RESOURCES.RESULTS.RELIEF.

Transcription

1 RESOURCES.RESULTS.RELIEF. Hme Management Strategies fr OCD Step 1: Teaching yur child abut anxiety N matter what type f anxiety prblem yur child is struggling with, it is imprtant that he r she understands the facts abut anxiety. Fact 1: Anxiety is a nrmal and adaptive system in the bdy that tells us when we are in danger. Fact 2: Anxiety becmes a prblem when ur bdy tells us that there is danger when there is n real danger. As an imprtant first step, help yur child t understand that all his r her wrries and physical feelings have a name: Anxiety. T learn hw t explain this t yur child, see Hw t Talk t Yur Child abut Anxiety. Step 2: Teaching yur child r teen abut OCD It is imprtant that yur child r teen understand that all the upsetting thughts and rituals that he r she is having is called OCD. One way t think abut OCD is as a cmputer virus r a hiccup in the brain. Talking T Yur Child: OCD as a cmputer virus Parent: Let s talk abut yur OCD tday. One way t think abut it is as a cmputer virus. What d viruses d t cmputers? Child: Well, viruses can mess up the cmputer. Sme prgrams might nt wrk well, but it culd als break the whle cmputer Parent: That s right. Well, think f yur OCD as a cmputer virus in yur brain. It can mess up certain prgrams, and smetimes it just shuts the brain right dwn. Fr example, smetimes yu just keep washing yur hands ver and ver again. That s yur OCD virus messing up the prgram. Other times, yu just dn t want t leave the huse because yu are s anxius; that s the OCD virus again. Yur OCD virus turns the vlume f scary thughts up really high in yur brain. S, tgether we need t get rid f that OCD cmputer virus. What d yu think?

2 2 Talking T Yur Child: OCD as a hiccup Parent: Let s talk abut yur OCD tday. One way t think abut it is as a hiccup in yur brain. What happens when we hiccup? Child: We make a hiccup sund, and it keeps happening again and again. Parent: That s right. It just keeps cming back, and we have n cntrl. Well, OCD is like a hiccup. Yu have thusands f thughts in yur head every day, but when yu have an OCD hiccup, the same thught cmes up again and again, and just wn t g away. Fr example, smetimes when yu g t bed at night, yur brain has an OCD hiccup. D yu knw what it is? Child: Yes. I check all the drs and windws t make sure they are lcked. Parent: Exactly. The OCD hiccup in yur brain tells yu that yu need t check again and again t make sure that everything is lcked. S, tgether we need t stp yur brain frm hiccupping. What d yu think? Step 3: Building yur child s tlbx The best way t help children r teens deal with OCD is t give them tls that can be used instead f the cmpulsins. Fr OCD, tls in the tlbx include: Tl #1: Naming the bully OCD can quickly take ver yur child s life. A gd way fr yu t start helping yur child tackle OCD is t encurage him r her t see the OCD as a separate entity, rather than a mistake n the part f yur child. T d this, children and teens are encuraged t see their OCD as a bully that is trying t cntrl them and tell them what t d. Have yur child give a name t the OCD bully, such as the wrry bug, the pest, r the OCD mnster. Yu and yur child can then talk abut OCD withut blaming anyne fr it. Fr example, It lks like the OCD mnster has been bullying yu arund tday! TOOL #2: Changing r Delaying the Rituals This tl is especially useful with yunger children. Once yu begin helping yur child t deal with OCD, yu can ask him r her t delay r change a ritual slightly as a first attempt t bss back the OCD. Fr example, Let s try bssing back the OCD by having yu wait 5 minutes befre washing yur hands, r Let s try putting the right sck n befre the left sck. Afterward, make sure t praise yur child s accmplishment, and remind him r her that this is hw we bss back the OCD. Helpful Tip: Delaying r changing an OCD ritual can be very difficult. If yur child is very anxius, it is OK t take very small steps. Fr example, delaying washing hands fr 30 secnds. Yu might even want t make a fear ladder with yur child that has gradually harder exercises fr him r her t d, such as, starting with a delay f 30 secnds t nt washing hands all day. (See Helping yur Child t Face Fears: Expsure fr mre infrmatin.)! It is a gd idea t remind yur child whenever OCD is being a bully. Fr example, I see that yu are arranging all yur scks in the sck drawer. Is the OCD bully acting up again? Dn t frget t give lts f rewards and praises t yur child fr any attempts he r she makes t fight ff the OCD rituals.

3 3 Praise, Praise, Praise!! Because it is hard wrk t manage OCD, yur child needs lts f encuragement. Sme helpful rewards can be: Stickers that yur child can put n a psterbard every time he r she tries t bss back OCD Verbal praise: What a great jb yu are ding! ; I m s prud f yu! ; Lk hw brave yu are! Rewards at hme: extra TV time, family time tgether, playing a fun bard game, dinner at a favurite restaurant, r a new ty. Sme rewards shuld be mre lng-term. Fr example, When yu are able t bss back the OCD fr a whle day and nt check any drs, we will g t the ty stre and get a new vide game fr yu. Tl #3: Addressing Reassurance-Seeking Because children with OCD ften want reassurance frm their parents, this is an imprtant tl, nt nly fr yur child, but als fr yu. When yur child asks fr reassurance, fr example, are yu sure the kitchen is clean?, yu can answer in the fllwing ways: What if it s nt cmpletely clean? What wuld happen then? If yur child gets very anxius, yu can remind him r her that OCD is being a bully, and ask which tl he r she can use frm the OCD tlbx. Yu can give yur child reassurance nce, and then if he r she asks again, yu can reply: I already answered that questin. Why dn t yu try using yur tlbx? T learn hw t explain this t yur child, see Hw t Address Excessive Reassurance Seeking. Tl #4: Facing Fears: Expsure and Respnse Preventin The majrity f the wrk in helping yur child r teen bss back the OCD is in helping yur child t gradually face his r her fears. This invlves develping a list f all f yur child s rituals (e.g., washing hands, checking drs), as well as a list f situatins when yur child cmpletes the rituals (e.g., when tuching the drknb r when ging t bed at night). With OCD, this is smetimes called Expsure and Respnse Preventin, because children r teens need t face their fears (e.g., tuching the drknb), and then deliberately nt d their cmpulsin (e.g., washing hands). Facing fears is the expsure part; nt ding the cmpulsin is called respnse preventin. Gradually, yur child can begin reducing these behavirs by nt ding the cmpulsins and then tlerating the anxiety until it subsides. This tl will prbably be the mst effective f all the OCD tls.

