romanovsky, who I can highly recommend. She was amazing and extremely effective. 
    If she doesn’t have availability im sure she can recommend some other therapists.

    Jul 14, 2021

    When you find a therapist make sure they are familiar with misophonia 

    Jul 14, 2021

    Hi, this sounds like OCD, which can take many forms, including worrying about bad things happening to your loved ones. The psychotherapy of choice for the treatment of OCD is exposure and response prevention (ERP), which is a form of CBT. I would recommend finding a therapist that specializes in this. Here are three names I was given by the Children's Health Council. While they may not be close to you, some offer virtual sessions. With time and practice, your daughter will be able to manage it!

    Jul 19, 2021

    From personal experience with our family, I can   recommend Dr. Amy Jenks to perhaps assist your daughter with what may be an OCD issue.  

    https://bayareaocd.com/dr-jenks

    Aug 1, 2021

  • Seeking holistic therapist for 12yo with OCD tendencies

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    Dec 16, 2020

    Hi,

    Our 12 year old daughter has asked to see a therapist for generalized anxiety. She has OCD tendencies, but while they fluctuate, they are relatively mild. She is happy, does well at school, extroverted, but tends towards being anxious and overthinks things. She recently started telling us that there are things she can't talk to us about, which is when we suggested a therapist, and she took us up on the suggestion.

    We started off searching for a CBT therapist, but they are all booked up. We got referred to someone, but in her second meeting with us she asked us how we feel about medication. That to me is a red flag, as she did not ask how we feel about exercise, meditation, CBT and the like. In fact she said she thinks CBT is a fad... which it might or might not be, but I'd rather try that first before even discussing medication for someone with mild OCD tendencies.

    If anyone knows of a therapist who is holistic in her approach and wary of medication for kids with mild symptoms, please let me know.

    Thank you,

    Dec 16, 2020

    Hi there,

    So sorry your daughter is going through this. My now-17-year-old daughter was dealing with some similar issues around that age. OCD is tricky and often kids/teens who are dealing with it aren't able to articulate quite how it is affecting them. We found it very helpful to have a qualified therapist assess the severity of OCD. The treatment for OCD is a specific type of therapy called Exposure and Response Prevention (ERP), which. not all CBT therapists do. It's really key to learning how to deal with OCD. 

    That is very strange that the CBT therapist you found mentioned that she thinks CBT is a fad. In any case, if she doesn't regularly treat OCD I would look elsewhere for a therapist who has more extensive experiences with OCD. 

    Dec 21, 2020

    I very much suggest you find a qualified OCD therapist. You can get help here:

    http://iocdf.org/ or the local organization here: 

    https://www.ocdbayarea.org/

    OCD really does need a therapist trained in a type of therapy called ERP. 

    My child also had what we thought was mostly anxiety and mild OCD, but in actuality was severe OCD. 

    Dec 28, 2020

    Hi. My 11 year old stopped telling us about OCD thoughts Bc she was embarrassed. We messed around with the wrong therapists and put off RX trying to figure it out.  I have no idea, of course, whether you are facing OCD, but if you are I recommend signing up to work only with folks who know their field. The iocdf.org is a great help. I’m sorry for your struggles. Reach out if i can help. 

    Dec 28, 2020

  • OCD Help (CBT/ERP) for 10yo ... and what to do in the meantime?

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    Jan 27, 2020

    We are seeking immediate help for our ten year old who began exhibiting OCD at the end of November.  Handwashing/showers/not touching clothes/toys/bedroom/us.  We have seen psych and ruled out PANDAS but need a CBT/ERP therapist.  We are on wait lists but miserable in the meantime.  How do we not accommodate her rituals when we/she hasn't had counseling - don't have the tools to explain that we are being supportive by not accommodating.  We are reading the books but not connecting with her in terms of what is happening.  Further, she says she doesn't have a problem - how do we get her to the first appointment?  What support groups are there for parents?  Any advice appreciated.

    Jan 27, 2020

    You definitely want to see a CBT/ERP therapist. ERP is the best treatment for OCD...... Hopefully you've contacted the San Francisco Bay Area Center for Cognitive Therapy (http://sfbacct.com/).... they're often full but can usually offer referrals.

    My child with OCD has been treated by CBT/ERP therapist Ilyana Romanovsky. She's amazing and has helped our daughter immensely. She may not be taking new clients either, but also might have some referrals for you.

