[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:10.95,0:00:13.07,Default,,0000,0000,0000,,So, I was hoping that you could tell
Dialogue: 0,0:00:13.08,0:00:17.03,Default,,0000,0000,0000,,me and tell other parents what obsessive compulsive disorder
Dialogue: 0,0:00:17.74,0:00:20.18,Default,,0000,0000,0000,,looks like in children and adolescents.
Dialogue: 0,0:00:20.94,0:00:21.86,Default,,0000,0000,0000,,So, 
Dialogue: 0,0:00:21.98,0:00:26.42,Default,,0000,0000,0000,,obsessive compulsive disorder in children and adolescents, not surprisingly,
Dialogue: 0,0:00:26.43,0:00:30.75,Default,,0000,0000,0000,,is characterized by obsessions or intrusive thoughts
Dialogue: 0,0:00:30.76,0:00:33.41,Default,,0000,0000,0000,,or images or feelings that are unwanted.
Dialogue: 0,0:00:33.58,0:00:35.60,Default,,0000,0000,0000,,So, children may have 
Dialogue: 0,0:00:36.17,0:00:38.55,Default,,0000,0000,0000,,like worries or fears or
Dialogue: 0,0:00:38.56,0:00:40.98,Default,,0000,0000,0000,,thoughts that just pop into their head for no reason
Dialogue: 0,0:00:40.99,0:00:42.23,Default,,0000,0000,0000,,that are very upsetting to them.
Dialogue: 0,0:00:42.24,0:00:43.99,Default,,0000,0000,0000,,So, things like they're afraid of germs or
Dialogue: 0,0:00:44.00,0:00:46.71,Default,,0000,0000,0000,,something bad happening to somebody or that they're gonna
Dialogue: 0,0:00:47.32,0:00:50.72,Default,,0000,0000,0000,,do poorly in school or that or that something they left
Dialogue: 0,0:00:50.73,0:00:53.54,Default,,0000,0000,0000,,the door unlocked and a burglar might come.
Dialogue: 0,0:00:53.88,0:00:55.67,Default,,0000,0000,0000,,And compulsions
Dialogue: 0,0:00:56.00,0:00:59.46,Default,,0000,0000,0000,,which are the behaviors that are designed to make these bad feelings go away.
Dialogue: 0,0:00:59.47,0:01:02.66,Default,,0000,0000,0000,,So, a child that worries about germs or contamination
Dialogue: 0,0:01:03.07,0:01:06.29,Default,,0000,0000,0000,,will wash their hands or clean things in order to make
Dialogue: 0,0:01:06.30,0:01:08.66,Default,,0000,0000,0000,,this worry about germs are getting sick go away.
Dialogue: 0,0:01:08.92,0:01:12.60,Default,,0000,0000,0000,,A child that's afraid of something bad happening like a robber coming or
Dialogue: 0,0:01:12.61,0:01:16.18,Default,,0000,0000,0000,,a burglar coming to the house will make sure all the doors are locked
Dialogue: 0,0:01:16.52,0:01:19.78,Default,,0000,0000,0000,,and that everybody is safe to make this bad concern go away.
Dialogue: 0,0:01:20.73,0:01:23.05,Default,,0000,0000,0000,,So, some of the things you describe like worries and
Dialogue: 0,0:01:23.06,0:01:25.86,Default,,0000,0000,0000,,fears sound like things that all kids deal with.
Dialogue: 0,0:01:26.02,0:01:29.68,Default,,0000,0000,0000,,So, how does a parent know if their child or their adolescent
Dialogue: 0,0:01:29.80,0:01:31.54,Default,,0000,0000,0000,,has a disorder,o\Ns\N27\N00:01:32,059 --> 00:01:35,629\Nthe obsessions and the compulsions are a problem in their life?
Dialogue: 0,0:01:36.26,0:01:40.26,Default,,0000,0000,0000,,So, parents can tell if the obsessions or compulsions are problems
Dialogue: 0,0:01:40.49,0:01:43.23,Default,,0000,0000,0000,,if they're taken to the extreme.
Dialogue: 0,0:01:43.24,0:01:46.44,Default,,0000,0000,0000,,So, a child that spends an inordinate amount of time
Dialogue: 0,0:01:46.58,0:01:49.94,Default,,0000,0000,0000,,worrying about bad things happening or checking the locks
Dialogue: 0,0:01:50.22,0:01:55.44,Default,,0000,0000,0000,,or washing their hands is a sign that these typical
Dialogue: 0,0:01:55.57,0:01:58.82,Default,,0000,0000,0000,,kind of fears or normal concerns might be problematic.
Dialogue: 0,0:01:59.08,0:02:03.02,Default,,0000,0000,0000,,A common symptom is children that feel they need
Dialogue: 0,0:02:03.03,0:02:06.58,Default,,0000,0000,0000,,to rewrite, erase and rewrite their school work or their school papers
Dialogue: 0,0:02:06.68,0:02:09.71,Default,,0000,0000,0000,,so that everything is perfect. There can't be any crooked letters
Dialogue: 0,0:02:09.85,0:02:11.72,Default,,0000,0000,0000,,or any crooked words, and they may spend two or
Dialogue: 0,0:02:11.73,0:02:14.75,Default,,0000,0000,0000,,three hours on one paragraph or one paper
Dialogue: 0,0:02:15.13,0:02:17.57,Default,,0000,0000,0000,,erasing and rewriting over and over again to
Dialogue: 0,0:02:17.58,0:02:19.79,Default,,0000,0000,0000,,the point where the paper is all messy or ripped
Dialogue: 0,0:02:20.00,0:02:22.78,Default,,0000,0000,0000,,because they might be afraid that if there's something that's not exactly
Dialogue: 0,0:02:22.79,0:02:25.30,Default,,0000,0000,0000,,perfect with this paper that they're gonna get a bad grade,
Dialogue: 0,0:02:25.31,0:02:26.70,Default,,0000,0000,0000,,that they're going to flunk.
Dialogue: 0,0:02:26.95,0:02:30.17,Default,,0000,0000,0000,,Other children with OCD that have contamination fears
Dialogue: 0,0:02:30.18,0:02:32.30,Default,,0000,0000,0000,,or cleaning rituals or cleaning compulsions
Dialogue: 0,0:02:32.42,0:02:36.42,Default,,0000,0000,0000,,may spend two hours in the shower—one or two or three hours in the shower.
Dialogue: 0,0:02:36.55,0:02:40.20,Default,,0000,0000,0000,,They may spend 30 or 40 minutes brushing their teeth or brushing their hair
Dialogue: 0,0:02:40.42,0:02:42.61,Default,,0000,0000,0000,,to make sure that everything is exactly right.
Dialogue: 0,0:02:42.62,0:02:46.73,Default,,0000,0000,0000,,Or they may spend hours cleaning their rooms or arranging their rooms
Dialogue: 0,0:02:46.74,0:02:49.97,Default,,0000,0000,0000,,because they need to have everything just arranged in a certain way.
