In the video above, Dr. Jerry Bubrick explains the “gold standard” treatment for obsessive-compulsive disorder. The key is communicating an understanding that anxiety will pass even without a child performing a ritual or compulsion.


The gold standard treatment we have for OCD and OC spectrum disorders is a technique called “exposure with response prevention,” where essentially we help children overcome their fears by having them face their fears directly head-on. Anxiety disorders, in general, are maintained through avoidance. So if someone’s afraid of something or it causes them anxiety, they’re going to want to avoid it. And avoiding it temporarily eases their anxiety or prevents their anxiety from coming, but it actually builds and actually maintains their anxiety over time.

So exposure with response prevention says, well if you’re avoiding the situation and that’s kind of making you worse over the long run, what we should really do is have you face your fear in the moments, in a very structured and systematic way — have you kind of learn to get used to the anxiety that comes from that process.

Exposure with response prevention really works through mainly a phenomenon called “habituation,” where your body basically adapts to whatever it is that it was fearing or it was having a hard time adjusting to. We see the same thing with all the different senses. So if you, on a hot day, jump into a cold pool, your body will feel the temperature of the water. But if you stay in the water, over time, eventually your body gets used to it. The temperature stayed the same, but your body adapted.

The same thing happens with anxiety. When we systematically and slowly introduce kids to the things that they’re afraid of, they feel the anxiety, but then they learn how to get used to it, they learn how to adapt, and it doesn’t bother them anymore.