    There is an online group for parents of kids with OCD that I've found helpful..... https://groups.io/g/OCD-POTAYA/topics

    In terms of getting her to the first appointment, hopefully the therapist you end up working with can offer some advice. My daughter was very aware of how OCD was making her life miserable and open to going to therapy.

    Jan 29, 2020

    I wish you and your family well. While you're on the path to find a mental health reason and treatment for this, I think it's great that you looked into PANDAS. You might also want to try an IGenex test for lyme/bartonella as those infections could cause similar presentations. Check with the Bay Area Lyme Foundation or LymeLight for assistance with this if needed. Just to rule out the physical stuff. 

    All the best

    Jan 29, 2020

    I’m a little OCD and it started to manifest when I was 13-14 or so with lots of hand washing. I never saw anyone for it so I’m not sure if what is true for me is also true for others but it really helped when I learned that too much cleanliness is linked to allergies. It reduced the germ fear a lot. Also, my OCD to this day is triggered by stress and I explain that to my family so when I seem really “difficult” with what level of tidiness I am demanding of them I ask them to please accommodate me because I have a big work project etc. so I would really ask you to manage your stress and anger and not add that to your daughter’s as it will only make things worse. Ask her what you can do to help support her and reduce her stress.  

    Jan 29, 2020

    What to Do When Your Brain Gets Stuck: A Kid's Guide to Overcoming Ocd
    Book by Dawn Huebner is a good explanation/workbook for kids.

    There is also a Facebook SF Bay Area Parents of Kids with OCD (Kids of any age)

    been there and glad you are getting help!

    Jan 29, 2020

    I’d check into any resources possibly through NAMI (National alliance on mental illness). They offer support groups for parents of children with mental illness.  (https://www.nami.org/Find-Support/Family-Members-and-Caregivers)

    it’s great you’ve ruled out PANDAS as at that age, that’s often a culprit. You don’t have to worry about convincing her something isn’t quite right about the behaviors - that’s for the therapist. You want to be careful with that as well so she doesn’t feel shame or it cause more anxiety which could lead to escalation of behaviors. Until you find someone, i suggest trying to focus on any possible underlying emotions and issues vs focusing on the behaviors. The behaviors are symptoms of something else.

    have you checked with school to see if the school social worker or psychologist can assist in the mean time? I’d also look into support through your EAP if you or your spouse has one through work. They can often assist in finding therapists.

    good luck!

    Jan 29, 2020

    Have you checked Roger's behavior health in Walnut Creek?
    My child, who was diagnosed with severe OCD, was accepted to their program.
    I can't say enough good things about it!
    They accept some insurance, including Kaiser.
    There are many resources online for both kids and parents. I like Peace Of Mind foundation and if you haven't already, check IOCDF.
    Best of luck!! There is help and hope for your child and your family. Hugs

    Jan 31, 2020

    Hello,

    My daughter was diagnosed with OCD and we have gone through a few different treatments. She is now 10 years old and we have been seeing Emily Berner at the San Francisco Center For Cognitive Behavioral Therapy for the last few months. She is an MFT and it has been GREAT for all of us. Emily works with the family when the kid does not want to cooperate with counselor, and this has helped us a lot (though my daughter did end up working with Emily). My kid also insisted there was nothing wrong - there is so much shame around OCD. It is painful for them to admit what is going on because it is so embarrassing.

    BTW there is a great movie about OCD which I recommend that you show to your daughter at some point - it is called Unstuck, and features kids with OCD, showing their perspective. 

     Sounds like you need to get into therapy as soon as possible so that you can get the support you need and start to lay the groundwork for your work with your child whether or not she chooses to do therapy. I highly recommend Emily. It has also been super helpful to talk to other parents of kids with OCD (I have found two). If you find a support group I would love to join it! I am still scouting around to see if I can find a support group for my daughter so that she does not feel so alone with OCD. 

    Hang in there. Remember that the more anxious you are about it, the more anxious she will get, which leads to worsening of OCD symptoms. I am positive that the therapy my husband and I have participated in to deal with my daughter's OCD has had as much of a positive effect on her condition as the therapy that SHE has participated in.

    Feb 2, 2020

    Our son (who has different issues) has seen Tsveta Laleva at this practice: http://www.lindseyantin.com

    They don't take insurance, but work w/ a lot of kids - they just posted something about the number of kids they see w OCD. I highly recommend!

