Obsessive-Compulsive Disorder (OCD) can be deeply distressing for both the child or teen experiencing it and the family supporting them. At Anchor Therapy, our OCD therapists often meet parents who feel overwhelmed, confused, or even helpless as they try to understand their child's behaviors whether it is constant hand-washing, repeated questioning, or an intense need for things to be "just right." OCD in children can show up differently than in adults and early intervention is key to helping them manage the intrusive thoughts and compulsive behaviors that interfere with daily life.
Supporting a child with OCD requires more than just patience- it calls for informed, compassionate strategies that balance empathy with structure. From a therapeutic standpoint, we emphasize the importance of understanding the disorder, recognizing what is driven by anxiety versus defiance, and learning tools that empower both child and parent. In this blog, we will explore how to approach OCD with clarity and confidence, including how mental health counseling can support lasting change and provide relief for the whole family system.
Anchor Therapy is a counseling center in Hoboken, NJ with mental health therapists specialized in helping children, teens, adults, couples, and families with anxiety, depression, relationship issues, trauma, life transitions, and more. Anchor Therapy is accepting new clients and is now providing in-person sessions and teletherapy sessions to residents of New Jersey, New York, and Florida.
At what age does OCD start?
OCD can begin at any age, but it most commonly emerges in childhood, adolescence, or early adulthood. Research and clinical experience show two typical age ranges for onset: early onset, which occurs between ages 8 and 12, and later onset, typically between ages 18 and 25. In some cases, children may begin showing signs as early as age 5 or 6, although these behaviors are sometimes mistaken for typical developmental quirks. Boys are more likely to experience an earlier onset of OCD than girls, while girls more commonly develop symptoms during adolescence. Recognizing the signs early is crucial as timely diagnosis and intervention can significantly improve outcomes and help prevent the disorder from becoming more severe or disruptive over time.
What are the symptoms of OCD in children?
OCD in children can be difficult to identify at first, especially because some behaviors may appear similar to typical childhood habits or developmental phases. However, the key difference lies in the intensity, frequency, and distress these behaviors cause. Children with OCD experience unwanted and intrusive thoughts (obsessions) that create significant anxiety which they try to neutralize through repetitive behaviors or mental acts (compulsions). Read our blog “How to Break the Cycle of Obsessive Thoughts.” These rituals can interfere with daily functioning- impacting school, friendships, and family routines. Check out our blog “5 Ways to Help Your Children with Behavioral Issues in School.”
Children may not always be able to explain why they are doing certain things which can make their behavior seem irrational or confusing to parents and teachers. For example, a child might ask the same question over and over again to seek reassurance or avoid touching certain objects out of fear of contamination. Others may struggle with perfectionism, becoming extremely upset if things are not arranged a certain way or if tasks are not done “just right.” Because OCD can also be internal, some compulsions may go unnoticed, such as silently repeating phrases or counting in their head. Read our blog “How Counseling Can Help You Break OCD Habits.”
Here are some common symptoms of OCD in children:
Excessive handwashing or grooming
Repeated checking (e.g., doors, locks, homework)
Constant reassurance-seeking
Intense fear of germs, illness, or contamination
Avoidance of certain objects, places, or people
Needing things to be symmetrical or in a specific order
Repeating actions until they feel “right”
Compulsive counting, tapping, or repeating words silently
Becoming very upset when routines are disrupted (View our blog “How to Create A Daily Routine”)
Intrusive thoughts that are scary, upsetting, or violent which the child may feel ashamed to share (Our blog “How to Manage OCD Intrusive Thoughts with CBT” is a must-read)
Recognizing these symptoms early and seeking support from a mental health professional can make a meaningful difference in your child’s ability to manage OCD and maintain a healthy, balanced life!
What are the 9 symptoms of OCD?
OCD presents in many ways, but there are several core symptoms that commonly appear in both children and adults. One major symptom is obsessive fear of contamination where a child may be overly worried about germs, illness, or dirt, leading to excessive cleaning or avoidance of public spaces. Closely related is excessive washing or cleaning, such as frequent handwashing, showering, or sanitizing objects far beyond what is necessary. Another common symptom is checking behaviors- repeatedly checking doors, locks, lights, or homework to prevent harm or avoid mistakes, often driven by an irrational fear that something bad will happen if they do not.
Children may also experience repeating behaviors, such as rereading, rewriting, or redoing tasks until they feel “just right.” Ordering or arranging items in a specific way is another symptom, often linked to a strong need for symmetry or precision. Counting rituals may also be present, where a child silently counts steps, actions, or objects as a way to reduce anxiety. A less visible but equally distressing symptom is mental compulsions where the child may repeat certain phrases, prayers, or numbers in their head to neutralize upsetting thoughts.
Additionally, many children with OCD engage in excessive reassurance-seeking, frequently asking parents, teachers, or peers for confirmation that everything is okay. Lastly, intrusive thoughts- disturbing or unwanted thoughts that go against the child’s values or sense of self- are a key symptom. These thoughts can be violent, sexual, or blasphemous in nature, and often cause significant shame or confusion.
Recognizing these nine core symptoms is essential for early identification and effective treatment of OCD.
Can childhood OCD go away?
Childhood OCD does not typically go away on its own, but with the right treatment and support, many children experience significant improvement and may even achieve full remission of symptoms. The most effective treatment for childhood OCD is a combination of Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), and, in some cases, medication such as Selective Serotonin Reuptake Inhibitors or SSRIs. Early intervention is critical. When OCD is addressed early with evidence-based care, children are more likely to learn effective coping strategies, reduce the intensity of their symptoms, and prevent the disorder from worsening over time.
What are the benefits of counseling for OCD in children and teens?
