How ERP Helps Children With OCD
When a child is anxious, our instinct is often to comfort and protect, but when Obsessive Compulsive Disorder (OCD) is involved, that well-meaning comfort can accidentally feed the fear instead of helping them face it. The repetitive behaviours, the constant rumination, the distress from intrusive thoughts - it’s overwhelming for a parent. Fortunately, OCD is manageable, and Exposure and Response Prevention (ERP) therapy is one of the most effective approaches.
Making Sense of OCD
OCD is not simply about being extra tidy or a chronic overthinker. It’s a mental health condition where obsessive thoughts trigger intense anxiety, which the child tries to neutralize with compulsions - rituals or behaviors meant to make the worry go away.
For instance, a child might fear getting sick and feel the need to wash their hands 20 times a day. The washing offers temporary relief, but in the long run, it feeds the fear. ERP therapy breaks that cycle and teaches children healthier coping strategies.
What is ERP Therapy?
Exposure and Response Prevention is a type of cognitive behavioural therapy specifically designed to treat OCD. It helps kids confront the things they fear without resorting to compulsions.
In the exposure phase, children gradually face the feared thought, image, or situation. Then in the response prevention phase, children choose not to engage in compulsive behaviour that typically follows the fear. Over time, this process reduces the power of fear response and rewires the brain’s relationship with anxiety.
Types of Exposure in ERP Therapy
Exposure in ERP often varies depending on the individual. Therapists use different types of exposure tailored to the child’s specific obsessions and compulsions:
In Vivo: Involves confronting feared situations in real life.
Imaginal: Sometimes, facing a fear in real life isn’t possible or practical. In this case, the feared scenario is imagined in vivid detail.
Interoceptive: Involves triggering physical sensations that are feared.
These exposures help the child become more tolerant of discomfort and less reactive to fear, creating space for new patterns of thinking and behavior.
Misconceptions About ERP for Children
Some parents are understandably nervous about ERP. It’s natural to want to protect your child from fear. but avoiding fears is what keeps OCD going. Here are some common myths (and the truth behind them):
ERP is too scary or harsh for kids
ERP is always done gradually, at the child’s pace, with support and trust. Kids aren’t forced into overwhelming situations; they’re guided with empathy and encouragement.
Talking about fears will make them worse
Avoiding fears gives them more power. ERP helps kids talk about and face fears in a safe space, reducing their intensity over time.
ERP will make my child more anxious
Yes, ERP involves some anxiety. But this anxiety is temporary and therapeutic. It teaches children that they can tolerate discomfort and that it will pass.
ERP only works for adults
ERP has been proven effective for children and teens. In fact, younger brains often adapt more quickly to learning new responses.
How Parents Can Support ERP at Home
Your role as a parent is key to helping ERP therapy succeed. Here’s how you can help:
Learn and understand ERP so you can reinforce the process outside of sessions.
Avoid reassurance - as comforting as it feels, it feeds the OCD cycle.
Encourage bravery, not perfection. Progress in ERP is about trying, not getting it exactly right.
Celebrate exposure, even the small wins.
Model calmness - your own reactions help shape your child’s view of anxiety.
Want to Give It a Try?
If your child is struggling with OCD, you are not alone, and they are not broken. Therapy works, and the future is full of hope. Book a free 15-minute consultation to learn more.