    Feb 5, 2020

    Hi Noelle, The most active group recently was a yahoo group that I belonged to, but yahoo disbanded groups, so it looks like it's migrated to https://groups.io/g/SFOCD - I would definitely join there.  In addition, the general (worldwide) group on facebook that I've found helpful is Support group for parents of Kids with OCD - there's a lot to wade through, but a lot of bay area parents are on there. The annual OCD conference this year is in Seattle and I'd definitely recc. attending - it's the thing that got us pointed in the right direction.   My son attended PHP in Rogers summer of 2018 and then followed up with Amy Jenks in Orinda for several more months.  It saved his life.  I think the world of both.  We've been battling OCD since elementary school (he's 16 now), and it's just - gone.  We all know it could come back, but he has the tools and knows he can fight it if it does.  We LOVED Amy Jenks in Orinda.  My son was a difficult case, and she just kept pivoting and trying new things until she found the ways that worked for him - she's amazingly gifted.  If you contact her and she's full, she also had a list of other providers - I know that http://sfbacct.com/ is also very well-regarded - I've heard Dr. Barkin, Tomkins, and Emily Berner speak.  Whatever you do, I'd go for one of these super-specialists - we wasted way too many years with people who said they treated OCD and did ERP but it was nothing compared to real ERP.  If they're full, keep trying - spots open up all the time.  We had to be flexible with days and times, but it was worth it. 

    Feb 5, 2020

  • CBT Therapist for a teen girl with anxiety and OCD

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    Feb 27, 2019

    Hi Fellow Parents,

    i am searching for my shy niece who has been showing signs of OCD throughout middle and high school.  She has also been sleeping more since started high school.  Recently, she was diagnosed with anxiety and depression.  Looking back, she was showing signs of anxiety in six grade but too settle to recognize.  She is also very caring and sensitive to her friends and the school community.  Lately, she is isolating herself from friends. Her doctor recommended a Cognitive Behavioral Therapist.  If you could recommend someone in San Ramon, Berkeley, Oakland Area, I would very much appreciated.  Someone who takes insurance would be fantastic since funds are limited.  I can be reached by my private email as well!

    thank you very much!

    Teen

    Feb 27, 2019

    Our 9 year old has a phobia and a little generalized anxiety. We found Dr Kim at the Wright Institute in Berkeley very very helpful.

    akim [at] wi.edu 

    All the best.

    Mar 4, 2019

    So sorry to hear that your niece is dealing with this. What a great aunt you are for reaching out to seek resources for her.

    You say that your niece has been showing signs of OCD—has she been diagnosed with OCD by a psychiatrist? If not, I’d definitely seek the expertise of a good psychiatrist ASAP.

    If she has OCD, CBT therapy is absolutely essential. It can be hard to find a CBT therapist in the Bay Area with an opening, nevermind one who’s covered by insurance. Not sure what insurance your niece has, but I’d call the insurance and explain the situation and ask for their assistance in locating some practitioners who are trained in CBT.

    My daughter was recently diagnosed with OCD by a psychiatrist (Lester Isenstadt, who does accept some insurance plans and whom I can highly recommend)  after struggling with anxiety on and off throughout 8th and 9th grade. He prescribed an SSRI medication to help her for the short-term but made it clear that the only way to truly address OCD is with CBT.

    We went with a CBT therapist whom he recommended—unfortunately she doesn’t take insurance. Her name is Ilyana Romanovsky and she practices in Berkeley and is located near the Claremont Hotel. Our daughter has only been seeing Ilyana for 6 weeks, but she has already made huge strides.

    Another great source for CBT is the San Francisco Bay Area Center for Cognitive Therapy, which is in Oakland.  

    Mar 4, 2019

    Please contact Roger's Behavior Health in Walnut Creek. It is a great center that treat exactly what you need. They will be able to help you or refer you to a cbt therapist.
    Also, you can look up therapists here:
    https://iocdf.org
    And specifically in San Ramon Dr. Robin Yeganeh is highly recommended 925-400-9604
    www.cbthealth.com
    Best of luck to you!

