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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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Im worried that my child (a boy aged 7) is a little obsessional

Resolved Question:

I'm worried that my child (a boy aged 7) is a little obsessional and I don't know whether it's something he will grow out of or whether he needs a bit of help. He has phases where he feels the need to confess all the time to minor mis-deeds (he loves animals and keeps worrying he's trodden on an ant on the way to school eg). He worries about germs and had a phase of bathing several times a day. Today he told me while we were having a cuddle that when he is having a nice time (like 'now') he can't help thinking of bad things, like today, he was thinking about a donkey being pulled backways by the tail in a children's programme he saw. These phases, which started a few months ago I guess, seem to come and go, but never fully go. We moved countries less than a year ago but he seems to have settled and be very happy here. What do you think?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Doctor Blake replied 3 years ago.

Doctor Blake :

Good morning and welcome to JA.

Doctor Blake :

Normally, I would say that a 6, 7, 8 year old boy who is "obsessed" by particular things is pretty typical.

Doctor Blake :

However, the content of your son's obsessions are more reflective of an underlying problem.

Doctor Blake :

Please understand that it is unethical to diagnose 3rd party over the internet... but I suspect that (given the intensity and content you report) that there may be some OCD (Obsessive Compulsive Disorder) kinds of processes going on.

Doctor Blake :

Some youngsters with neurodevelopmental disorders (such as a pervasive developmental disorder or mild autism) may also demonstrate these behaviors...

Doctor Blake :

but among pediatric populations, the "overall" of symptoms (OCD, ADHD, ASD, etc) is often so pronounced that it's difficult to say what is happening for certain.

Doctor Blake :

In any event... OCD (even among pediatric populations) is one of THE MOST TREATABLE conditions!

Doctor Blake :

In some cases, medication (typically an SSRI) is warranted.

Doctor Blake :

But, again even among pediatric patients, a cognitive behavioral technique called Exposure with Response Prevention (ERP) has been demonstrated to be one of the most effective treatments available. Some research evidence shows improvement after as few as four sessions (although those first 4 sessions can be pretty "bumpy"!)

Doctor Blake :

CBT is a very specialized form of therapy that is provided by a Psychologist, Counselor, or Social Worker with specific training in CBT. Unlike traditional "talk therapy," in which a patient may stumble upon a cure once s/he gains enough insight into their problems, CBT uses specific strategies and methods to change thoughts/feelings (cognitions) and actions (behaviors) that lead to the disorder (in this case, OCD). Very few therapists will work with a JUST THE CHILD (although there will be independent work done with them..)... because the child lives in a FAMILY. So, the best source for you to explore is a family--based cognitive behavioral therapists.


ERP has been demonstrated to significantly alleviate cognitions and behaviors related to OCD in a very brief period of time. (Some research suggests that ERP may even be *more* effective than medication for the treatment of OCD!)


 


I would strongly urge you to speak to your physician about your plan to see a Cognitive-Behavioral Therapist who can provide ERP (the best) or at least CBT to you to address your OCD. Make sure your physician is willing/able to team with the mental health professional providing the treatment. As you experience changes that may well happen after you commence ERP, the doctor will need to be made aware of this, in the event that medications may need to be changed.


 


When searching for your mental health therapist (again Psychologist, Counselor, or Social Worker) is would be very specific about your needs. Ask them if they employ Cognitive Behavioral Therapy. Have they ever worked with someone with OCD? Have they ever used the Exposure with Response Prevention technique to address OCD symptoms? You might have to do a little "shopping around," but it's OK for you to be demanding about your health care! YOU DESERVE IT.


 


Finally, you should know that, of all the mental diseases, anxiety and depression are among the most successfully treated. And among anxiety disorders, OCD and phobias are the most responsive to CBT/ERP! You have a great deal to be hopeful about! I hope you are successful in finding a qualified CBT therapist to address your concerns.

Doctor Blake :

I know this is a lot of information at once... but there ARE specialists available to treat this condition.

Doctor Blake :

Oh... I see you're on. I'll wait to see if there are other specifics.

Customer:

Oh dear, I preferred your first sentence, but I was worried that this was like OCD. I'm not keen on medication at all, especially so young. Tell me more about ERP and what else I could do myself.

Customer:

Oh, just got the rest of your message thank you

Doctor Blake :

I know... I liked my first sentence a lot better too.

Doctor Blake :

But I'm afraid that the content and intensity of your son's presentation *may* suggest OCD.

Doctor Blake :

Of course, I can't diagnose over the internet, without having seen your son... so your first step will be to see a child/pediatric psychologist to be certain.

