Guiding Your Child Through Exposure Therapy: Evidence-Based Strategies for Parents

Written By Catherine Tamayo

By: Catherine Tamayo, LPCC

Parents do the best they can with the knowledge they have, yet support for children with OCD and anxiety isn’t often widely discussed in our communities. Much of the guidance available focuses on short-term relief, but navigating the complexities of anxiety and OCD in children requires an informed, long-term consistent approach. Exposure therapy is an evidence-based method proven to help children face and manage their fears under the guidance of a therapist and family support. This blog outlines some practical, evidence-based strategies for parents to effectively support their children during exposure therapy sessions, fostering increasing inner security and promoting lasting mental well-being.

Understanding Exposure Therapy

Exposure therapy is a cornerstone in treating anxiety disorders and OCD. It involves gradually, consistently, and repetitively encouraging individuals to face their fears. This evidence-based approach helps reduce avoidance behaviors and empowers children to build inner security when anxiety triggers arise.

However, progress is not always linear, and setbacks are a natural part of the process. It’s important to modify expectations accordingly. Change—even positive change—can feel stressful for children with OCD, and symptoms may temporarily worsen during times of transition. Acknowledging this reality and providing steady, compassionate support can help them feel encouraged to persist.

The Role of Parents in Exposure Therapy

Parents' active participation significantly impacts the efficacy of exposure therapy. However, the way parents support their child may differ based on their child’s age and developmental needs. Younger children may need more direct involvement, such as hands-on coaching and structured exposure exercises, while older children and teens may require guidance on self-monitoring and independent implementation of strategies. Regardless of the child’s age, a supportive and consistent approach is key to helping them build confidence and inner security.

Here are key ways parents can support their child’s treatment process:

1. Developing the Plan with Therapists

  • Work closely with therapists to craft an exposure plan that directly addresses your child’s specific fears and behavioral goals.

  • Ensure the plan is practical and manageable within the daily routine of your family. Consistency is key to success.

  • Provide insights about your child’s preferences, motivations, and challenges to help therapists tailor exposure exercises in a way that engages your child.

2. Support During Exposure Sessions

  • Monitor and record the difficulty levels of exposure tasks as recommended by the therapist.

  • Provide encouragement rather than reassurance. Encouragement acknowledges their effort (“I see how hard you’re trying”), while reassurance minimizes their fears (“There’s nothing to worry about”).

  • Remember that individuals grow at different rates. Progress should be measured according to your child’s own baseline, not compared to others. Pushing too hard for rapid improvement can create stress that worsens symptoms.

3. Managing Reactions and Setbacks

  • Understand that discomfort is an expected part of therapy, serving as a growth opportunity.

  • Use empowering statements that foster persistence and acknowledge their capability, such as:
    “It’s tough right now, but you can do hard things. I’m proud that you are trying.”

4. Recognize Small Improvements

  • What may seem like a minor step to a parent—like cutting a shower by five minutes or resisting one reassurance request—can be a major victory for a child with OCD.

  • Acknowledging these small wins helps build momentum and reinforces their effort. Instead of only focusing on major milestones, celebrate consistent effort and perseverance.

5. Create a Supportive Environment

  • Parents play an essential role in fostering a home environment that encourages progress while also being understanding of their child’s challenges.

  • While it’s natural to want to ease a child’s distress, participating in compulsions or providing frequent reassurance can reinforce OCD. Instead, parents can support their child by validating their experiences while also encouraging them to use their exposure strategies.

  • It’s helpful to remind your child that while OCD is challenging, they are capable of working through their fears. Approach their struggles with empathy and reinforce the idea that your family is working together to take on OCD as a team.

6. Set Limits, But Remain Empathetic to Mood

  • Work together to set clear, pre-established boundaries around:

    • How much reassurance is given

    • How much time is spent discussing OCD

    • How much compulsions interfere with family life

  • Understand that mood fluctuations impact a child’s ability to resist compulsions. On harder days, they may struggle more, and on better days, they should be encouraged to challenge their OCD as much as possible. Adjust expectations accordingly while maintaining a commitment to progress.

  • A therapist may assist in identifying, setting and reinforcing these limits, helping to create a plan that balances structure with flexibility based on the child’s needs and progress.

When to Consider Medication for Anxiety & OCD

When anxiety and OCD significantly impair a child's daily functioning, adding a medication management evaluation can be considered. While exposure therapy offers profound benefits on its own, integrating evidence-based medication management may enhance therapy outcomes. This approach should be discussed with a medication management provider that specializes in OCD and anxiety to tailor it to your child’s specific needs. A careful, informed approach can help maximize the effectiveness of treatment while managing symptoms more comprehensively.

Encouragement and Reflection

Exposure therapy represents a journey of bravery for children and resilience for families. By adopting these evidence-based strategies, parents can create a robust support system that addresses the challenges of anxiety and OCD effectively, promoting long-term mental health stability for their children. Post-session reflection is key as it helps children process their experiences and continue to build inner security.

  • By processing the session’s experiences, children can make more meaningful connections between their fears and how they manage them, reinforcing learning.

  • Regular reflection and validating feedback can further help build resilience by normalizing the experience of facing fears and overcoming them.

  • This practice fosters open communication between the child and parent, enhancing mutual understanding and support throughout the therapeutic process.

  • Acknowledge and celebrate even small moments of progress and wins to motivate your child and reinforce the benefits of persistent effort.

For parents in Minnesota or Wisconsin seeking additional support with evidence-based therapy and medication management, click here to get started.

Resources

References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: Author.

  • Abramowitz, J. S., Taylor, S., & McKay, D. (2009). Obsessive-compulsive disorder. The Lancet, 374(9688), 491-499.

  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20-35.

  • Chansky, T. E. (2001). Freeing Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents. Crown.

  • Child Mind Institute. (n.d.). OCD in Children. Retrieved [date you accessed the information], from https://childmind.org/guide/parents-guide-to-ocd/

Catherine Tamayo
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Finding Balance: Managing Anxiety and Well-Being in a Digitally Accessible World