Dialogue: 0,0:02:50.65,0:02:50.92,Default,,0000,0000,0000,,So,
Dialogue: 0,0:02:50.93,0:02:53.36,Default,,0000,0000,0000,,it sounds like, and correct me if I'm wrong, that
Dialogue: 0,0:02:53.37,0:02:56.64,Default,,0000,0000,0000,,it's not just kids who are doing things frequently,
Dialogue: 0,0:02:56.84,0:03:02.94,Default,,0000,0000,0000,,but children and adolescents who are really doing these behaviors to an extreme.
Dialogue: 0,0:03:02.95,0:03:06.16,Default,,0000,0000,0000,,So, it's taking up a large part of their day, impacting their life,
Dialogue: 0,0:03:06.26,0:03:07.61,Default,,0000,0000,0000,,their family, schooling.
Dialogue: 0,0:03:07.62,0:03:08.42,Default,,0000,0000,0000,,Is that correct?
Dialogue: 0,0:03:08.53,0:03:13.41,Default,,0000,0000,0000,,Yes. So, OCD really does. It either can take up a large proportion of time,
Dialogue: 0,0:03:13.65,0:03:15.96,Default,,0000,0000,0000,,or it's something that's really gonna be interfering.
Dialogue: 0,0:03:16.10,0:03:19.62,Default,,0000,0000,0000,,You can also have some OCD symptoms that may not take up a lot of time,
Dialogue: 0,0:03:19.63,0:03:21.88,Default,,0000,0000,0000,,but still can be very upsetting or interfering.
Dialogue: 0,0:03:22.28,0:03:25.76,Default,,0000,0000,0000,,So, some children with OCD have intrusive images.
Dialogue: 0,0:03:25.77,0:03:28.36,Default,,0000,0000,0000,,They get pictures or thoughts in their head that are really scary,
Dialogue: 0,0:03:28.37,0:03:32.09,Default,,0000,0000,0000,,like maybe doing something bad or hurting somebody or hurting themselves.
Dialogue: 0,0:03:32.36,0:03:35.49,Default,,0000,0000,0000,,And these are thoughts that are unwanted. They don't want to do these things.
Dialogue: 0,0:03:35.50,0:03:38.06,Default,,0000,0000,0000,,They have no intention of hurting themselves or somebody else.
Dialogue: 0,0:03:38.25,0:03:41.38,Default,,0000,0000,0000,,But these thoughts keep coming into their head and making them very upset.
Dialogue: 0,0:03:41.48,0:03:43.50,Default,,0000,0000,0000,,And even though the thoughts can be very brief,
Dialogue: 0,0:03:43.67,0:03:46.34,Default,,0000,0000,0000,,they still can cause a lot of problems for the child.
Dialogue: 0,0:03:46.79,0:03:49.75,Default,,0000,0000,0000,,So, if a family is seeing their child or their adolescent
Dialogue: 0,0:03:49.99,0:03:53.00,Default,,0000,0000,0000,,have obsessions, have compulsions, 
Dialogue: 0,0:03:53.44,0:03:56.29,Default,,0000,0000,0000,,and they're affecting their life in a significant way,
Dialogue: 0,0:03:56.86,0:04:01.09,Default,,0000,0000,0000,,what should they do? Whom should they speak with about their concerns?
Dialogue: 0,0:04:01.41,0:04:04.93,Default,,0000,0000,0000,,Well, the important thing is to find
Dialogue: 0,0:04:04.94,0:04:07.47,Default,,0000,0000,0000,,a therapist or a mental health professional
Dialogue: 0,0:04:07.59,0:04:09.65,Default,,0000,0000,0000,,that has experience working with children and
Dialogue: 0,0:04:09.66,0:04:12.20,Default,,0000,0000,0000,,has experience working with obsessive compulsive disorder.
Dialogue: 0,0:04:12.21,0:04:13.60,Default,,0000,0000,0000,,This would typically be a 
Dialogue: 0,0:04:13.73,0:04:15.83,Default,,0000,0000,0000,,clinical child and adolescent psychologist
Dialogue: 0,0:04:16.17,0:04:18.71,Default,,0000,0000,0000,,or a child and adolescent psychiatrist
Dialogue: 0,0:04:19.02,0:04:22.11,Default,,0000,0000,0000,,or another professional that has experience in this area.
Dialogue: 0,0:04:22.92,0:04:24.47,Default,,0000,0000,0000,,What information about
Dialogue: 0,0:04:25.16,0:04:30.25,Default,,0000,0000,0000,,treating OCD or obsessive compulsive disorder should parents be aware of?
Dialogue: 0,0:04:30.87,0:04:33.99,Default,,0000,0000,0000,,Well, the important thing is that there are
Dialogue: 0,0:04:34.10,0:04:39.06,Default,,0000,0000,0000,,two treatment approaches for OCD that have been been studied and
Dialogue: 0,0:04:39.07,0:04:42.94,Default,,0000,0000,0000,,researched very carefully and been shown to have some benefit for children,
Dialogue: 0,0:04:42.95,0:04:44.26,Default,,0000,0000,0000,,adolescent with OCD.
Dialogue: 0,0:04:44.51,0:04:48.07,Default,,0000,0000,0000,,The first is exposure-based cognitive behavior therapy
Dialogue: 0,0:04:48.26,0:04:50.82,Default,,0000,0000,0000,,and the second is a specific class of medications
Dialogue: 0,0:04:50.83,0:04:55.22,Default,,0000,0000,0000,,called the selective serotonin reuptake inhibitors or SSRIs.
Dialogue: 0,0:04:55.96,0:04:57.79,Default,,0000,0000,0000,,Cognitive behavior therapy
Dialogue: 0,0:04:57.96,0:05:02.01,Default,,0000,0000,0000,,is really considered the first line treatment approach.
Dialogue: 0,0:05:02.02,0:05:07.12,Default,,0000,0000,0000,,So, the recommendation is that that in almost all cases, children with OCD 
Dialogue: 0,0:05:07.13,0:05:10.54,Default,,0000,0000,0000,,should try cognitive behavior therapy first because
Dialogue: 0,0:05:10.55,0:05:12.75,Default,,0000,0000,0000,,it has no side effects,
Dialogue: 0,0:05:13.03,0:05:15.90,Default,,0000,0000,0000,,and it's really been shown to have very positive effects
Dialogue: 0,0:05:15.91,0:05:18.57,Default,,0000,0000,0000,,in many cases on children with OCD.
Dialogue: 0,0:05:18.71,0:05:20.54,Default,,0000,0000,0000,,And importantly, also is that
Dialogue: 0,0:05:20.78,0:05:23.45,Default,,0000,0000,0000,,once the child has been able to benefit from cognitive
Dialogue: 0,0:05:23.46,0:05:26.64,Default,,0000,0000,0000,,behavior therapy or completed treatment with cognitive behavior therapy,
Dialogue: 0,0:05:26.73,0:05:28.11,Default,,0000,0000,0000,,the gains tend to last.
