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Obsessive-Compulsive Disorder

Residential Treatment for Adolescents with Obsessive-Compulsive Disorder

Located in Atlanta, Skyland Trail offers residential psychiatric treatment for teens ages 14 to 17 with OCD.

Evidence-based Therapy for Teen OCD

Adolescent clients in our treatment program for Obsessive-Compulsive Disorder (OCD) participate in individual and group therapy sessions focused on cognitive behavioral therapy with exposure and response prevention (CBT-ERP).

Cognitive-Behavioral Therapy with Exposure and Response Prevention

Teens with OCD often express that their thoughts do not feel like their own; they may feel as if their intrusive thoughts “pop up” out of nowhere. Even though they may recognize that their obsessive thoughts are irrational or misleading, the thoughts cause such great distress that they demand immediate attention. Compulsions are usually thought of as actions taken to reduce the distress caused by obsessive thoughts.

Successful treatment for teen OCD requires an approach that addresses both the intrusive, anxiety-producing thoughts and the compulsions that follow. Through numerous studies, cognitive behavioral therapy with exposure and response prevention (CBT-ERP) has been recognized as the leading treatment method for reducing obsessive thoughts and compulsive behaviors.

Teens who engage in treatment for OCD will gain a foundation in cognitive behavioral therapy (CBT), which provides a framework for understanding the connections among thoughts, feelings, and behavior. Accurately identifying thoughts is an important precursor for engaging in exposure. Before CBT-ERP can be effective, teens must identify exactly which thoughts cause the greatest distress with support from their treatment team. Teens then work collaboratively with their treatment providers to generate “challenges” that will help them confront their distressing thoughts gradually. Because obsessive thoughts in OCD can take a variety of forms, treatment is tailored to each individual. Importantly, while teens engage in exposure to their distressing thoughts, they must resist engaging in any anxiety-reducing behaviors. Resisting the urge to engage in compulsions is referred to as “response prevention.”

With practice, teens experience “habituation” to their intrusive thoughts. In other words, the thoughts no longer result in the same level of distress as they once did. Accordingly, the urge to engage in compulsions lessens, and teens are able to gain better control of their behavior. When their OCD is well managed, teens become free to pursue the activities they value most: spending time with friends and family, pursuing academic or career goals, and enjoying hobbies.

Residential Treatment for Teens with OCD

Shanee Toledano, PhD, lead psychologist for the OCD and anxiety track describes the residential treatment program for teens with OCD.

Acceptance and Commitment Therapy (ACT) for Teen OCD

One of the latest advancements in OCD treatment, a blended approach of CBT-ERP and Acceptance and Commitment Therapy (ACT), has had extremely promising results for helping individuals better understand and address their intrusive thoughts. Whereas traditional CBT-based approaches focus on modifying or reframing anxiety-producing thoughts, ACT focuses on placing thoughts within a broader context and living meaningfully despite the presence of distressing thoughts.

ACT incorporates principles of mindfulness and teaches teens how to become disentangled from the distressing thoughts that seem to take all of their attention and mental energy. Through ACT, teens learn to differentiate themselves from the content of their thoughts, a process that leads to improved self-worth, increased contentment, and development of a secure identity.

Family Programming

Families often inadvertently become part of the “cycle” of OCD, in which a teen’s engagement in avoidance or compulsive behavior further reinforces the anxiety and intrusive thoughts. When a teen is experiencing severe symptoms of OCD, parents and even siblings tend to change their own behavior in a way that unintentionally allows the anxiety to continue to increase.

One of the most common examples is a phenomenon called “reassurance-seeking.” Individuals with OCD may experience a strong urge to hear from a loved one that everything is okay. A teen may repeatedly ask a parent, “Did I do something wrong?” No matter how many times the parent provides a reassuring response, the anxiety eventually returns and causes the teen to ask again. In this way, the interaction between parent and teen becomes part of the compulsion.

Treatment for teens with OCD, therefore, requires that families learn more effective ways to respond to the teen’s symptoms while continuing to provide the emotional support and loving environment that any teen requires.

Adolescent Residential Treatment for OCD

Adolescents ages 14 to 17 entering the residential treatment program admit to the J. Rex Fuqua Campus. The J. Rex Fuqua Campus includes 26 units bedrooms and private bathrooms. Teens participate in a structured daily structure including evidence-based therapy, academic instruction, and expressive therapies like art and music therapy.

Frequently Asked Questions about Teen OCD Treatment

CBT-ERP sounds very stressful. What if it is too difficult for my teen?

Teens who engage in CBT-ERP commonly report that engaging in exposures results in much less anxiety than they initially expected. This makes sense, as anxiety causes unrealistic expectations for the future. It is important for teens and families who are considering this treatment to know that CBT-ERP incorporates a very gradual, step-by-step approach to confronting anxiety. Teens will develop their challenges collaboratively with their therapists and will always have a say in their treatment plan.

My teen will not tell me what the obsessive thoughts are about. How can we get help if we cannot talk about it?

Often, teens feel shame or guilt regarding their intrusive thoughts, which can keep them from seeking treatment. It is important for teens to know that, although their thoughts are unique, many individuals with OCD struggle with similar themes. One of the most difficult things about OCD is that it tends to invade areas of life that an individual feels most strongly about. For instance, someone who cares deeply about helping other people may have intrusive thoughts about hurting someone. Knowing that these types of thoughts are not uncommon – and that they do not hold any meaning for an individual’s character or worth – may help teens feel more comfortable discussing the themes of their obsessive thoughts.


Contact our admissions team to learn how Skyland Trail can help you or your loved one.