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The Worry Hill - Page 5

Children love these stories, but they also need to understand how difficult ERP may be. To help persuade Maria to try this approach, I explained, "Exposure may be hard, though probably not any harder than your life with OCD is right now. In fact, it's often harder to think about exposure than it is to actually do it. Besides, the hard work of exposure at least gives you a chance to get rid of OCD; the work you put into OCD right now only makes it worse." In this way, I help the child understand that she has the power to take charge and take control of OCD—a liberating experience—instead of letting it control her.

Collaboration makes the child a key partner in treatment. The child and family need to know that the therapist isn't the one who'll "fix" the child's OCD: only the child has the power to do that. "I won't force you to face your fears," I assured Maria. "You and I will discuss together what you'll do when you're ready. But no one can ride a bicycle for you, so you'll have to do it for yourself. We'll take one step at a time, so that it'll never be too scary."

I told Maria's parents, "For now, please keep helping Maria at home in the same way you've been doing. You, too, will have to learn how to let her face her fears without your help, but we'll do that after Maria feels more confident about handling the OCD on her own."

Upon hearing that her parents would still be helping her and that she'd be in charge of the degree of exposure she'd try to handle, Maria sighed with relief and smiled. She seemed more relaxed and ready to participate.

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