Dialogue: 0,0:05:28.12,0:05:28.87,Default,,0000,0000,0000,,So, 
Dialogue: 0,0:05:29.85,0:05:33.24,Default,,0000,0000,0000,,in most cases, cognitive behavior therapy would be the
Dialogue: 0,0:05:33.50,0:05:35.57,Default,,0000,0000,0000,,preferred treatment to start with
Dialogue: 0,0:05:35.87,0:05:37.26,Default,,0000,0000,0000,,for a number of reasons.
Dialogue: 0,0:05:37.27,0:05:41.69,Default,,0000,0000,0000,,The first is that cognitive behavior therapy has been shown to be effective 
Dialogue: 0,0:05:41.70,0:05:45.65,Default,,0000,0000,0000,,in a large proportion of cases, probably more so than medication.
Dialogue: 0,0:05:46.06,0:05:49.85,Default,,0000,0000,0000,,And the symptom reduction or the benefits of cognitive behavior therapy again,
Dialogue: 0,0:05:49.86,0:05:53.23,Default,,0000,0000,0000,,have been shown to probably be better than that for medication
Dialogue: 0,0:05:53.24,0:05:55.34,Default,,0000,0000,0000,,to some degree. The CBT,
Dialogue: 0,0:05:55.62,0:05:58.68,Default,,0000,0000,0000,,that's short for cognitive behavior therapy,
Dialogue: 0,0:05:58.93,0:06:01.87,Default,,0000,0000,0000,,may tend to lead to slightly better outcomes.
Dialogue: 0,0:06:02.00,0:06:05.99,Default,,0000,0000,0000,,Also, with CBT, once treatment is finished,
Dialogue: 0,0:06:06.13,0:06:09.30,Default,,0000,0000,0000,,the kids, children tend to maintain their gains for
Dialogue: 0,0:06:09.31,0:06:12.47,Default,,0000,0000,0000,,somewhat longer than with medication, oftentimes with medication,
Dialogue: 0,0:06:12.79,0:06:15.23,Default,,0000,0000,0000,,which can be associated with side effects.
Dialogue: 0,0:06:15.46,0:06:19.05,Default,,0000,0000,0000,,Once the medication is stopped, the symptoms may come back.
Dialogue: 0,0:06:20.04,0:06:23.01,Default,,0000,0000,0000,,So, you make reference to cognitive behavioral therapy.
Dialogue: 0,0:06:23.02,0:06:26.09,Default,,0000,0000,0000,,How would a parent know if the treatment that
Dialogue: 0,0:06:26.10,0:06:28.88,Default,,0000,0000,0000,,they're getting or if the therapist that they're seeing
Dialogue: 0,0:06:29.54,0:06:31.84,Default,,0000,0000,0000,,used this cognitive behavioral therapy?
Dialogue: 0,0:06:32.28,0:06:34.32,Default,,0000,0000,0000,,Well, the important consideration that the
Dialogue: 0,0:06:36.50,0:06:39.56,Default,,0000,0000,0000,,most active ingredient of cognitive behavior therapy
Dialogue: 0,0:06:39.57,0:06:42.33,Default,,0000,0000,0000,,is something called exposure plus response prevention.
Dialogue: 0,0:06:42.77,0:06:46.21,Default,,0000,0000,0000,,So, there are many different forms of cognitive behavior therapy, and
Dialogue: 0,0:06:46.22,0:06:48.29,Default,,0000,0000,0000,,and there are many forms of cognitive behavior therapy that
Dialogue: 0,0:06:48.30,0:06:52.01,Default,,0000,0000,0000,,are used for children with obsessive compulsive disorder.
Dialogue: 0,0:06:52.38,0:06:53.44,Default,,0000,0000,0000,,But only
Dialogue: 0,0:06:53.68,0:06:55.63,Default,,0000,0000,0000,,cognitive behavior therapy that's
Dialogue: 0,0:06:55.64,0:06:58.89,Default,,0000,0000,0000,,based on exposure plus response prevention
Dialogue: 0,0:06:59.14,0:07:02.32,Default,,0000,0000,0000,,has been shown to be effective for OCD. So, parents,
Dialogue: 0,0:07:02.70,0:07:04.88,Default,,0000,0000,0000,,when interviewing a therapist or trying to
Dialogue: 0,0:07:04.89,0:07:07.80,Default,,0000,0000,0000,,find a therapist or talking to a therapist about
Dialogue: 0,0:07:07.98,0:07:08.92,Default,,0000,0000,0000,,whether or not
Dialogue: 0,0:07:09.32,0:07:11.80,Default,,0000,0000,0000,,that treatment is helpful to the child should really
Dialogue: 0,0:07:11.81,0:07:15.38,Default,,0000,0000,0000,,ask if the therapist does exposure plus response prevention.
Dialogue: 0,0:07:15.53,0:07:18.06,Default,,0000,0000,0000,,Ok. Could you give me an example of what
Dialogue: 0,0:07:18.47,0:07:21.28,Default,,0000,0000,0000,,exposure plus response prevention
Dialogue: 0,0:07:21.56,0:07:23.20,Default,,0000,0000,0000,,is, or what it looks like?
Dialogue: 0,0:07:23.99,0:07:26.32,Default,,0000,0000,0000,,Well, first, let me tell you 
Dialogue: 0,0:07:27.22,0:07:30.41,Default,,0000,0000,0000,,the rationale underlying exposure plus response prevention.
Dialogue: 0,0:07:30.75,0:07:34.02,Default,,0000,0000,0000,,In OCD when children experience unwanted thoughts
Dialogue: 0,0:07:34.03,0:07:36.77,Default,,0000,0000,0000,,or images like the obsessions,
Dialogue: 0,0:07:37.00,0:07:41.22,Default,,0000,0000,0000,,that can obviously be distressing or upsetting or troubling to them.
Dialogue: 0,0:07:41.58,0:07:45.40,Default,,0000,0000,0000,,The compulsions or the ritualistic behavior like the hand washing or
Dialogue: 0,0:07:45.41,0:07:49.04,Default,,0000,0000,0000,,the checking or the repeating or the touching over and over again
Dialogue: 0,0:07:49.53,0:07:53.13,Default,,0000,0000,0000,,are then done to make the bad feelings or make the obsessions go away.
Dialogue: 0,0:07:53.14,0:07:54.86,Default,,0000,0000,0000,,And the obvious example is
Dialogue: 0,0:07:54.98,0:07:57.50,Default,,0000,0000,0000,,a child that's afraid of germs or contamination
Dialogue: 0,0:07:57.69,0:08:02.11,Default,,0000,0000,0000,,will repeatedly wash their hands to make these germs or contamination go away.
Dialogue: 0,0:08:02.41,0:08:03.70,Default,,0000,0000,0000,,So,  
Dialogue: 0,0:08:04.24,0:08:07.75,Default,,0000,0000,0000,,when children with obsessions or who are upset by their obsessions
Dialogue: 0,0:08:07.76,0:08:11.03,Default,,0000,0000,0000,,engage in the rituals or the compulsions like hand washing,
Dialogue: 0,0:08:11.30,0:08:12.55,Default,,0000,0000,0000,,what that tends to do,
Dialogue: 0,0:08:12.56,0:08:16.97,Default,,0000,0000,0000,,it tends to reinforce or strengthen the obsessive thoughts.
