Child & Teen OCD Therapy
Maybe your child washes their hands until they're raw, or needs everything to feel "just right" before they can leave the house. Maybe your teen asks "Are you sure?" twenty times a night, or gets stuck rereading the same page of homework. You might be wondering, "Why can't they just stop? And why does helping seem to make it worse?"
You're not alone, and it's not your fault. OCD is common in kids and teens, it often starts in childhood, and it responds very well to the right treatment. At SageMind Psychology, our team uses Exposure and Response Prevention (ERP), the most well-researched treatment for OCD, to help kids face their fears, let go of rituals, and get back to being kids. Parents are part of the process every step of the way.
What OCD can look like in kids and teens
OCD isn't about being neat or particular. It's a cycle: an unwanted thought, image, or urge (an obsession) brings on intense anxiety or a feeling that something is "off," and your child feels driven to do something (a compulsion) to make that feeling go away. The relief doesn't last, and the cycle starts again. Parents tell us things like:
"My son washes his hands so often they crack and bleed."
"She has to check the locks and the stove over and over before bed."
"They ask me the same question again and again, and my answer is never enough."
"He has to redo things until they feel 'just right,' and homework takes hours."
"My daughter gets really upset if things aren't lined up or even."
"They're terrified they'll hurt someone, even though they would never want to."
"She confesses tiny things she did 'wrong' and needs me to tell her it's okay."
"He won't touch doorknobs or eat food someone else made."
"My teen spends hours in their head going over things, and I can see how exhausted they are."
"Our whole family's routine has changed to work around their rituals."
Many kids hide their OCD because they feel embarrassed or know their fears don't fully make sense. Rituals can also happen silently, like counting, praying, or mentally reviewing. If you're seeing pieces of this, you're in the right place. Our team works with OCD every day.
Is this a quirk, or is it OCD?
Lots of kids have favorite routines, lucky socks, or a phase of wanting things a certain way. It may be time to reach out when:
Rituals or worries take up a lot of your child's day, or seem to keep growing
Your child seems distressed, not comforted, by their routines
OCD is getting in the way of school, sleep, friendships, or family time
Your child gets very upset or melts down if a ritual is interrupted
Your family has started changing plans, answering the same questions, or joining in on rituals to keep the peace
Wanting to ease your child's distress is a loving instinct. With OCD, though, going along with rituals can keep the cycle going. The good news is that OCD treatment works, and the earlier kids get support, the sooner they can feel like themselves again.
How we help kids and teens with OCD
Small, brave steps that teach OCD it isn't in charge.
Our team uses evidence-based therapies with strong research support for childhood OCD. We tailor treatment to your child's age, personality, and goals, and we move at a pace that feels challenging but doable.
Exposure and Response Prevention (ERP): The gold-standard treatment for OCD. With their therapist, kids gradually face the thoughts, situations, or feelings that trigger OCD and practice not doing the ritual. Over time, the anxiety fades on its own, and kids learn they can handle uncertainty.
Cognitive Behavioral Therapy (CBT): Kids learn how the OCD cycle works, spot "OCD thinking," and build coping skills that support their ERP practice. For younger children, we use games, stories, and play to make skills stick.
Parent coaching: OCD often pulls the whole family in. We help parents recognize "accommodation," like answering repeated questions or rearranging routines, and step back from it in a supportive, planned way so your child gets braver at home too.
Dialectical Behavior Therapy (DBT): For kids and teens whose OCD comes with intense emotions, meltdowns, or overwhelm, DBT teaches skills for staying steady while they practice facing their fears.
What ERP looks like in practice.
Families often ask what ERP actually involves. Every plan is individualized, but here's the general picture:
Understanding OCD: Your child learns how the OCD cycle works and often gives OCD a name, so it becomes something to boss back instead of part of who they are.
Building a fear ladder: Together, your child and their therapist list OCD triggers from easiest to hardest. Your child has a say in where to start.
Practicing exposures: Starting low on the ladder, your child faces a trigger, like touching a doorknob or leaving a drawer slightly open, and practices riding out the uncomfortable feeling without doing the ritual.
Practicing in real life: Kids practice at home, at school, and out in the world, where OCD actually shows up. Parents learn how to coach and encourage them along the way.
Climbing the ladder: As each step gets easier, your child moves up, building confidence that they can handle discomfort and uncertainty.
ERP is collaborative. Kids are never surprised or forced into exposures, and they build courage one step at a time.
Support for every kind of OCD.
OCD can latch on to almost anything. Here are some of the most common ways it shows up in kids and teens, and how we help:
Contamination fears: Worry about germs, dirt, illness, or "gross" things, leading to excessive washing, showering, cleaning, or avoiding touching things. ERP helps kids gradually approach what feels "contaminated" and hold off on washing, so the fear loses its power.
Checking and fears of something bad happening: Fears of a fire, a break-in, or someone getting hurt, leading to checking locks, appliances, or that loved ones are safe. ERP helps kids tolerate the uncertainty and resist the urge to check.
