Practice Specialties

Children, adolescents, and young adults with obsessive-compulsive disorder (OCD) experience intrusive and unwanted thoughts, urges, or images (obsessions) that cause significant distress or anxiety, and perform rituals (compulsions) to reduce that distress. Common obsessions include fears of contamination or harming others, a need for order or a “just right” feeling, worries about morality, or taboo thoughts. Compulsions can be behaviors (e.g., excessive washing, checking, or ordering) or mental rituals (e.g., neutralizing a “bad” thought with a “good” one, reviewing memories, or silently counting) and vary greatly. Unfortunately, performing rituals only provides temporary relief, and maintains the obsession-compulsion cycle of OCD.

How we can help

At Riverstone, we use Exposure and Response Prevention (ERP)—the gold-standard treatment for OCD—to break the obsession-compulsion cycle and reduce symptoms. Treatment begins by identifying a client’s unique obsessions and compulsions. Through ERP, we then support clients as they gradually face feared thoughts or situations (exposure) while refraining from performing rituals or compulsive behaviors (response prevention). This process teaches that anxiety naturally decreases without compulsions and that feared outcomes are unlikely or manageable. Over time, clients reduce reliance on rituals, build tolerance for uncertainty, and develop skills that support long-term recovery.

In a well-intentioned effort to relieve their child’s distress, parents often accommodate their child’s OCD in ways that end up helping maintain OCD symptoms. This can happen when parents provide repeated reassurance, change family routines to avoid OCD triggers, or perform tasks for their child like touching doorknobs or rewashing dishes. Because accommodation from family members is the norm (not the exception) when youth have OCD, we work closely with families throughout treatment to provide support and guidance to gradually reduce accommodations that may be maintaining the cycle of OCD.