OCD Can Affect Much More Than Worries or Rituals
OCD can affect far more than worries or rituals. It can interfere with school, friendships, family life, sleep, and the confidence to do everyday things.
The good news is that OCD is highly treatable.
Using Exposure and Response Prevention (ERP)—a treatment that gradually helps children face feared situations while learning they don't have to follow OCD's rules—I help children, teens, and young adults build confidence in handling uncertainty so OCD no longer dictates their daily lives.
Treatment is individualized, collaborative, and tailored to each child's developmental stage, strengths, and goals.
Evidence-Based Care with a Personalized Approach
✔ Exposure and Response Prevention (ERP)
✔ Individualized treatment plans
✔ Parent involvement throughout treatment
✔ Practical strategies that extend beyond the therapy office
Licensed Clinical Psychologist • PhD • New York University • Child Mind Institute • University of Pittsburgh Medical Center • Florida International University • University of Washington & Seattle Children's Hospital Training • PSYPACT Authorized
Specialized OCD Treatment for Children, Teens, and Young Adults
If you're looking for treatment for childhood OCD, you're probably not just looking for someone who treats anxiety.
You're looking for someone who understands OCD specifically—how it affects children differently, how it impacts families, and how to help it get better.
I'm Dr. Fiona Macphee, a licensed clinical psychologist specializing in evidence-based treatment for OCD and anxiety disorders in children, adolescents, and young adults.
My treatment approach combines Exposure and Response Prevention (ERP) and other evidence-based cognitive behavioral therapies with a warm, collaborative style that helps young people feel understood while gradually building confidence.
Depending on your child's age and needs, treatment may include:
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Individual therapy
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Parent coaching
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School collaboration
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Community-based sessions
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Real-world practice outside the office when appropriate
Parents are active partners throughout treatment because meaningful progress often happens not only during therapy sessions, but also in everyday life. I'll help you understand how OCD works, recognize when it's pulling your family into its cycle, and respond in ways that support your child's recovery.
One of the things I enjoy most about treating OCD is watching children discover that they are far more capable than OCD has led them to believe. Seeing that confidence spread into school, friendships, and family life is one of the most rewarding parts of my work.
How OCD Can Affect Everyday Life
One of the most confusing things about childhood OCD is that it doesn't always look the way people expect.
Many parents picture excessive handwashing or fears of germs. While those symptoms certainly occur, OCD can also involve repeated reassurance-seeking, checking, intrusive thoughts, perfectionism, mental rituals, confessing, or needing things to feel "just right."
Over time, these behaviors often become more frequent and begin interfering with everyday life.
School attendance may become more difficult. Bedtime routines grow longer. Simple decisions become exhausting. Family outings require more planning, and friendships become harder to maintain.
What may have started as a few worries or rituals can gradually begin taking up more and more space in a child's life.
For some children, OCD is largely internal. They quietly struggle with intrusive thoughts, anxiety, or mental rituals that others rarely see.
For others, OCD becomes much more visible. Attempts to interrupt a ritual, withhold reassurance, or tolerate uncertainty may lead to significant emotional distress or intense emotional outbursts. What can appear to be defiance, stubbornness, or "bad behavior" is often a child whose OCD has become so overwhelming that they don't yet know another way to cope.
Whether OCD shows up through obvious rituals and emotional outbursts or through quiet internal struggles, it has a way of gradually asking for more and more of a child's time, energy, and confidence.
Exposure and Response Prevention (ERP): The Gold-Standard Treatment for OCD
Exposure and Response Prevention (ERP) is considered the most effective treatment for childhood OCD.
At its core, ERP helps children gradually face the situations, thoughts, or feelings that trigger OCD while learning not to respond with the rituals, avoidance, or reassurance that OCD demands.
An exposure simply means gradually practicing something OCD tells your child to avoid or fear. Response prevention means resisting the rituals or reassurance that OCD says are necessary afterward.
Although rituals and avoidance may provide temporary relief, they actually strengthen OCD over time by teaching the brain that the fear was dangerous and the ritual was necessary.
ERP breaks that cycle.
With guidance and support, children practice approaching fears in small, manageable steps while discovering something incredibly important:
They can tolerate uncertainty without listening to OCD.
Over time, the brain learns that anxiety naturally rises and falls on its own, even without rituals. As confidence grows, OCD gradually loses its influence.
Many families begin noticing meaningful improvement within three to six months of consistent treatment, although every child and every situation is different.
What Therapy Looks Like
No two children experience OCD in exactly the same way, and therapy shouldn't look the same for every child either.
Treatment is active, collaborative, and individualized. Rather than simply talking about anxiety each week, we work together to help your child build the confidence and skills needed to respond differently to OCD—both in therapy and in everyday life.
Understanding OCD
Children first learn to recognize how OCD operates.
Together we identify the thoughts, feelings, rituals, and patterns that keep OCD going and begin understanding why reassurance, avoidance, and compulsions provide only temporary relief.
Learning to Respond Differently
Children don't simply talk about OCD during therapy—they actively practice responding to it in new ways.
Together, we'll gradually approach situations that trigger OCD while resisting the rituals, avoidance, or reassurance that OCD expects. As children discover they can handle uncertainty without following OCD's rules, confidence grows and OCD gradually loses its grip.
Parent Coaching
Parents are active partners throughout treatment because OCD often pulls the entire family into its cycle.
Together, we'll help you understand how OCD operates, recognize when it's involving you through reassurance, avoidance, or rituals, and learn how to respond in ways that support your child's progress rather than unintentionally strengthening OCD.
You'll leave treatment with practical strategies and greater confidence—not only in how to respond when OCD shows up, but also in how to support your child's growing independence and resilience between sessions.
Real-World Practice
Some of the most meaningful progress happens outside the therapy office.
When appropriate, we'll practice approaching real-life situations that trigger OCD—whether that's touching objects, eating at a restaurant, leaving the house, going to school, or another situation specific to your child. Together, we'll practice responding without following OCD's rules so your child can build confidence where it matters most.
School Collaboration
When OCD is affecting school attendance, learning, or participation, collaboration with teachers and school staff can help create consistency across settings and support your child's success both academically and socially.
The Goal of Treatment
The goal of treatment is to reduce OCD symptoms while helping children get back to living the life they want to live.
As treatment progresses, many families notice that daily routines become easier, reassurance becomes less necessary, and children become increasingly willing to face situations they once avoided.
Frequently Asked Questions
Are parents involved in treatment?
Yes. Parents are active partners throughout treatment because meaningful progress often happens outside of therapy sessions. Depending on your child's age and needs, treatment may include parent coaching, family sessions, or dedicated parent meetings.
How long does treatment usually take?
Every child is different, but many families begin noticing meaningful improvement within three to six months of consistent treatment. The overall length of therapy depends on your child's symptoms, goals, and progress.
Do you offer telehealth?
Yes. I provide secure telehealth services and am authorized through PSYPACT to work with clients in many participating states. Depending on your child's needs, treatment may also include community-based sessions or school collaboration.
What happens during the complimentary consultation?
We'll spend about 20 minutes discussing your concerns, what you've been noticing, and whether my approach is a good fit for your family. I'll answer your questions, explain what treatment may look like, and discuss next steps if we decide to work together.
Ready to Take the Next Step?
A complimentary consultation is an opportunity to discuss your concerns, ask questions, and determine whether my approach is the right fit for your family. Together, we'll talk about what's been happening, what treatment might look like, and the next steps toward helping your child regain confidence and spend less time listening to OCD.