    Mar 4, 2019

    I am the parent of a now-adult child with OCD. If you think your niece has OCD, I strongly encourage her to be seen by a psychiatrist (MD) who specializes in OCD for a firm diagnosis. It is a distinct illness. UCSF has an OCD clinic with an emphasis on pediatric OCD and the clinic takes insurance. They are experts and can provide a diagnosis and treatment plan. She will also need to get a specific form of CBT called ERP (I highly recommend going to the website of the International OCD Foundation for info and referrals to treatment providers). Most therapists who specialize in ERP don’t take insurance bc they are in high demand and can be paid higher amount and avoid the insurance hassle. I suggest calling your behavior health insurer and asking them to find someone. If they cannot, you can then ask for them to cover the cost of treatment with an out of network therapist. Beware that lots of therapists claim they treat OCD in their listings but they have little experience or no training with ERP. So you want to make sure you aren’t given a run around to someone who isn’t qualified. OCD is a federal and state Parity Act diagnosis so read up on that if your niece has health care insurance that also includes behavioral health. I hope she gets treatment soon so that she can learn to cope with her illness and participate in her life. 

    Mar 4, 2019

Archived Q&A and Reviews

Questions

Intensive outpatient treatment for 18yo's OCD

March 2013

It has become apparent to me that my 18 yr old son's OCD is more severe than I had suspected and that he needs more than the ''talk therapy'' he has been receiving. He is open to tackling this issue head on so I would like to know if anyone has any experience with intensive outpatient programs that provide therapies aimed at helping individuals manage &/or reduce their OCD symptoms. Any leads would be greatly appreciated.

It's wonderful that you are helping your son look into this, especially as there are good options for OCD treatment (using CBT, and specifically Exposure and Response Prevention) in this area.

Some ideas for intensive OCD treatment in the Bay Area:
- in Menlo Park, Pacific Anxiety Group
- in San Ramon, CBT & Mindfulness Center

If these centers aren't local for your son, something to consider is that solo CBT therapists may be able to meet on an intensive therapy basis as well (multiple CBT sessions per week, extended length exposure sessions each time, etc.)

Also, the OCD Foundation website is a great resource for information from the field's experts about OCD education, how to distinguish (and approach) obsessions vs. compulsions, how families can help, etc.

It is now widely accepted that the best treatment for OCD is exposure response prevention (ERP), which is a specific type of cognitive-behavioral therapy. If you want this kind of OCD treatment, look to the OCD Foundation website, which maintains a list of inpatient and outpatient intensive treatment programs in the United States. Here: http://www.ocfoundation.org/

Most programs are self-pay, although some accept insurance. The ones that do accept insurance have quite long wait lists (about 2 months).

ERP works, but it is very specialized care, so be prepared to fight for authorizations and reimbursement, even if you have insurance. It is also probably the best treatment out there. OCD patient

Phobease is a well respected program. Based in cognitive therapy vs talk therapy...... here is a previous page on Berkeley Parents Network http://parents.berkeley.edu/recommend/therapy/liebgold.html read through and check it out. Mary

12-y-o with OCD: things are not getting better

April 2010

I have a 12 year old daughter with OCD. I've tried medication and cognitive behavioral therapy for her and things are not getting better. I'm interested in people's experiences and resources. I'd like to find out if there are any parents or kids her age who are interested in getting together or talking about working with OCD.

My husband has dealt with OCD since he was a child. It was not diagnosed properly until he was in his late twenties. Until that point, he had been diagnosed with anxiety disorders and even post traumatic stress disorder. He believes that earlier diagnosis could have helped him in many ways. For starters, he would have felt like had an explanation for the way his brain worked. Also, there are mental paths that get more firm over time and had he learned tools earlier, he might have been able to shift those paths with less effort.

As it is, he has really minimized the negative impact that OCD has on his life. The strategies that have helped the most are meditation and therapy with a psychologist who specializes in OCD. Meditation taught him how to observe his thoughts and not necessarily intervene - a critical skill when your thoughts are disruptive. It also gave him a mostly reliable way to calm down when he was afraid or over-aroused.

In therapy, EMDR has been particularly helpful, but there are other kinds of exposure therapies that a specialist in OCD would know about. He tried medication a couple of times, but found that it critically impacted him in other ways and did not necessarily resolve the OCD.

One book that was really useful for him - and for me as his partner - is The OCD Workbook by Hyman and Pedrick.