"Just right" feelings, symmetry, and ordering: A strong need for things to be even, lined up, or done a certain number of times, or redoing tasks until they feel right. ERP helps kids practice leaving things "not quite right" and learn that the feeling passes.
Reassurance seeking and confessing: Asking the same questions again and again, or needing to confess small things to feel okay. ERP helps kids sit with doubt, and parent coaching helps families respond in caring ways that don't feed the cycle.
Scary or unwanted intrusive thoughts: Upsetting thoughts or images about hurting someone, doing something inappropriate, or acting against their values. These thoughts are distressing because they go against who your child is, and ERP is a well-researched way to help kids stop fighting them and let them pass.
Moral worries: Intense fear of having lied, been unfair, or done something wrong, often with repeated praying, confessing, or apologizing. ERP helps kids loosen the grip of these doubts in a way that respects their family's values.
Mental rituals: Compulsions that happen silently, like counting, repeating words, reviewing memories, or replacing "bad" thoughts with "good" ones. These are easy to miss. ERP helps kids notice mental rituals and practice letting thoughts be.
OCD that's affecting school: Hours of homework from rereading or rewriting, avoiding school because of contamination fears, or rituals that make mornings impossible. Along with ERP and parent coaching, our School Refusal Program (DBT-SR) offers focused support for kids who are struggling to get to school.
Many kids with OCD also experience anxiety, ADHD, depression, or big emotions. Our clinicians look at the full picture and build a treatment plan around your child.
Programs for extra support. For some families, a more specialized program can help:
Kids who are neurodivergent, including autistic, ADHD, and twice-exceptional (2E) kids: our neurodivergent-informed therapy and ADHD and executive functioning support
Teens who want to practice skills alongside peers: our DBT skills groups
Kids and teens who need more support than weekly therapy: our Intensive Outpatient DBT Program for children and teens
Families who want a clearer picture of what's going on: our psychological assessments
A team behind every family. Our clinicians work together, receive ongoing supervision, and consult on cases, so your child benefits from the experience of the whole team. We are LGBTQIA+ affirming and neurodiversity-informed. Meet our clinical team.
Getting started is simple
You don't have to untangle OCD on your own. It starts with a 15-minute call.
Book a free 15-minute consultation. Tell us what you're seeing, ask questions, and get a feel for how we work.
Get matched with the right clinician. We'll pair your family with the team member best suited to your child's needs.
Start therapy. After an intake session, your child begins building skills, and you get support too.
We offer therapy in person at our Brooklyn Heights office and online (telehealth) in New York, New Jersey, and 40+ additional PSYPACT states. Online sessions can be especially helpful for OCD, since kids can practice ERP right at home, where many of their rituals happen.
SageMind Psychology is an out-of-network practice. Many families use out-of-network benefits, and we provide superbills to help you seek reimbursement. Learn about rates and insurance.
Book your free consultation or contact us with questions.
Questions parents ask us
How do I know if it's OCD or just a habit or phase?
Habits and routines usually feel comforting or neutral. OCD rituals are driven by fear or a strong sense that something is wrong, and they tend to cause distress, take up more and more time, and get in the way of daily life. If you're not sure, a free consultation is a low-pressure way to find out.
Why can't my child just stop?
OCD makes rituals feel urgent, like something terrible will happen or the bad feeling will never end unless they're done. Most kids would stop if they could. ERP helps them learn, through practice, that the anxiety passes on its own without the ritual.
Should I keep reassuring my child or helping with their rituals?
It's completely natural to want to help, and most families end up accommodating OCD in some way. Over time, though, reassurance and joining in on rituals can keep OCD going. Parent coaching helps you gradually step back in a way that's planned, supportive, and kind to both you and your child.
Will ERP make my child's anxiety worse?
ERP does involve some discomfort, and that's part of how it works. But it's done gradually, starting with small steps your child agrees to, and kids usually feel proud as they see their fears shrink. Your child's therapist sets the pace together with your child and family.
My child has upsetting thoughts about hurting someone. What does that mean?
Unwanted intrusive thoughts are a common part of OCD, and they're often upsetting precisely because they go against what your child cares about. A clinician can help you understand what's going on and how to help. If you ever have concerns about immediate safety, please call 911 or go to your nearest emergency room.
What age do you work with?
We work with children, tweens, and teens, and we include parents in treatment. ERP is adapted for each age, from playful, game-based exposures for younger kids to more independent, skills-focused work for teens.
How long does OCD treatment take?
It depends on your child and their goals. Many families notice changes as their child starts practicing ERP and building confidence. Your clinician will check in on progress with you along the way.
Does my child need medication for OCD?
Many kids make strong progress with ERP alone. Some benefit from medication alongside therapy. Our team doesn't prescribe medication, but we're happy to coordinate with your child's pediatrician or psychiatrist.
Can my child do therapy online?
Yes. We offer telehealth in New York, New Jersey, Massachusetts, Vermont, and 40+ additional PSYPACT states, as well as in-person sessions in Brooklyn Heights.
Do you take insurance?
We are an out-of-network practice. We provide superbills you can submit to your insurance for possible reimbursement, and we can help you check your out-of-network benefits. Reimbursement depends on your plan.