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For OCD, Not Helping Might Be Best

Well-meaning assistance may do more harm than good, experts say,,

MONDAY, July 6 (HealthDay News) -- Instinctively easing a child's anxiety could be counterproductive if girl or boy suffers from obsessive-compulsive disorder, say University of Florida researchers.

Helping children with OCD complete the rituals associated with the condition -- such as reassuring compulsive washers that their hands are clean -- might ease the immediate situation, they say, but this actually might strengthen the child's desire to repeat the obsessive behavior later.

"Parents do that because that is what a parent whose child doesn't have OCD would do," the study's lead author, Lisa Merlo, an assistant professor of psychiatry, said in a university news release. "If your child is upset, you try to comfort them. But what we know is, for patients with OCD, if they get an accommodation, that reinforces the OCD to them."

"It's validating the OCD in the kid's mind," she said, and that's what you don't want to do."

The findings, published in the current issue of the Journal of Consulting and Clinical Psychology, are based on analysis of 49 children with OCD, aged 6 to 18. Researchers found that children with the most severe OCD conditions also had families that most accommodated the child's behavior.

"You would think if parents are helping, the kids would be less impaired," Merlo said. "But what we are seeing is that it snowballs and makes it worse and worse."

However, the researchers could not say for sure whether the family's "help" made the disorder worse or whether the excessive assistance was in response to the child's condition being severe from the onset.

After the analysis, the families participated in 14 sessions of cognitive-behavioral therapy, a treatment in which children handle their fears by facing them and using alternate methods to deal with them. The parents, meanwhile, were instructed in how they should respond when their child's OCD behaviors arose.

After the treatment, researchers noticed a significant decrease in how often families were assisting children during their OCD behaviors and rituals. Children whose families had the biggest decrease in these accommodations also had the biggest improvement in their OCD symptoms, Merlo said.

Jonathan Abramowitz, an associate professor and associate chairman of psychology at the University of North Carolina at Chapel Hill, noted that this unintentional reinforcement of OCD has also been reported anecdotally by adults in relationships.

"We see it with adults' spouses and partners, too," he said in the news release. "In trying to be helpful to the person with OCD, they end up making the problem worse."

The American Academy of Child & Adolescent Psychiatry estimates that roughly one in 200 U.S. children has obsessive-compulsive disorder, and the Obsessive Compulsive Foundation estimates that 1 in 50 adults has it.

More information

The Obsessive Compulsive Foundation has more about OCD.

-- Kevin McKeever

SOURCE: University of Florida Health Science Center, news release, June 2009

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