OCD Therapy for Children & Teens on Long Island
Evidence-Based Treatment using Exposure and Response Prevention (ERP)
Obsessions, Compulsions, and Anxiety
Evidence-based ERP Treatment
Serving Long Island and Queens, NY
You may be noticing things like…
Repeating questions or needing constant reassurance
Excessive confessing or “telling on themselves”
Avoiding certain words, objects, places, or people
Mental rituals that others may not notice
Fear of contamination, illness, vomiting, harm, mistakes, or “bad things happening”
Re-doing, checking, tapping, or needing things to feel “just right”
Distress when routines are interrupted
Trouble tolerating uncertainty or not knowing for sure
For kids and teens, OCD often shows up as more than just “anxiety.” It can look like frustration, shutdowns, avoidance, irritability, school struggles, or needing parents involved in rituals and reassurance.
Types of OCD in Children and Teens
Contamination OCD
Excessive fear of germs, illness, or contamination, leading to avoidance, excessive handwashing, or cleaning rituals.
Checking OCD
Repeated checking behaviors (doors, safety, harm-related concerns) driven by fear that something bad will happen if not checked.
“Just Right” / Perfectionism OCD
A need for things to feel exact, even, or “just right,” often leading to repetition, frustration, or difficulty completing tasks.
Emetophobia (Fear of Vomiting)
A specific form of OCD involving fear of vomiting or being around others who are sick, often leading to food restriction, avoidance, and heightened anxiety.
Learn more about emetophobia treatment for children and teens
Harm OCD
Intrusive thoughts about harming others or losing control, often accompanied by intense fear, avoidance, and reassurance-seeking.
Intrusive Thought OCD (Pure OCD)
Distressing thoughts related to harm, morality, or identity, often without visible compulsions but involving significant internal distress.
Why Traditional Talk Therapy Often Isn’t Enough for OCD
For many children and teens, OCD is not just “anxiety” or overthinking.
It is a cycle of:
intrusive thoughts
fear or doubt
compulsions or reassurance
temporary relief
then more fear again
That is why insight alone usually is not enough.
Many kids with OCD already know their fears “don’t fully make sense” — but still feel trapped by them.
ERP helps break that cycle.
Exposure and Response Prevention (ERP)
The Gold-Standard Treatment for OCD
① Gradual Exposure
Slow exposure to scary thoughts, situations, or sensations, without overwhelming the child.
② Response Prevention
Learning to resist compulsions, reassurance seeking, or avoidance behaviors that keep OCD stuck
③ Tolerance of Uncertainty
Building the capacity to sit with discomfort so anxiety decreases naturally, without rituals.
Why Families Seek Specialized OCD Therapy
Parents often reach out when they notice that their child is:
stuck in repetitive fear cycles
asking for reassurance constantly
avoiding everyday situations
spending large amounts of time in rituals or mental compulsions
becoming increasingly distressed, irritable, or shut down
OCD can be confusing because it does not always look obvious from the outside.
Many children hide symptoms, mask distress, or do not know how to explain what is happening.
Specialized treatment matters.
What to Expect
• Weekly structured ERP sessions
• Customized exposure hierarchy
• In-session practice
• Between-session assignments
• Parent coaching
• Coordination with pediatricians or psychiatrists
Most families see measurable progress within several months of consistent ERP.
Frequently Asked Questions
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Obsessive-compulsive disorder (OCD) in children and adolescents often presents as repetitive behaviors, intrusive thoughts, or persistent reassurance seeking that interferes with daily life.
Common signs include:
• Repeated checking (doors, homework, health concerns)
• Excessive handwashing or contamination fears
• Fear of vomiting (emetophobia)
• Mental reviewing or “just right” behaviors
• Reassurance seeking from parents
• Perfectionism that significantly slows academic output
• Bedtime rituals or difficulty separatingMany high-achieving children mask symptoms at school while struggling privately at home. When anxiety begins to control routines, relationships, or academic functioning, a specialized evaluation or ERP therapy may be indicated.
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Exposure and Response Prevention (ERP) is considered the gold-standard, evidence-based treatment for pediatric OCD.
ERP works by gradually exposing a child to feared situations, thoughts, or sensations while helping them resist compulsive behaviors and reassurance. Over time, the brain learns that anxiety decreases naturally without rituals.
Research consistently shows that structured ERP therapy is more effective for OCD than supportive or insight-based talk therapy alone.
At Duhning Psychological Services, PLLC, ERP is delivered in a structured, developmentally appropriate format tailored to each child’s symptom profile.
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Traditional talk therapy focuses on discussing fears, exploring emotions, and building insight. While supportive, this approach does not directly interrupt the OCD cycle.
ERP is active and behavioral. Sessions include:
• Developing an exposure hierarchy
• Practicing exposures in-session
• Reducing avoidance and reassurance
• Teaching tolerance of uncertaintyERP targets the mechanism that maintains OCD rather than simply discussing the anxiety surrounding it.
For many families on Long Island, prior therapy has been supportive but not specialized. ERP provides a structured path forward.
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Yes. OCD can involve many different types of intrusive thoughts, including worries about harm, contamination, illness, morality, or saying or doing something wrong. Intrusive thoughts are often very distressing, but they are treatable.
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If your child is becoming increasingly distressed, avoidant, ritualistic, reassurance-seeking, or stuck in patterns that are interfering with daily life, school, sleep, routines, or family functioning, therapy may be helpful.
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The first step is a consultation to discuss your concerns, determine fit, and talk through next steps.
If anxiety feels intense, illogical, reassurance-driven, and stuck, it is important to seek the right treatment to prevent it from spreading and getting worse.