Disciplining a Child with OCD
There's no question that disciplining a child with OCD presents special challenges for a parent. One reason why this is true is that you as a parent quite literally “feel your child's pain.” Certainly, you don't want to feed her anxiety. The stress she's under after a tough day spent managing or hiding her OCD at school can be palpable. And then it's not always easy to recognize which behaviors are the OCD versus those times when she is simply “acting up.”
On the other hand, discipline for a child with OCD (or any impulse control disorder such as ADHD or autism) is arguably even more important than it is for the less challenged child. Whether specific negative behaviors are caused by the OCD or not, if your child doesn't learn proper limits for her behavior and get the necessary practice to redirect her feelings of frustration and anger away from negative behaviors, she will be missing essential skills for life. Fortunately, by considering these issues you're already a step closer to giving your child what she needs to succeed. The disciplining techniques that work best for the OCD-impacted family are simply good parenting skills adapted for the special demands presented by OCD.
Rewards Do Work
Some parents worry that giving a reward for a child's progress in the battle against OCD is just a bribe, nothing more than a manipulation of a child's desire to acquire things. In fact, the opposite is true. A bribe connotes trickery, the receipt of an undeserved reward. But, when a child with OCD is rewarded for making progress in her exposure exercise, whether or not the “end goal” has been reached, the child is getting a well-deserved, positive reinforcement for the effort of doing hard work.
A reward acknowledges that she has accomplished something difficult, that she's practiced, made an attempt, and at least tried to reach her goal. Certainly no child would choose to suffer the symptoms of OCD simply to get a reward. Giving a child a reward helps accentuate the positive way out of those symptoms.
Using rewards for positive reinforcement while your child does homework exercises for OCD can be extremely effective if you follow a few basic ground rules:
Focus on one goal at a time (don't mix taking out the trash with getting dressed).
Give rewards frequently for small changes, not one big change (start with washing hands fewer times, not the end goal of once before dinner).
Make rewards small (stickers, treats).
Let your child choose her goal and rewards (from jointly drawn up lists of possibilities).
Have clear rules for success (e.g., the child should not have to be reminded).
Know when she's reached a wall (exhausted, overwhelmed, done for the day).
Combine praise and rewards.
On average, it takes two to three weeks for a child to master an exposure — if the goal is the right size at the right point in her battle plan. Flexibility is important. If after two or three days she's not making progress, break the goal down into smaller chunks. Success leads to more success, while failing too often leads to increased frustration and more failure.