Doctor Blake :

Are there other questions that I can try to address?

Customer:

What would happen if I waited for a bit to see if he grows out of it?

Doctor Blake :

Well, I suppose that's a possibility.

Doctor Blake :

...but not necessarily a likelihood.

Customer:

Would the treatment be more effective if started sooner?

Doctor Blake :

And, please understand, if you provide developmentally appropriate ERP, THERE MAY BE NO NEED FOR MEDICATION whatsoever!

Doctor Blake :

Well, the question is... the longer your son persists in the obsessions or compulsions, the more he learns that they are a "necessary" part of his life. ERP helps kids (well, anyone... not just kids) learn that the obsessions/compulsions are NOT necessary.

Customer:

I really don't like the idea of being pushed into medication. If we go to see someone and don't want to go down that route, may we refuse?

Customer:

Yes that is helpful

Doctor Blake :

Absolutely! You don't have to do ANYTHING you don't want to do with your son.

Doctor Blake :

Explain that you've done some research and have learned about ERP... and would like to try that with a qualified psychologist first.

Customer:

It won't get taken out of our hands then, once the experts are involved?

Doctor Blake :

(I would encourage you to search some online for this process/procedure.)

Doctor Blake :

As parents, you have to grant consent for ALL assessments and treatment.

Doctor Blake :

Now, you may have to be assertive! You might have to say, "No! I don't want this..." <or> "I want A,B,C."

Customer:

Yes.

Doctor Blake :

But nobody can do anything with your child without your consent.

Customer:

That's a relief!

Doctor Blake :

Agreed!

Customer:

How might it have started?

Doctor Blake :

Some kids I've treated with ERP have found it actually sort of fun. And they experience relief quite quickly.

Customer:

What is 'quite quickly' - weeks? months?

Doctor Blake :

The question of how it started is one that I really can't answer... (not knowing you or your son)... but I don't think it's related to the moves from country to country.

Customer:

Are there typical causes?

Doctor Blake :

Research has indicated that, while the first 4-5 sessions of ERP can often be "rocky..." by session 4-5, individuals have essentially learned "Oh, gosh - what was I *thinking*!" and apply a host of new skills to eradicate the problem.

Doctor Blake :

They will often continue for several (4-5) sessions beyond this to be certain that the treatment has "held."

Doctor Blake :

There may also be monthly follow-up to be certain that all is well. (Sometimes individuals with OCD may develop other fears or anxieties that may need to be monitored.)

Customer:

What age group is ERP mostly used on? (Is 7 normal?) Give more detail on 'rocky' please...

Doctor Blake :

ERP can be used on pediatric through geriatic populations. I have conducted ERP sessions with children (and their parents) for kids as young as 5 years old.

Doctor Blake :

Well, when I say rocky, please understand what ERP is asking the client to do...

Doctor Blake :

Let's say a client is obsessed with touching doorknobs 4 times in quick succession before walking through a door.

Doctor Blake :

A typical session would involve:

Doctor Blake :

teaching physiological relaxation techinques

Doctor Blake :

Having the individual walk toward the door in a relaxed state

Doctor Blake :

allowing the individual to touch the doorknob JUST ONCE (not the "necessary" 4 times)

Doctor Blake :

and them having them walk through the doorway.

Doctor Blake :

on the otherside of the doorway, the relaxation techniques are reapplied.

Doctor Blake :

So... those first 3-4 sessions can be a little "rocky" because we're asking an individual to STOP doing what they think is necessary... and it often makes them very anxious.

Doctor Blake :

Once they get through it enough times, they realize, "Oh! Wow! What I thought was necessary ISN'T!"

Doctor Blake :

With a caring, gentle, developmentally appropriate therapist, it's very simple and straightforward.

Customer:

Yes I see

Doctor Blake :

So, I've very hopeful for your son!

Doctor Blake :

Thanks for writing in to JA. I hope you understand that we're fast approaching the end of the time I can provide right now.

Customer:

Thank you very much. I suppose you are more used to all this than I am. It has been very disturbing to have my fears confirmed but very informative. I shall talk it all over with my husband and plan our way forward.

Customer:

I'm very grateful for the amount of information you have given and for your friendly approach

Doctor Blake :

Thanks to you. Don't worry... all will be well. Check out resources online on Pediatric OCD... very helpful.

Doctor Blake :

Best of luck to you and your family.

Doctor Blake :

Please click <ACCEPT>

Customer:

Yes. Thanks again and bye!

Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience: Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
Doctor Blake and 2 other Mental Health Specialists are ready to help you

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