Good luck. Your daughter is struggling with a real challenge, but with your support and help, this does not have to determine her life. friend

CBT for teenager with OCD

March 2010

My son has recently been diagnosed with OCD after years of being misdiagnosed. I would like some referrals of therapists who specialize in CBT in the East Bay who either take insurance and/or will take credit cards (from my experience with therapists, I feel as if this is a stretch). And, if anyone has experienced this, what has your experience been with treatment and medications. Concerned Mom

We don't have a referral, but my husband has ocd and benefited very much from cbt, which is the right therapy for this disorder. He was able to get by for a long time without medication, but after taking a stressful attorney position has used ssri's and benzodiazepine combination (the standard protocol). With a teen, because of the slight risk of suicidal ideation with ssri's, it may be better to try the cbt alone first with benzodiazempine as needed, but that would all be for your doctor to consider. Many people lead productive successful lives with ocd so don't get discouraged. (Though it can be debilitating at times, without proper treatment, so I am not minimizing it.) It's not a great thing to have but there is far worse in life. Check out the Anxiety Disorder Association of America website, a good resource. Best of luck to you and your child. OCD in family

The best source for CBT referrals is to try the San Francisco Bay Area Center for Cognitive Behavioral Therapy (www.sfbacct.com). 510 652-4455. Just leave a message in the main mailbox and someone will get back to you. Thanks! Michael Y. Simon, MFT

Inpatient care for teenager with OCD?

Sept 2007

We're looking for recommendations for inpatient care for young teenager with OCD. Anyone with experience at Herrick Hospital or other places around the Bay Area? Thanks.

Do not go to Herrick. Check out the Obsessive-Compulsive Foundation website (google the name and you'll find it) for a list of specialized programs and info. Anonymous

10-year-old with OCD refuses meds or therapy

Jan 2005

My ten-year-old daughter suffers from obsessive compulsive disorder (OCD). She is adamantly opposed to being medicated and will not talk with a counselor.

I am searching for two things: (1) a homeopathic approach (I think I can convince her to try a ''natural'' approach if I can find something helpful); and (2) a support group.

The best support group would be specifically for her, with other kids. The next best support group would be for parents of OCD sufferers. I attended a support group that consisted of adult sufferers, and although it was an enormous help to be with people who understood the condition, I didn't really feel that I could get the kind of support I need as a parent.

So many of my friends and colleagues read this listserve that I cannot, out of respect for my daughter's privacy, include my name ... but if there is some way to hook up with other parents, I would be sooooo grateful. Parent of OCD Sufferer

Homeopathy works well for this kind of thing. Christine Ciavarella (P.A.) at the Hahnemann Medical Clinic, 524-3117 Bonnie

My daughter also suffers from OCD. Cognitive Behavioral Therapy is helping her learn how to manage it. She was getting no where with the once a week therapy and just going was causing her more anxiety. She attended an intensive program last summer at the Anxiety Center of Northern California, which really helped her. I would be happy to talk to you about it. I would be interested in a support group for parents, although I do not know of any existng groups. js

Frances Kalfus, L.Ac, OMD, is an experienced, classically trained homeopath who has a nice way with children and is particularly sensitive to psychological issues. I have been very impressed with the efficacy of her treatment. Dr. Kalfus can be reached at her North Berkeley office, 558-1911. Best of luck with your daughter. Jane

Obsessive-compulsive teenager

Feb 2004

My teenage son shows signs of obsessive-compulsive behavior. At first, it wasn't so noticeable, but lately, he is becoming worse. For example, he is always late for school because he is obsessed with washing his hands and face. And he normally doesn't get enough sleep because he takes so long to prepare to go to sleep, like taking extra long showers and brushing teeth, etc. Does anyone know any reasonable, good therapist in the area who treats this sickness? Also, my son does not think anything is wrong with his behavior and gets angry when we try to talk to him about it. We would appreciate any advice given. Thanks a lot. anon

I am a psychologist and from a description of symptoms, it does sound like your son might have OCD. The best approach to treating the disorder is a combination of medication AND therapy. The best type of specialist to see is someone who can prescribe the medications (very effective and helpful ones are now available)and recommend the right type of therapist. Usually, a pediatrician will have the names of the more behavioral pediatric specialists in our area who are used to seeing adolescents with this problem....it is not surprising he is defensive about it; instead of focusing on the symptoms (i.e., hand washing, etc), focus on how the specialist will help him keep within the framework of his life, i.e., being on time for school, for example. anon

Please check out the book ''The Boy Who Couldn't Stop Washing'' by Judith Rappaport,M.D. for a great description and case study examples about OCD. It's in paperback, and very interesting and easy to read (for you and your son). If he has OCD, he will be able to relate to the stories in the book, and hopefully to realize this is a brain-based disorder, and not something within his conscious control or something to be ashamed of. The treatment of OCD begins with SSRI medication (like Prozac, Zoloft, etc), rather than psychotherapy. Your primary care physician might be able to make a recommendation to a psychiatrist for you, as of course you need to establish the diagnosis before starting treatment. Kathleen