Dialogue: 0,0:08:17.05,0:08:22.35,Default,,0000,0000,0000,,So, everytime the child gives into his or her OCD by checking or washing or repeating,
Dialogue: 0,0:08:22.57,0:08:26.18,Default,,0000,0000,0000,,that tends to make the thoughts stronger and more believable.
Dialogue: 0,0:08:26.40,0:08:26.95,Default,,0000,0000,0000,,So,
Dialogue: 0,0:08:27.63,0:08:30.41,Default,,0000,0000,0000,,what exposure plus response prevention does is try
Dialogue: 0,0:08:30.42,0:08:33.55,Default,,0000,0000,0000,,to break the connection between the obsessive thoughts
Dialogue: 0,0:08:33.96,0:08:36.01,Default,,0000,0000,0000,,and the rituals or the compulsions.
Dialogue: 0,0:08:36.26,0:08:39.66,Default,,0000,0000,0000,,And by demonstrating to children that just because they have an obsessive
Dialogue: 0,0:08:39.67,0:08:42.39,Default,,0000,0000,0000,,thought doesn't need to mean they need to do their ritual.
Dialogue: 0,0:08:42.66,0:08:44.27,Default,,0000,0000,0000,,So, for example, in treatment,
Dialogue: 0,0:08:44.28,0:08:46.67,Default,,0000,0000,0000,,the first thing that we would do is make
Dialogue: 0,0:08:46.68,0:08:49.67,Default,,0000,0000,0000,,a list of all the child's obsessive compulsive symptoms.
Dialogue: 0,0:08:49.90,0:08:53.71,Default,,0000,0000,0000,,And then starting with the mildest symptom or the smallest symptom,
Dialogue: 0,0:08:53.95,0:08:56.37,Default,,0000,0000,0000,,we would trigger the child's symptom.
Dialogue: 0,0:08:56.38,0:08:56.95,Default,,0000,0000,0000,,For example,
Dialogue: 0,0:08:56.96,0:09:01.26,Default,,0000,0000,0000,,maybe by putting something contaminated on the child's hand to get him or her
Dialogue: 0,0:09:01.62,0:09:04.00,Default,,0000,0000,0000,,to become more anxious feeling.
Dialogue: 0,0:09:04.30,0:09:06.64,Default,,0000,0000,0000,,And at that point, the child would want to do their ritual,
Dialogue: 0,0:09:06.65,0:09:09.40,Default,,0000,0000,0000,,would want to wash their hands to make the bad feeling go away.
Dialogue: 0,0:09:09.90,0:09:10.80,Default,,0000,0000,0000,,But in treatment,
Dialogue: 0,0:09:10.81,0:09:13.08,Default,,0000,0000,0000,,we would work with the child or encourage the child to
Dialogue: 0,0:09:13.09,0:09:16.04,Default,,0000,0000,0000,,not wash their hands and instead wait and see what happens.
Dialogue: 0,0:09:16.05,0:09:19.84,Default,,0000,0000,0000,,And what happens is that the bad feelings or the anxiety goes away by itself.
Dialogue: 0,0:09:20.23,0:09:23.91,Default,,0000,0000,0000,,And by repeatedly doing this, doing the exposure or
Dialogue: 0,0:09:24.24,0:09:28.74,Default,,0000,0000,0000,,making the child want to do a ritual, but then having them not do the ritual,
Dialogue: 0,0:09:28.88,0:09:30.88,Default,,0000,0000,0000,,they learn that their anxiety will go away without
Dialogue: 0,0:09:30.89,0:09:33.29,Default,,0000,0000,0000,,having to do the rituals, and that relationship
Dialogue: 0,0:09:33.30,0:09:36.54,Default,,0000,0000,0000,,the connection between the obsession and the and the ritual is broken.
Dialogue: 0,0:09:37.16,0:09:38.30,Default,,0000,0000,0000,,And over repeated
Dialogue: 0,0:09:38.55,0:09:39.14,Default,,0000,0000,0000,,trials 
Dialogue: 0,0:09:39.40,0:09:41.32,Default,,0000,0000,0000,,of doing the exposure
Dialogue: 0,0:09:41.33,0:09:43.50,Default,,0000,0000,0000,,plus response prevention, the child learns that the
Dialogue: 0,0:09:43.51,0:09:46.78,Default,,0000,0000,0000,,thoughts they have the scary thoughts or feelings that they have
Dialogue: 0,0:09:46.79,0:09:50.58,Default,,0000,0000,0000,,about bad things happening or about germs or contamination
Dialogue: 0,0:09:50.80,0:09:52.26,Default,,0000,0000,0000,,or other kinds of things
Dialogue: 0,0:09:52.57,0:09:55.18,Default,,0000,0000,0000,,really aren't that bad and that they'll go away
Dialogue: 0,0:09:55.19,0:09:57.23,Default,,0000,0000,0000,,on their own without having to do the rituals.
Dialogue: 0,0:09:57.82,0:09:59.08,Default,,0000,0000,0000,,So, it sounds like
Dialogue: 0,0:09:59.43,0:10:02.73,Default,,0000,0000,0000,,exposure and response prevention is
Dialogue: 0,0:10:03.15,0:10:05.31,Default,,0000,0000,0000,,when a child practices
Dialogue: 0,0:10:05.52,0:10:06.79,Default,,0000,0000,0000,,in a graduated way.
Dialogue: 0,0:10:06.80,0:10:08.61,Default,,0000,0000,0000,,So, what they're fearful of,
Dialogue: 0,0:10:08.62,0:10:10.65,Default,,0000,0000,0000,,you don't make them do first, but they build up
Dialogue: 0,0:10:10.66,0:10:13.37,Default,,0000,0000,0000,,to it by practicing different strategies along the way.
Dialogue: 0,0:10:13.38,0:10:15.01,Default,,0000,0000,0000,,Do I understand that correct? Yes. Correct.
Dialogue: 0,0:10:15.02,0:10:18.09,Default,,0000,0000,0000,,The treatment is done in a way that's very sensitive for children.
Dialogue: 0,0:10:18.10,0:10:20.50,Default,,0000,0000,0000,,So, we always have the children start with a very kind of
Dialogue: 0,0:10:20.51,0:10:24.27,Default,,0000,0000,0000,,an easy or very mild symptom that's easy for them to resist.
Dialogue: 0,0:10:24.56,0:10:25.65,Default,,0000,0000,0000,,We don't have them
Dialogue: 0,0:10:25.93,0:10:26.51,Default,,0000,0000,0000,,work
Dialogue: 0,0:10:26.81,0:10:29.30,Default,,0000,0000,0000,,on their most difficult or most anxiety
Dialogue: 0,0:10:29.31,0:10:31.78,Default,,0000,0000,0000,,provoking symptoms until well on into treatment.
