Progress notes

Orlando CBT Counselor | OCD Affects the Whole Family

Meticulous Father Mowing the Lawn with Scissors


“Everyone needs a house to live in, but a supportive family is what builds a home.”                              – Anthony Liccione


Obsessive Compulsive Disorder (OCD) affects the whole family and the patient with OCD. A father is driving children to school because of the mother’s social anxiety. Disrupted family meals due to a child’s irrational fear about certain foods. A sibling’s resentment about a parent’s increased focus on a brother’s OCD; or a senior couple struggling for years with an adult child living at home with OCD; Families turned upside down, and couples experiencing marital conflict because of OCD. Contrary to what some people think family involvement is necessary for OCD treatment.

In my practice, one of the best predictors of treatment success is family involvement, especially parents and spouses. The primary reason why family involvement is necessary is that family members are often co-opted to accommodate the carrying out of compulsions, rituals or safety behaviors. It may seem like the path of least resistance or compassionate; complying with a loved one’s demand (e.g. buying significant amounts of hand sanitizer or paper towels, checking locks, faucets or stoves, preparing safe foods and removing unsafe foods, providing reassurance, etc.) only serves to strengthen the OCD. In other words, families need to learn how not to play with OCD.

Family members are an integral part of the ‘treatment team.’ Family members need education about OCD – What is OCD? What causes OCD? How do we treat OCD?.  Family members also act as cheerleaders when their family member is doing cognitive behavioral therapy (CBT) and exposure response prevention (ERP) homework. It is important family members encourage their loved one as they recover from OCD.  Negative feedback or criticism only serves to hurt treatment. When a family member with OCD is performing an exposure practice encouragement and validation is essential to success.

Treatment of pediatric OCD requires some parental involvement 100% of the time. It is preferable both parents attend counseling but if one parent attends and ‘coaches’ the other parent, that can be effective. In the adult treatment of OCD, I believe some family or spousal involvement is required about 90% of the time. It is essential individuals recovering from OCD have a good support system. The family often is that support system.

Are you or a family member ready to go toe to toe with OCD? Call my office if you have any questions or would like more information.

Michael Manchester is a Licensed Mental Health Counselor practicing in Central Florida. His practice is located in downtown Orlando. Mike specializes in the treatment of OCD and Anxiety Disorders. He is a member of the International Obsessive Compulsive Disorder Foundation, Diplomate of the Academy of Cognitive Therapy and Certified Cognitive Therapist. He works with adults and adolescents in addition to friends families of people struggling with OCD and anxiety disorders.