Reduces obsessive thoughts and compulsive behaviors through evidence-based strategies like CBT and ERP
Teaches coping skills to manage anxiety and tolerate distress without relying on rituals
Improves emotional regulation, helping children better understand and express their feelings (View our blog “How to Regulate Your Emotions”)
Increases self-esteem and confidence by empowering children to face fears and gain control over their symptoms (Our blog “The Ultimate Guide to Building Self-Confidence” is a must-read)
Enhances problem-solving skills, promoting independence in managing day-to-day challenges
Strengthens family relationships by involving parents in the treatment process and reducing conflict around OCD behaviors (View our blog “What Is My Parenting Style?”)
Provides a safe, supportive space for children and teens to talk about intrusive thoughts without fear or shame (Read our blog “How to Parent Anxious Children in Hoboken, NJ”)
Prevents symptoms from worsening or interfering with school, friendships, and daily routines
Promotes long-term resilience, equipping young people with tools to manage symptoms throughout life
However, OCD is generally considered a chronic condition, meaning it can fluctuate or persist into adolescence and adulthood, even if symptoms improve for periods of time. Stress, life transitions, or other mental health conditions (like anxiety or depression) can trigger a recurrence of symptoms. That said, many children who receive appropriate treatment go on to lead full, productive lives with OCD becoming a manageable part of their overall mental health profile. Ongoing therapy, family support, and self-awareness are key factors in helping a child maintain long-term progress and resilience.
Check out our blog “Your Guide to Natural Treatment for OCD.”
What behavior is OCD confused with in children?
OCD in children is often confused with typical childhood behaviors because some rituals and repetitive actions are a normal part of development. For example, many children go through phases where they insist on routines, such as wanting to wear the same clothes every day or needing bedtime rituals to feel secure. These behaviors usually have a clear beginning and end, cause little distress, and do not interfere significantly with the child’s daily life. In contrast, OCD behaviors are intense, persistent, and driven by anxiety or intrusive thoughts, causing significant distress and disruption.
Another common source of confusion is between OCD and behavioral or oppositional issues. Parents or teachers might mistake OCD-driven rituals or avoidance as defiance or stubbornness. For instance, a child who refuses to touch certain objects or repeatedly asks for reassurance may appear controlling or manipulative when, in reality, they are struggling to manage overwhelming anxiety. This misunderstanding can lead to frustration on both sides and make it harder to get the child the support they need. It is important to recognize that OCD behaviors are not intentional misbehavior but symptoms of a mental health condition.
Finally, OCD can sometimes be mistaken for other mental health disorders such as anxiety disorders, Attention-Deficit/Hyperactivity Disorder (ADHD), or Autism Spectrum Disorder (ASD) because of overlapping symptoms. For example, the repetitive behaviors seen in OCD might resemble the routines and rituals common in autism, but the underlying motivation is different. OCD compulsions are performed to reduce anxiety caused by obsessions while autistic routines often serve to create predictability or comfort. Similarly, a child with ADHD might appear restless or distracted, but OCD-related compulsions are specific actions aimed at reducing distress rather than general hyperactivity or impulsivity. View our blog “Parenting A Child with ADHD.”
Proper assessment by a mental health professional is essential to distinguish OCD from these other conditions and to ensure that your child receives the care he or she needs.
Empowering Children and Teens to Break Free From OCD with Counseling
OCD can feel overwhelming for children and teens, often leaving them confused, anxious, and frustrated by the thoughts and rituals they cannot seem to control. These compulsions, like repetitive checking; excessive washing; or needing things to be “just right”, are more than habits; they are driven by powerful, intrusive fears that create intense emotional distress. For young people, OCD can interfere with school performance, friendships, and daily routines, leading to a growing sense of isolation and self-doubt. That is where counseling becomes a critical tool- not only for symptom relief but also for helping children and teens regain a sense of control over their lives.
Counseling for OCD typically involves CBT, and more specifically, a technique called ERP. ERP helps young clients gradually face their fears in a safe, supportive environment while learning how to resist the urge to perform compulsions. Over time, this reduces the anxiety that drives the OCD cycle. In therapy, children also learn how to reframe obsessive thoughts and challenge the beliefs that fuel their compulsions. This process not only decreases symptoms but also builds emotional resilience and problem-solving skills they can carry into adulthood.
An important part of therapy is the involvement of parents and caregivers. Family education and support are essential in helping children apply what they learn in sessions to real-life situations. Parents are guided on how to respond to their child’s OCD behaviors in a way that supports progress rather than unintentionally reinforcing the disorder. When the family works as a team backed by professional guidance, the child or teen feels more supported and less alone in their struggles, which often accelerates healing.
Most importantly, counseling empowers children and teens by giving them the tools to take back control from OCD. As they gain confidence and develop healthier coping mechanisms, they begin to see that they are not defined by their intrusive thoughts or compulsive behaviors. Instead, they learn that they are strong, capable, and able to live full, meaningful lives beyond the limits of OCD. With the right therapeutic support, many young people not only manage their symptoms but thrive in ways they never thought possible!
Helping a child or teen navigate OCD can be challenging but, with the right support, it is absolutely possible for them to find relief and regain confidence in their daily life. Counseling offers a safe, structured path toward understanding and managing OCD, not just for the young person but for the whole family. By addressing the disorder with compassion, education, and evidence-based strategies, children and teens can break free from the grip of intrusive thoughts and compulsive behaviors.
Victoria Scala
is the Social Media Manager, Intake Coordinator, and Community Engagement Director at Anchor Therapy in Hoboken, New Jersey. She is a graduate of the Honors College of Rutgers University-Newark and is currently studying Clinical Mental Health Counseling at the graduate level. In her roles, Victoria is committed to managing the office’s social media/community presence and prioritizing clients' needs.
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