Dialogue: 0,0:10:32.43,0:10:33.31,Default,,0000,0000,0000,,In addition,
Dialogue: 0,0:10:33.52,0:10:35.43,Default,,0000,0000,0000,,there's a lot of work that we do with the child in
Dialogue: 0,0:10:35.44,0:10:38.56,Default,,0000,0000,0000,,the family before we even start working on the specific symptoms.
Dialogue: 0,0:10:38.57,0:10:42.48,Default,,0000,0000,0000,,So, there's a lot of education about anxiety and about OCD so
Dialogue: 0,0:10:42.49,0:10:45.82,Default,,0000,0000,0000,,that they can learn more about what's causing their problem and
Dialogue: 0,0:10:45.83,0:10:47.78,Default,,0000,0000,0000,,why they have the symptoms that they have.
Dialogue: 0,0:10:47.95,0:10:53.07,Default,,0000,0000,0000,,We talk a lot about methods for reducing anxiety and for helping make them stronger
Dialogue: 0,0:10:53.52,0:10:57.52,Default,,0000,0000,0000,,in terms of their ability to handle their OCD or deal with their OCD.
Dialogue: 0,0:10:57.79,0:10:58.40,Default,,0000,0000,0000,,In treatment,
Dialogue: 0,0:10:58.41,0:11:00.42,Default,,0000,0000,0000,,we also work very closely with parents to
Dialogue: 0,0:11:00.43,0:11:03.32,Default,,0000,0000,0000,,give parents the appropriate tools to help them
Dialogue: 0,0:11:03.43,0:11:06.98,Default,,0000,0000,0000,,assist their children and help support their children in treatment
Dialogue: 0,0:11:07.22,0:11:09.92,Default,,0000,0000,0000,,and to set up situations at home that are also going to
Dialogue: 0,0:11:09.93,0:11:13.53,Default,,0000,0000,0000,,help the children learn how to master or overcome their OCD.
Dialogue: 0,0:11:13.70,0:11:14.28,Default,,0000,0000,0000,,So,
Dialogue: 0,0:11:14.59,0:11:18.48,Default,,0000,0000,0000,,parents might be part of the treatment and help their children to practice,
Dialogue: 0,0:11:18.49,0:11:19.80,Default,,0000,0000,0000,,but they should still be
Dialogue: 0,0:11:20.10,0:11:22.92,Default,,0000,0000,0000,,doing that in concert with a mental health professional?
Dialogue: 0,0:11:23.05,0:11:26.76,Default,,0000,0000,0000,,Yeah, it's important that parents work with a mental health professional 
Dialogue: 0,0:11:27.02,0:11:29.22,Default,,0000,0000,0000,,to best learn how to manage or
Dialogue: 0,0:11:29.23,0:11:32.44,Default,,0000,0000,0000,,interact with their child around his or her OCD symptoms.
Dialogue: 0,0:11:32.65,0:11:36.47,Default,,0000,0000,0000,,What commonly happens with children with OCD is that
Dialogue: 0,0:11:36.48,0:11:38.33,Default,,0000,0000,0000,,they will gradually involve their parents or
Dialogue: 0,0:11:38.34,0:11:40.16,Default,,0000,0000,0000,,other family members and their symptoms.
Dialogue: 0,0:11:40.17,0:11:44.56,Default,,0000,0000,0000,,For example, making their mother or father wash things for them
Dialogue: 0,0:11:44.85,0:11:48.71,Default,,0000,0000,0000,,or having them avoid certain kinds of food or things at home
Dialogue: 0,0:11:48.81,0:11:52.20,Default,,0000,0000,0000,,if the child is afraid that those might be contaminated or covered with germs.
Dialogue: 0,0:11:52.53,0:11:54.55,Default,,0000,0000,0000,,They may ask parents to check, for example,
Dialogue: 0,0:11:54.56,0:11:57.45,Default,,0000,0000,0000,,the doors or check the locks or check the stove
Dialogue: 0,0:11:57.46,0:11:59.94,Default,,0000,0000,0000,,if they're afraid of a burglar or a fire.
Dialogue: 0,0:12:00.24,0:12:03.79,Default,,0000,0000,0000,,And it really over time can really involve parents and even brothers and
Dialogue: 0,0:12:03.80,0:12:06.75,Default,,0000,0000,0000,,sisters in ways that can be very difficult for the family to manage.
Dialogue: 0,0:12:07.31,0:12:10.56,Default,,0000,0000,0000,,So, one of the goals of treatment is to teach parents
Dialogue: 0,0:12:10.74,0:12:13.10,Default,,0000,0000,0000,,and brothers and sisters and other family members or
Dialogue: 0,0:12:13.11,0:12:15.86,Default,,0000,0000,0000,,other important people in the child's life how
Dialogue: 0,0:12:15.87,0:12:18.42,Default,,0000,0000,0000,,to disengage from the child's symptoms, to not
Dialogue: 0,0:12:18.43,0:12:20.55,Default,,0000,0000,0000,,be so involved in the child's symptoms,
Dialogue: 0,0:12:20.66,0:12:23.31,Default,,0000,0000,0000,,which will allow the child then to get better with treatment
Dialogue: 0,0:12:23.32,0:12:25.99,Default,,0000,0000,0000,,and lead to kind of normal family functioning again.
Dialogue: 0,0:12:26.35,0:12:29.17,Default,,0000,0000,0000,,But this can be a little bit tricky. So, it really should be done
Dialogue: 0,0:12:29.42,0:12:31.31,Default,,0000,0000,0000,,working closely with the mental health
Dialogue: 0,0:12:31.32,0:12:33.53,Default,,0000,0000,0000,,professional that is experienced in this area.
Dialogue: 0,0:12:34.77,0:12:35.48,Default,,0000,0000,0000,,So,
Dialogue: 0,0:12:35.67,0:12:38.44,Default,,0000,0000,0000,,parents should look for a cognitive behavioral
Dialogue: 0,0:12:38.45,0:12:42.40,Default,,0000,0000,0000,,therapist who uses exposure and response prevention.
Dialogue: 0,0:12:42.55,0:12:48.60,Default,,0000,0000,0000,,That sounds to be a very important thing that parents should seek. Are there other
Dialogue: 0,0:12:48.87,0:12:53.26,Default,,0000,0000,0000,,aspects or things that parents should ask about when looking
Dialogue: 0,0:12:53.27,0:12:56.28,Default,,0000,0000,0000,,for a therapist for their child for treating OCD?
Dialogue: 0,0:12:56.70,0:12:56.82,Default,,0000,0000,0000,,Yeah,
Dialogue: 0,0:12:56.83,0:12:58.40,Default,,0000,0000,0000,,it's very important that parents are
Dialogue: 0,0:12:58.41,0:13:00.98,Default,,0000,0000,0000,,very careful and very knowledgeable when they're
Dialogue: 0,0:13:01.34,0:13:03.43,Default,,0000,0000,0000,,looking for a therapist
Dialogue: 0,0:13:03.57,0:13:05.57,Default,,0000,0000,0000,,to work with their child's OCD.
