The back-to-school season can evoke a range of emotions in students, including excitement, nervousness, anticipation, and uncertainty. For students with obsessive-compulsive disorder (OCD) and their families, this time of year can be especially overwhelming.
While many kids are worried about making friends, new teachers, and classes, children and teens with OCD can face internal struggles that aren’t always visible to others. They may appear to be daydreaming, distracted, or disinterested, but are actually dealing with distressing, unwanted thoughts, images, feelings, sensations, or urges—known as obsessions. This can lead them to engage in compulsions, which are behaviors done in an attempt to alleviate the anxiety and distress from their obsessions. As caregivers, it can be heartwrenching to watch them struggle, and difficult to know how to seek help.
Keep reading to learn how OCD can show up in school and what you can do to support your child.
OCD in elementary school
Amy, age 9, is entering third grade with intense fears of contamination. She avoids sitting on the floor during “circle time,” experiences significant distress when someone sneezes nearby, and constantly wipes down her belongings with disinfectant wipes. Her biggest fear isn’t getting sick—it’s the thought of passing germs to her brother, who has an autoimmune condition. Her compulsions feel like a way to protect her brother’s health, even if they make her school day more stressful. Amy’s parents are at a loss for how to help her overcome her fears.
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OCD in middle and high school
Jose, age 15, is starting 10th grade and has nagging thoughts about whether or not his friends really like him. He constantly asks them for reassurance, even though he knows it annoys them. Over summer break, they didn’t invite him to hang out, which only fueled his doubts. Jose knows his need for assurance pushes people away, but he can’t seem to stop.
How to support your child as they head back to school
Often, when a child experiences OCD, there is a domino effect, as it impacts nearly every area of a family’s life. Family members may find themselves unwittingly pulled into compulsions, giving reassurance constantly, or avoiding things that used to be fun, all in an attempt to rid their child or teen of the intense anxiety that they are feeling.
So what are the loved ones of these children or teens to do? How can they support them as they return to school, given all the unknowns that will arise?
Here are some ways parents and caregivers can support their child as they start a new school year:
Prepare ahead of time
For elementary-aged students, you’ll want to prepare your child for the new school year. Talk to your child openly about the start of school to find out what concerns they have. If possible, schedule a meeting with their teacher before the start of the school year. Just meeting the teacher may help ease some jitters, and you may even want to include other staff members who will be interacting with your child.
For a teenager, things may look a little different. You can help them prepare for triggers that are specific to their symptoms. Teach them how to become more aware of what their OCD looks like and how attending school may impact them.
Build predictability (but don’t chase certainty)
Predictability plays a significant role in the success of most children, regardless of their age, and this is particularly true in the context of school. Just as adults thrive in structured and predictable environments, kids do, too. Remember that OCD craves rigidity, predictability, and absolute certainty about any given concern, which is impossible to achieve. Of course, we know that not everything can be planned, and unforeseen events do occur.
That is why it’s key not to focus so much on the particular theme, fear, or concern the child has, but instead on the underlying components of the condition. OCD causes people to doubt everything and to fixate on the what-ifs. OCD will try to convince them that this time it really is different, and so they must do what OCD tells them to do. This often sounds like, “If I give in to this compulsion just one more time, then everything will be okay.” The more they are aware of the way that OCD works and are equipped to respond to it, the less likely they are to fall for it.
Help your child understand that no matter what the anxiety latches onto, OCD is fueled by uncertainty and doubt. Help them recognize OCD and ensure they have the tools to manage it when it appears.
Know your child’s triggers
Awareness of triggers is important. We know that OCD often attaches itself to things or people we value, so what affects one child with OCD will be different for another, even though they share the same condition. To help raise awareness, it is essential first to identify and recognize what your child values. Next, help your child understand that the thoughts OCD latches onto are ego-dystonic, meaning that they aren’t aligned with what your child desires. That is why your child is so troubled by the thoughts and why they get “stuck” on them. It can be beneficial to help them separate who they are from what they think. Thinking about something is not the same as doing something—this is a crucial distinction.
Helping your child long-term
It is worth noting that the intent here is not to accommodate your child’s rituals and compulsions. This would not be helpful in the long run. Instead, these suggestions are intended to help you support your child and ease them into the new school year. This allows your child to feel heard and can reduce the stress and fatigue that often accompany OCD. Helping them and their teachers understand what is happening is an important part of facing OCD head-on. Understand that this is a gradual process—your child’s OCD didn’t get to this point overnight, so it may take some time to get their symptoms under control.
Caregivers should work alongside someone with specialized training in OCD to develop a more comprehensive plan of action. Hopefully, your family has begun exposure and response prevention (ERP) therapy and has acquired some skills that can guide this process. With the help of an OCD specialist, you and your child can come up with ideas for how to confront their fears at a manageable level, even in a school setting.
Through ERP, your child will learn how to sit with uncomfortable feelings and resist the urge to engage in compulsions. They will see that anxiety, like any other feeling, eventually passes, and they don’t have to do anything to make this happen.
Above all else, your child should know that they are not in this alone. They have a wider support system, which includes the people around them who care for them and are willing to walk with them as they learn to manage their symptoms.
Taking ERP to school
Your child’s ERP therapist will help identify a specific, personalized treatment plan that works for your child and your family to tackle their OCD fears. Working alongside a therapist can help your family determine what managing OCD will look like when your child is at school and home. With the right support and treatment, your child can reclaim the joy and confidence every student deserves to feel at school.
Bottom line
School can be challenging for children and teens with OCD, but with education, support, and evidence-based treatments like ERP, families can navigate the back-to-school season without falling into OCD’s trap.
Key takeaways
- OCD often shows up in ways that mimic distraction, perfectionism, or defiance, making it easy to miss.
- As a caregiver, you can support your child by preparing ahead and helping them understand how OCD works.
- It’s essential not to accommodate your child’s OCD, but instead equip them with the tools to handle uncertainty.
- Seeking exposure and response prevention can help your child face school with strength and confidence.
