OCD in Kids vs. Adults: What to Know and How to Get Help

I’m thrilled to share this guest post from Alexandra Bennett, LCSW, a therapist I deeply respect for her expertise in treating OCD and anxiety in children and adolescents. In addition to her private practice, Alexandra also works in a school setting supporting students with learning differences, giving her a unique perspective on the challenges children and families face.

In this post, she shares valuable insights into how OCD can look different in children and adults, what to watch for, and how evidence-based treatment can help break the cycle. Whether you are a parent, a professional, or simply curious about OCD, her expertise brings clarity and compassion to a complex topic.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a complex and often misunderstood mental health condition. It involves a cycle of obsessions, which are unwanted thoughts, images, or urges, and compulsions, which are repetitive behaviors or mental rituals performed to temporarily ease anxiety.

While compulsions may bring relief in the moment, they strengthen the OCD cycle over time, making the anxiety more powerful and the rituals harder to resist. Untreated, OCD can interfere with school, work, relationships, and everyday functioning.

Example of the OCD cycle:Someone touches a doorknob and fears they have picked up harmful germs that could make their family sick. To feel safe, they wash their hands three times. The anxiety eases briefly, but the next time they touch a doorknob, the fear returns and the cycle repeats.

How OCD Looks Different in Kids and Adults

OCD does not always look the same, which can make it hard to identify.

In children and teens:

• They may not know exactly what they fear and may say something vague like “something bad will happen.”

• Parents often get pulled into rituals, such as bedtime routines that must be done a certain way or repeated reassurances.

• Symptoms can disrupt school, friendships, and family routines.

In adults:

• They may be more aware of their fears but often experience “mental compulsions,” such as silently counting, replaying events, or mentally neutralizing thoughts.

• Partners or loved ones may become part of reassurance-seeking or checking behaviors.

• Avoidance behaviors, such as skipping tasks, places, or conversations, can start to limit daily life.

  
  

How to Know If You or Your Child May Be Struggling

OCD can be hard to recognize because symptoms often mimic normal worries or habits. The key difference is that the thoughts or behaviors feel intrusive, time-consuming, and disruptive.

Signs in children and teens:

• Repeating actions until things feel “just right”

• Asking for constant reassurance

• Avoiding certain activities or places without a clear reason

• Emotional distress if routines are disrupted

• Withdrawing from friends or showing a sudden drop in school performance

  
  

Signs in adults:

• Intrusive, repetitive thoughts that feel impossible to control

• Repetitive rituals or mental routines to reduce anxiety

• Avoiding people, places, or situations that trigger fears

• Losing significant time each day to compulsions

• Feeling exhausted, frustrated, or ashamed of the cycle

  
  

How OCD Is Treated

The gold-standard treatment for OCD is Exposure and Response Prevention Therapy (ERP), a specialized form of Cognitive Behavioral Therapy (CBT). ERP retrains the brain by helping clients face fears gradually while resisting the urge to perform compulsions.

Effective ERP often includes:

• Education: Understanding how the OCD cycle works and why compulsions keep it going

• Gradual exposure: Starting with less distressing triggers and building up to more challenging ones

• Response prevention: Learning to sit with discomfort without performing the compulsion

• Family support: For children, parents learn how to step out of rituals while still offering emotional support

• Consistency and practice: Applying skills in daily life to build confidence and resilience

  
  

Some clients also benefit from medication, mindfulness strategies, or acceptance-based approaches that complement ERP and support long-term progress.

With the right care, OCD is highly treatable. Many children and adults experience significant relief, allowing them to regain their confidence, routines, and peace of mind.

Finding the Right Support

If you see yourself or your child in these patterns, know that you are not alone and that effective help is available. Alexandra specializes in evidence-based care for OCD and anxiety in children, adolescents, and young adults, and offers both in-person and virtual therapy. You can learn more about her work and schedule a free consultation through her website.

If you are an adult struggling with OCD or anxiety, you can also reach out to me to schedule a consultation and explore how we can work together.