Dialogue: 0,0:13:05.84,0:13:09.98,Default,,0000,0000,0000,,The therapist again, must have experience with OCD.
Dialogue: 0,0:13:10.53,0:13:15.39,Default,,0000,0000,0000,,The therapist must do exposure plus response prevention for the OCD.
Dialogue: 0,0:13:15.79,0:13:17.84,Default,,0000,0000,0000,,And the child must really be
Dialogue: 0,0:13:17.85,0:13:20.10,Default,,0000,0000,0000,,knowledgeable in working with children and adolescents.
Dialogue: 0,0:13:20.11,0:13:21.99,Default,,0000,0000,0000,,These are all important factors.
Dialogue: 0,0:13:22.30,0:13:22.84,Default,,0000,0000,0000,,So,
Dialogue: 0,0:13:23.76,0:13:27.10,Default,,0000,0000,0000,,are there other takeaway messages that you would want to give
Dialogue: 0,0:13:27.11,0:13:30.54,Default,,0000,0000,0000,,to a parent whose child or adolescent has 
Dialogue: 0,0:13:30.90,0:13:31.50,Default,,0000,0000,0000,,OCD
Dialogue: 0,0:13:31.83,0:13:34.70,Default,,0000,0000,0000,,in terms of what they should be doing as a parent?
Dialogue: 0,0:13:35.28,0:13:37.86,Default,,0000,0000,0000,,There are a number of things that parents should think about
Dialogue: 0,0:13:37.87,0:13:40.82,Default,,0000,0000,0000,,when their child has OCD.
Dialogue: 0,0:13:41.04,0:13:43.88,Default,,0000,0000,0000,,One of the big misconceptions that we run into is that parents
Dialogue: 0,0:13:43.89,0:13:47.66,Default,,0000,0000,0000,,sometimes think that the children are doing the behaviors on purpose.
Dialogue: 0,0:13:48.04,0:13:50.43,Default,,0000,0000,0000,,When in reality, in most cases,
Dialogue: 0,0:13:50.44,0:13:54.14,Default,,0000,0000,0000,,children with OCD are unable to control their symptoms. The anxiety
Dialogue: 0,0:13:54.48,0:13:57.39,Default,,0000,0000,0000,,is just too strong, and when the child says
Dialogue: 0,0:13:57.40,0:13:59.97,Default,,0000,0000,0000,,that they need to wash their hands or to check
Dialogue: 0,0:14:00.16,0:14:01.74,Default,,0000,0000,0000,,or to repeat certain things,
Dialogue: 0,0:14:01.79,0:14:05.13,Default,,0000,0000,0000,,it really is something that oftentimes is beyond their control.
Dialogue: 0,0:14:05.21,0:14:07.66,Default,,0000,0000,0000,,So, before parents try to do something to
Dialogue: 0,0:14:07.67,0:14:09.70,Default,,0000,0000,0000,,stop their children from doing these behaviors,
Dialogue: 0,0:14:09.71,0:14:12.80,Default,,0000,0000,0000,,they really should talk to a qualified mental health professional.
Dialogue: 0,0:14:13.35,0:14:18.92,Default,,0000,0000,0000,,Can you tell me how many children and adolescents have OCD or your best guess?
Dialogue: 0,0:14:19.79,0:14:21.42,Default,,0000,0000,0000,,OCD is pretty common in children and
Dialogue: 0,0:14:21.43,0:14:24.34,Default,,0000,0000,0000,,adolescents. Anywhere from about 1 to 3% of children
Dialogue: 0,0:14:24.60,0:14:28.15,Default,,0000,0000,0000,,and adolescents in this country have obsessive compulsive disorder.
Dialogue: 0,0:14:28.45,0:14:31.47,Default,,0000,0000,0000,,So, if you think about that, if you think of, say a child
Dialogue: 0,0:14:31.48,0:14:34.32,Default,,0000,0000,0000,,that goes to a school with 1000 children,
Dialogue: 0,0:14:34.33,0:14:38.06,Default,,0000,0000,0000,,maybe a medium size middle school or small high school,
Dialogue: 0,0:14:38.32,0:14:42.22,Default,,0000,0000,0000,,there are probably anywhere from 10 to 20 children at that school that have OCD.
Dialogue: 0,0:14:42.23,0:14:43.74,Default,,0000,0000,0000,,So, it's actually quite common,
Dialogue: 0,0:14:43.88,0:14:46.50,Default,,0000,0000,0000,,and in milder forms, it may even be more common than that.
Dialogue: 0,0:14:47.77,0:14:50.60,Default,,0000,0000,0000,,So, how come we don't hear about OCD a lot?
Dialogue: 0,0:14:51.42,0:14:54.39,Default,,0000,0000,0000,,OCD has oftentimes been called the Secret Disease or
Dialogue: 0,0:14:54.40,0:14:57.57,Default,,0000,0000,0000,,the Hidden Disease because the symptoms can be quite embarrassing.
Dialogue: 0,0:14:57.75,0:15:00.77,Default,,0000,0000,0000,,Sometimes they do involve kind of bizarre fears or
Dialogue: 0,0:15:00.78,0:15:04.29,Default,,0000,0000,0000,,worries that children might not want other people to know about.
Dialogue: 0,0:15:04.54,0:15:05.97,Default,,0000,0000,0000,,So, in a lot of cases,
Dialogue: 0,0:15:05.98,0:15:09.44,Default,,0000,0000,0000,,children or adolescents are able to hide their symptoms from friends
Dialogue: 0,0:15:09.45,0:15:12.23,Default,,0000,0000,0000,,or from classmates or from relatives, and in some cases,
Dialogue: 0,0:15:12.24,0:15:13.52,Default,,0000,0000,0000,,even from parents.
Dialogue: 0,0:15:13.96,0:15:19.26,Default,,0000,0000,0000,,So, we don't tend to hear about OCD as often as other disorders, say ADHD 
Dialogue: 0,0:15:19.27,0:15:22.30,Default,,0000,0000,0000,,or some other things that get more attention.
Dialogue: 0,0:15:22.55,0:15:23.78,Default,,0000,0000,0000,,What should parents look 
Dialogue: 0,0:15:24.20,0:15:24.62,Default,,0000,0000,0000,,for?
Dialogue: 0,0:15:25.47,0:15:25.65,Default,,0000,0000,0000,,If
Dialogue: 0,0:15:26.06,0:15:27.17,Default,,0000,0000,0000,,your
Dialogue: 0,0:15:27.18,0:15:30.49,Default,,0000,0000,0000,,parent thinks, suspects that their child might have a problem with OCD,
Dialogue: 0,0:15:30.50,0:15:32.29,Default,,0000,0000,0000,,there are a number of things to look for.
