Prospects for Independence
Paradoxically, when the debilitating symptoms of OCD are gotten under control, there are advantages related to having OCD for many young adults who may have always thought of themselves as its “sufferers.” The same perfectionism that can sabotage your child's success when the OCD is “in charge” can be an impetus for school and career success when the young adult has taken authority back from her OCD.
The key lesson that enables a youngster to successfully make this transition is learning the difference between “perfect” and “good enough.” This “good enough” principle first becomes critical in the early years of high school as your child confronts the battery of tests and standards required to be competitive for the college admissions process.
College Issues
As outlined in Chapter 11, there are accommodations permitted for the student with OCD in grades K through 12. These apply when it comes to test taking, such as a longer period for completing the exam, which may become essential when SATs and other college entrance exams need to be taken. If you have not previously completed an Independent Educational Plan (IEP) or 504 plan with your school's special education coordinator, this would be the time to do so. In addition to test taking, a formal plan makes possible (under federal law) other study aids for the young person with a mental disability. Among these is the provision of a private tutor, or in the case of a student with OCD, allotting more physical space around her desk if she's dealing with contamination fears.
The law assures privacy to your child at every step of his elementary, middle, and high school education and college admission process. This means that disclosure of your child's disability is entirely up to you, or if she is past the age of eighteen, to her.
Help at College
Just as you and your child may have had to weigh the benefits of disclosure versus nondisclosure at earlier points in her education, there is a similar choice to be made at the college level. The most important thing for you and your child to recognize is that confidentiality rules apply at every stage of her education. It is not necessary that “everyone knows” about your high school-or college-age student's OCD; just those who need to know, or those she chooses to inform.
Every college in the United States receiving federal funds is mandated to provide accommodations for its students with disabilities, and these are similar to those available in elementary, middle, and high schools. These provisions can apply to learning environments as well as to college-sponsored student housing.
Essential
The office responsible for providing needed services to college students with disabilities, including both health and mental health disorders, is called Disability Services or Special Services. It is often housed in the college department of student services, along with housing, health, or counseling services. Every student with OCD who begins college should make an appointment with a counselor in this office as soon as possible, even if only to discover what is available to him in the event he needs it at a later date. It is important to emphasize to your college-age student that confidentiality about his special needs or services at college is his guaranteed right.
First Jobs
If your teenager with OCD chooses to work part-time in high school, or full-time during summer vacations or immediately following graduation, this will present additional challenges for her continuing treatment or maintenance of treatment objectives already obtained. Especially as she begins a new job, it will be important to stay attuned to the extra stress working may add to her day-to-day schedule. The potential for a relapse in an area where triggers were previously under control, such as contamination fears from touching doorknobs or public restrooms, is very real when the added pressure of job performance is present for a young person new to the work environment.
If your teenager with OCD has made the process of ERP exposure exercises an integral part of her daily life, she may be able to handle the challenge by simply focusing additional attention on the problematic trigger. It may also be more than she can handle on her own. In that case, she should schedule an appointment with the therapist she last consulted for OCD treatment. Her purpose would be to do a “tune-up” within a single visit or over multiple appointments. You can assure her that it is entirely appropriate to revisit formal therapy when life circumstance changes; indeed, for a child with OCD, change itself is often sufficient cause for a preventative rededication to CBT therapy. Your goal is to make sure that the imminent change does not trigger new OCD symptoms, or undo her past successes.
In the event your teenager determines that the amount of stress presented by her job is becoming a problem, the possibility of reducing her hours of employment is one she should explore with her employer. At this stage, your role as parent is likely that of an advisor and a source of ongoing support for whatever decision your teenager makes. However, if she seems unaware of the manifestations of stress that you see in her, and you notice a significant increase in her OCD symptoms, you may need to gently bring it to her attention.
