Take Control of OCD: Author Q&A
Take Control of OCD: Author Q&A
PUBLISHED: Monday, May 10, 2021 by Katy McDowall

Take Control of OCD: A Kid's Guide to Conquering Anxiety and Managing OCD is a must-have guide for kids and teens ages 10–16 with obsessive-compulsive disorder to help them take control and use their strengths to find success in school and in life. Learn more in this interview with the author, Bonnie Zucker, Psy.D.

Q: How is the book organized? What is included?

A: The book is organized in the same way that I approach the treatment process. First, it starts out with psychoeducation so that the reader can understand what OCD is, including the various types, and the OCD cycle. Then we jump into creating the hierarchy that they will use for facing their fears (constructed as a ladder, with each rung reflecting a trigger situation that they will be “exposed” to). By developing the ladder early in the process, the reader is better able to not only see how OCD is interfering with their life, but also identify the specific goals that they will work toward.

Readers learn many strategies and techniques, all based on cognitive-behavioral therapy (CBT), which is the most empirically supported approach to treating OCD and anxiety. Relaxation techniques to address the physiological, or body, signs of anxiety are explained. Then, several chapters are devoted to the cognitive, or thoughts, component of OCD, where readers will learn and practice more than 10 specific strategies, including how to identify and challenge thinking errors, use self-talk, “stamp” the thoughts as “OCD,” and make loop and uncertainty training recordings to habituate to obsessive thoughts and worries (listening repeatedly to make them unalarming and boring). Acquiring these skills makes the exposure/response prevention (ERP) phase of treatment easier for the reader.

ERP, accomplished through the ladder, is the hallmark approach to treating OCD, wherein the reader intentionally practices the triggers to their OCD without doing the typical rituals or compulsions. The reader is guided to do the exposures and push themselves outside of their comfort zone, and they learn that it’s necessary to tolerate the discomfort that arises as they do so, until habituation occurs. Finally, they will also learn about the keys to effective stress management and how to foster resilience.

 

Q: What is new to the second edition, and why?

A: Starting with the psychoeducation piece, this version includes a comprehensive list of the various types of OCD. I really wanted the reader to be able to identify their type of OCD, so the list is detailed. Since I wrote the first edition more than 10 years ago, and have many more years of treating OCD, this edition includes additional strategies (e.g., thoughts challenge form, “stamping” it “OCD,” and imaginal exposures). There is also a much more detailed explanation of worry loop and uncertainty training recordings that I have found extremely effective with children and teens with OCD. This edition also includes more case examples and a chapter on other conditions that often co-occur with OCD.

 

Q: What types of OCD/presentations of OCD are addressed, and how are they considered differently and given different approaches?

A: Although all of the types of OCD are described, the main ones the book addresses, through 10 detailed case examples, are: contamination, emotional contamination, doubting/indecisiveness, harm, scrupulosity, symmetry/ “just feels right”, sexual orientation type, pedophilia type, and hypochondria/health. Each example includes that child’s ladder and the loop/uncertainty training recordings. Imaginal exposures for three of the examples are shared as a model. By showing how the strategies apply to the different types of OCD, especially what the ladders look like, the reader learns how to apply the techniques to their particular type of OCD.

 

Q: What's the best way for kids to use this book (over months, weeks, etc.)?

A: I would recommend reading a chapter a week, and given that there are 12 chapters, the information can be absorbed in 3 months. Then the reader will reference the book in an ongoing manner as they progress on their ladder and do more exposures.

 

Q: How can parents and teachers best support kids with OCD?

A: The best advice I have for parents and teachers is to be empathic and not shaming when it comes to kids with OCD and how they sometimes have seemingly odd behaviors and rituals. Kids are often embarrassed when they share their unrealistic yet powerful thoughts, and although the majority recognize these thoughts as unrealistic or nonsensical, they are nonetheless controlled by the thoughts and fears that accompany them.

When an adult can communicate understanding and be nonjudging, it’s a gift for the child with OCD. Equally as important is for parents (and if fitting, teachers) to learn how to not accommodate the OCD by supporting the rituals, providing reassurance, and so on. It’s really hard when you see a child suffering to not accommodate it, but the accommodations only strength the OCD. Finding language such as, “I really want to answer you right now, but it will only make the OCD worse. What else can I do to support you right now—is there a strategy from the book that we could use?”, helps support them without giving into the OCD-driven behavior. Staying in connection with the child is essential.

 

Bonnie Zucker, Psy.D., is a licensed psychologist with a background and expertise in psychotherapy with children, adolescents, and adults. She received her doctoral degree in clinical psychology from Illinois School of Professional Psychology in Chicago, her master’s degree in applied psychology from University of Baltimore, and her bachelor’s degree in psychology from The George Washington University.