Dialogue: 0,0:15:32.40,0:15:34.95,Default,,0000,0000,0000,,One would be avoiding situations that 
Dialogue: 0,0:15:34.96,0:15:36.42,Default,,0000,0000,0000,,the children may have used to like,
Dialogue: 0,0:15:36.43,0:15:39.92,Default,,0000,0000,0000,,like not wanting to go to school or avoiding social situations,
Dialogue: 0,0:15:40.19,0:15:42.28,Default,,0000,0000,0000,,maybe avoiding being away from home.
Dialogue: 0,0:15:42.34,0:15:45.35,Default,,0000,0000,0000,,Sometimes this occurs because the children are afraid that they're gonna do
Dialogue: 0,0:15:45.36,0:15:47.83,Default,,0000,0000,0000,,their rituals or their compulsions in public settings.
Dialogue: 0,0:15:48.37,0:15:53.36,Default,,0000,0000,0000,,Children with OCD, oftentimes, if it's related to perfectionism
Dialogue: 0,0:15:53.37,0:15:54.89,Default,,0000,0000,0000,,or writing or school work
Dialogue: 0,0:15:55.05,0:15:59.39,Default,,0000,0000,0000,,may all of a sudden take much longer to do their school work. So, an assignment that may
Dialogue: 0,0:15:59.57,0:16:01.83,Default,,0000,0000,0000,,take on average 30 minutes to complete,
Dialogue: 0,0:16:02.16,0:16:06.71,Default,,0000,0000,0000,,may all of a sudden take like an hour or 90 minutes or two hours for a child with OCD.
Dialogue: 0,0:16:07.04,0:16:11.50,Default,,0000,0000,0000,,Children that tend to erase and rewrite over and over again,
Dialogue: 0,0:16:11.51,0:16:13.30,Default,,0000,0000,0000,,try to get things perfect
Dialogue: 0,0:16:13.52,0:16:17.58,Default,,0000,0000,0000,,or really get upset when things aren't exactly right or exactly perfect,
Dialogue: 0,0:16:17.82,0:16:19.75,Default,,0000,0000,0000,,that may also be a sign of OCD.
Dialogue: 0,0:16:19.88,0:16:23.14,Default,,0000,0000,0000,,Finally, children that are spend excessive time,
Dialogue: 0,0:16:23.41,0:16:24.72,Default,,0000,0000,0000,,say washing
Dialogue: 0,0:16:24.91,0:16:29.14,Default,,0000,0000,0000,,or showering or bathing or engage in other activities,
Dialogue: 0,0:16:29.23,0:16:32.24,Default,,0000,0000,0000,,that also may be a sign that the child has OCD.
Dialogue: 0,0:16:33.12,0:16:34.98,Default,,0000,0000,0000,,Do we know what causes OCD?
Dialogue: 0,0:16:35.73,0:16:39.34,Default,,0000,0000,0000,,OCD is a biological disorder. It's genetic.
Dialogue: 0,0:16:39.35,0:16:41.20,Default,,0000,0000,0000,,So, it tends to run in families.
Dialogue: 0,0:16:41.73,0:16:45.87,Default,,0000,0000,0000,,But there's also some kinds of environmental factors associated with OCD.
Dialogue: 0,0:16:45.88,0:16:48.28,Default,,0000,0000,0000,,So, if a child is stressed
Dialogue: 0,0:16:48.62,0:16:52.47,Default,,0000,0000,0000,,or tired or sick, that may make the symptoms worse.
Dialogue: 0,0:16:52.73,0:16:53.98,Default,,0000,0000,0000,,Reactions....
Dialogue: 0,0:16:53.99,0:16:57.84,Default,,0000,0000,0000,,If the child is in a situation where others might be reacting to the OCD
Dialogue: 0,0:16:58.22,0:16:59.38,Default,,0000,0000,0000,,or 
Dialogue: 0,0:16:59.71,0:17:02.92,Default,,0000,0000,0000,,putting pressure on the child, that may also make OCD worse.
Dialogue: 0,0:17:03.67,0:17:07.17,Default,,0000,0000,0000,,And although some people might say because OCD is a biological disorder,
Dialogue: 0,0:17:07.18,0:17:08.88,Default,,0000,0000,0000,,shouldn't you treat it with medication?
Dialogue: 0,0:17:09.02,0:17:10.21,Default,,0000,0000,0000,,That's not the case.
Dialogue: 0,0:17:10.52,0:17:13.23,Default,,0000,0000,0000,,In fact, the cognitive behavior therapy is
Dialogue: 0,0:17:13.24,0:17:16.73,Default,,0000,0000,0000,,the most effective treatment that we have for OCD right now.
Dialogue: 0,0:17:17.69,0:17:19.15,Default,,0000,0000,0000,,So, would you say that
Dialogue: 0,0:17:19.36,0:17:21.99,Default,,0000,0000,0000,,for children and adolescents who have OCD,
Dialogue: 0,0:17:22.21,0:17:24.05,Default,,0000,0000,0000,,there's a fair amount of hope that with
Dialogue: 0,0:17:24.06,0:17:26.61,Default,,0000,0000,0000,,CBT treatment or cognitive behavioral treatment,
Dialogue: 0,0:17:26.62,0:17:27.65,Default,,0000,0000,0000,,things will get better?
Dialogue: 0,0:17:28.20,0:17:31.66,Default,,0000,0000,0000,,Yeah, there is a fair amount of hope associated with treatment.
Dialogue: 0,0:17:31.67,0:17:33.29,Default,,0000,0000,0000,,Cognitive behavior therapy,
Dialogue: 0,0:17:33.30,0:17:34.68,Default,,0000,0000,0000,,CBT,
Dialogue: 0,0:17:34.95,0:17:37.54,Default,,0000,0000,0000,,has been shown to be effective in a number of cases.
Dialogue: 0,0:17:37.55,0:17:39.03,Default,,0000,0000,0000,,Not everybody benefits from it.
Dialogue: 0,0:17:39.04,0:17:41.10,Default,,0000,0000,0000,,Not every child is able to do it.
Dialogue: 0,0:17:41.11,0:17:43.19,Default,,0000,0000,0000,,There may be certain situations or factors
Dialogue: 0,0:17:43.44,0:17:47.70,Default,,0000,0000,0000,,such as coexisting problems that might make it difficult for
Dialogue: 0,0:17:47.71,0:17:51.05,Default,,0000,0000,0000,,the child to engage in cognitive behavior therapy as the first treatment.
Dialogue: 0,0:17:51.36,0:17:54.65,Default,,0000,0000,0000,,Or in some situations, the CBT may be so severe
Dialogue: 0,0:17:54.76,0:17:56.94,Default,,0000,0000,0000,,that the child is unable to engage in the treatment.
Dialogue: 0,0:17:57.15,0:17:58.42,Default,,0000,0000,0000,,And in these cases,
Dialogue: 0,0:17:58.43,0:18:02.31,Default,,0000,0000,0000,,other families might want to consider medication and talk to either
Dialogue: 0,0:18:02.32,0:18:04.06,Default,,0000,0000,0000,,a qualified mental health professional about
Dialogue: 0,0:18:04.07,0:18:06.06,Default,,0000,0000,0000,,medication or a referral for medication.