4 4 Tl #5: Stpping Parent-Assisted Rituals Once yu start helping yur child r teen t battle OCD, yu might think that stpping all the rituals that yu yurself have becme invlved in is a gd idea. Fr example, yur child might ask yu t clean the huse r d the laundry in a certain way (such as using bleach everywhere, r cleaning clthes separately). Althugh ne f the gals in managing OCD is t stp all the rituals yu are invlved in, suddenly stpping them all can be very verwhelming fr yur child. When yur child starts facing his r her fears, these parent-assisted rituals can be anther part f OCD t bss back. That is, yu can make a fear ladder with yur child, t gradually reduce these rituals. Tip #1: Yur Child r Teen is the Bss! It is imprtant t ultimately let yur child decide when he r she is ready t reduce, change, r eliminate rituals that yu assist with. Yur child needs t feel in charge f bssing back OCD. Tip #2: Be Patient Mst parents are very frustrated with all the rituals they are invlved in. Hwever, it is imprtant t remember nt t get angry at yur child fr unsuccessful attempts at bssing back OCD. Instead, fcus n successes! Give yur child lts f praise, even if his r her attempt t stp sme rituals was unsuccessful. Being psitive is extremely mtivating. Tl #6: Cping Cards One f the mst helpful tls will be the things that yur child can say t him r herself t help deal with anxiety. Cping cards are very useful fr this. (see Develping and Using Cgnitive Cping Cards with Yur Child). Sme helpful cping statements fr OCD include: There s my OCD mnster! He s trying t bully me again! I dn t have t listen. I feel really anxius right nw, but I knw that feeling will g away sn. Fr mre detail and a sample f an OCD ladder, see Helping yur Child t Face Fears: Expsure. Helpful Tip: Sme f the OCD fears that yur child has might be based n false infrmatin r ignrance. Fr example, many children with OCD wh wash their hands excessively dn t knw that washing yur hands repeatedly is nt gd fr yu. It is imprtant t have sme germs; therwise, we never get t build up ur immunity. Yur child can put this kind f infrmatin nt a cping card. If yur child teen is unsure whether this new infrmatin is true, make a trip t the library r lk up the infrmatin n the internet. Tl #7: STOP plan: Challenging Unhealthy Thughts This strategy invlves challenging sme f the unhealthy beliefs that yur child hlds abut his r her bsessins. Fr example, yur child might think, If I dn t line up my shes perfectly, my mm will die! This thught is bviusly unrealistic and inaccurate, but it might be hard fr yur child t see that when he

5 5 r she is feeling anxius. The STOP plan can help yur child t STOP these unhealthy thughts, and rethink whether r nt they are in fact true. Fr mre infrmatin n the STOP plan fr yunger children, see Healthy Thinking fr Yung Children. T help teens think mre realistically, see Realistic Thinking fr Teens. Tl #8: Infrmatin abut Obsessins Sme children r teens have bsessins that invlve very upsetting, scary, r grss thughts. Fr example, sme children may have unwanted thughts like What if I pushed smebdy in frnt f a car? r I thught abut my mm getting hit by a car tday; that must mean that it will happen! A gd way t help yur child deal with these types f thughts it t talk t them abut bsessins. Here are sme facts abut bsessins: Fact #1: Everybdy has unwanted r unpleasant thughts smetimes. It is nrmal. Fact #2: Just thinking abut smething wn t make it happen. Fr example, if yu think abut breaking yur leg, it wn t necessarily happen. Fact #3: Thinking a bad thught des nt mean yu are a bad persn. It als des nt mean yu want t d anything bad. Obsessins are just garbage f the mind. Fact #4: The best way t bss back these thughts is t ignre them. If yu dn t pay attentin t the thught, it will g away n its wn. If yu try t fight it r push it ut f yur head, it will keep cming back! One final tip: Althugh all f these tls can be very effective in helping yu t manage yur child s OCD, smetimes it is nt enugh. Smetimes children have very severe OCD, and despite all yur best effrts, they may still be struggling daily. If this is the case with yur child, it is a gd idea t btain sme prfessinal help in dealing with OCD, either thrugh a cnsult with yur GP, a psychiatrist, r a child psychlgist/mental health wrker. Step 4: Building n Bravery Yur child's prgress cmes frm hard wrk. If yu are nticing imprvements, bth yu and yur child deserve lts f credit! Learning t vercme anxiety is like exercise yur child needs t "keep in shape" and practice his r her skills regularly, and make them a habit. This is true even after yur child is feeling better and has reached his r her gals. Dn't be discuraged if yur child has lapses and returns t ld behavirs every nce in a while, especially during stressful times r transitins. This is nrmal, and just means that ne r tw tls in the tlbx need t be practiced again. Remember, cping with anxiety is a lifelng prcess. Hint: Occasinally remind yur child what he r she was nt able t d befre learning hw t cpe with anxiety and face fears. It can be very encuraging fr yur child t see hw far he r she has cme!.