Obsessive-Compulsive Disorder in Children.

buy viagra beer Obsessive-Compulsive Disorder (OCD) in children can be difficult to diagnose.  Parents often confuse developmentally-appropriate rigid behaviors with OCD behaviors.  The following table (adapted from Freeman and Garcia’s go here Family based Treatment for Young Children with OCD: Therapist Guide, 2009) may be helpful for parents in differentiating OCD from developmentally appropriate routines.

Photo Courtesy of D. Sharon Pruitt

Photo Courtesy of D. Sharon Pruitt

DEVELOPMENTALLY APPROPRIATE BEHAVIORS
Age 1 to 2:  Strong preference for rigid routines around home rituals.  Very aware and can get upset about imperfections in toys and or clothes.

Age 3 to 5:  Repeat same play activity over and over again.

Age 5 to 6:  Keenly aware of the rules of games and other activities and may get upset if rules are altered or broken.

Age 6 to 11:  Engage in superstitious behavior to prevent bad things from happening and may show increased interest in acquiring a collect of objects.

Age 12+  Become easily absorbed in particular activities enjoyed (e.g., video games) or with particualr people (e.g., pop stars); may also show superstitious behavior in relation to making good things happen.  (e.g., performance in sports).

Weight Loss and Cognitive Behavioral Therapy

I have recently begun working with a few clients who are interested in losing weight.  1024px-Feet_on_scaleThe therapy treatment plan I use is one based on Cognitive Behavioral Therapy (CBT).  CBT was developed by Dr. Aaron T. Beck and is a form of psychotherapy in which the therapist and the client work together as a team to identify and solve problems. CBT helps clients overcome their difficulties by changing their thinking, behavior, and emotional responses.

Dr. Judith Beck (daughter of Dr. Aaron Beck) writes in “An Open Letter to Carnie Wilson: What you need to know to keep the Weight Off” a detailed description of the first step in using CBT to help with weight loss.

Judith Beck’s letter:

Dear Carnie,It’s not surprising that you gained back most of the weight you lost after your first weight loss surgery — so many people do. I’m glad to hear that you’ve now lost 30 pounds following a second lap band procedure. There are, though, a number of important skills you need to learn if you want to keep the weight off for good this time.

I would bet that no one ever taught you essential skills such as: how to motivate yourself to make healthy choices every day, what to do when you experience a craving; how to get yourself to exercise (even when you don’t feel like it), how to get immediately back on track when you make an eating mistake, and how to cope with negative emotions without turning to food.

My guess is that the number on your scale is still going down and so you probably feel quite motivated at the moment. But what will happen once your weight loss plateaus? Your daily weigh-ins on the scale won’t be so thrilling then. And you’ll probably experience more temptations and cravings. Is this what happened last time? Did you begin to have (sabotaging) thoughts like, “I don’t care. I know I’m not supposed to eat this, but I’m going to anyway?” These types of thoughts are common among dieters, especially dieters who struggle with keeping weight off. Fortunately, though, you can start practicing now for the difficult times you’re likely to face.

One important technique I want you to know about is predicting the kinds of sabotaging thoughts you’re likely to have in the future. You probably had these same types of thoughts in the past. Write each one on a card. Then write what you wish you would be able to remember so that you can respond to them effectively, not give in to them, and stick to your new eating plan.

You might have the thought, for example, “It won’t matter if I eat this food that I’m not supposed to eat.” How do you hope you might respond to that thought? Do you think it would be helpful if you told yourself, “No, it absolutely does matter! I’m just fooling myself.  

Thoughts like that have always led me to gain back weight in the past. And every time I give in, I increase the likelihood I’ll give in the next time. It’s so worth it to me to stick to my plan and resist temptation. I’d rather reach my weight loss goals than eat this now.”

This is just one technique from our cognitive behavioral program for weight loss and maintenance. There is a lot to learn, but won’t it be worth it if you can keep the weight off for good this time?

Sincerely,

Judith S. Beck, Ph.D.
Beck Institute for Cognitive Behavior Therapy

I highly recommend her book, The Beck Diet Solution, to anyone who is interested in a new approach to losing weight.