Dialogue: 0,0:18:06.56,0:18:09.64,Default,,0000,0000,0000,,But between these two treatments,
Dialogue: 0,0:18:09.79,0:18:12.06,Default,,0000,0000,0000,,there's a good chance that most children will be able to
Dialogue: 0,0:18:12.07,0:18:17.40,Default,,0000,0000,0000,,experience significant benefit and be able to live normal lives.
Dialogue: 0,0:18:17.68,0:18:20.61,Default,,0000,0000,0000,,Can you tell me a little bit about
Dialogue: 0,0:18:21.08,0:18:23.63,Default,,0000,0000,0000,,what OCD looks like in the long term, or what
Dialogue: 0,0:18:23.64,0:18:27.38,Default,,0000,0000,0000,,parents should expect for their children or adolescents who have OCD
Dialogue: 0,0:18:27.66,0:18:29.24,Default,,0000,0000,0000,,in a longer term sense?
Dialogue: 0,0:18:29.79,0:18:35.21,Default,,0000,0000,0000,,So, OCD is considered a chronic disorder, which means it tends not to go away by itself.
Dialogue: 0,0:18:35.22,0:18:38.57,Default,,0000,0000,0000,,It typically starts around age in childhood.
Dialogue: 0,0:18:38.88,0:18:41.17,Default,,0000,0000,0000,,So, maybe around the ages of 7 to 11.
Dialogue: 0,0:18:42.02,0:18:42.88,Default,,0000,0000,0000,,And
Dialogue: 0,0:18:43.67,0:18:44.15,Default,,0000,0000,0000,,it
Dialogue: 0,0:18:44.59,0:18:48.32,Default,,0000,0000,0000,,in some cases will have a sudden onset. So, it'll just kind of come,
Dialogue: 0,0:18:48.33,0:18:49.53,Default,,0000,0000,0000,,seems like almost out of the blue.
Dialogue: 0,0:18:49.54,0:18:52.46,Default,,0000,0000,0000,,In other cases, it tends to have more of a gradual onset. So, the symptoms
Dialogue: 0,0:18:52.61,0:18:57.01,Default,,0000,0000,0000,,tend to get worse over time and kind of a slower format.
Dialogue: 0,0:18:57.48,0:19:00.73,Default,,0000,0000,0000,,But without treatment, in most cases for children,
Dialogue: 0,0:19:00.74,0:19:03.79,Default,,0000,0000,0000,,most kids will just continue to experience the symptoms
Dialogue: 0,0:19:03.96,0:19:07.80,Default,,0000,0000,0000,,overtime into adolescence and even adulthood.
Dialogue: 0,0:19:08.02,0:19:08.59,Default,,0000,0000,0000,,In fact,
Dialogue: 0,0:19:08.60,0:19:11.52,Default,,0000,0000,0000,,most adults with OCD had an initial
Dialogue: 0,0:19:11.53,0:19:14.69,Default,,0000,0000,0000,,onset of their symptoms during childhood or 
Dialogue: 0,0:19:15.14,0:19:15.58,Default,,0000,0000,0000,,adolescence.
Dialogue: 0,0:19:15.70,0:19:18.12,Default,,0000,0000,0000,,But the good news is that effective treatment can really
Dialogue: 0,0:19:18.13,0:19:21.26,Default,,0000,0000,0000,,have a positive impact on children's long-term functioning.
Dialogue: 0,0:19:21.27,0:19:22.24,Default,,0000,0000,0000,,So, if they're able to
Dialogue: 0,0:19:22.45,0:19:25.20,Default,,0000,0000,0000,,benefit from cognitive behavior therapy or
Dialogue: 0,0:19:25.21,0:19:27.86,Default,,0000,0000,0000,,even perhaps medication in addition to the therapy,
Dialogue: 0,0:19:28.14,0:19:30.09,Default,,0000,0000,0000,,the chances are that they may have a
Dialogue: 0,0:19:30.10,0:19:33.54,Default,,0000,0000,0000,,very good long term prognosis in the sense that they can go on and to lead,
Dialogue: 0,0:19:33.74,0:19:35.18,Default,,0000,0000,0000,,you know, normal healthy lives.
Dialogue: 0,0:19:35.32,0:19:37.55,Default,,0000,0000,0000,,And it sounds like, correct me if I'm wrong,
Dialogue: 0,0:19:37.78,0:19:41.00,Default,,0000,0000,0000,,a lot of kids or adolescents will learn skills
Dialogue: 0,0:19:41.01,0:19:44.20,Default,,0000,0000,0000,,for managing their symptoms that they can draw upon
Dialogue: 0,0:19:44.86,0:19:45.88,Default,,0000,0000,0000,,as they age.
Dialogue: 0,0:19:46.61,0:19:46.80,Default,,0000,0000,0000,,Yeah.
Dialogue: 0,0:19:46.81,0:19:50.38,Default,,0000,0000,0000,,One of the benefits of cognitive behavior therapy is that children learn skills;
Dialogue: 0,0:19:50.39,0:19:54.84,Default,,0000,0000,0000,,they learn strategies for coping with their OCD, for challenging their OCD.
Dialogue: 0,0:19:55.23,0:19:59.28,Default,,0000,0000,0000,,And just for general problem solving and coping,
Dialogue: 0,0:19:59.35,0:20:01.42,Default,,0000,0000,0000,,which in the long term can really be beneficial.
Dialogue: 0,0:20:01.43,0:20:03.36,Default,,0000,0000,0000,,A lot of children that receive treatment
Dialogue: 0,0:20:03.45,0:20:05.15,Default,,0000,0000,0000,,actually can serve to strengthen them in many
Dialogue: 0,0:20:05.16,0:20:07.08,Default,,0000,0000,0000,,ways by increasing their confidence and their
Dialogue: 0,0:20:07.09,0:20:09.68,Default,,0000,0000,0000,,ability to deal with other difficult situations.
Dialogue: 0,0:20:10.63,0:20:16.29,Default,,0000,0000,0000,,One thing I know about other mental health disorders is that sometimes one mental
Dialogue: 0,0:20:16.30,0:20:20.00,Default,,0000,0000,0000,,health disorder will co-occur at the same time with another mental health disorder.
Dialogue: 0,0:20:20.01,0:20:24.97,Default,,0000,0000,0000,,And so kids are dealing with multiple concerns at the same time.
Dialogue: 0,0:20:24.98,0:20:28.66,Default,,0000,0000,0000,,Does that happen with OCD? Do we see that co-occur with other disorders?
Dialogue: 0,0:20:28.92,0:20:29.24,Default,,0000,0000,0000,,Yeah.
Dialogue: 0,0:20:29.42,0:20:31.76,Default,,0000,0000,0000,,OCD quite commonly
Dialogue: 0,0:20:31.94,0:20:33.44,Default,,0000,0000,0000,,cours with other disorders.
Dialogue: 0,0:20:33.45,0:20:35.38,Default,,0000,0000,0000,,The most common other disorders are another kind
Dialogue: 0,0:20:35.40,0:20:39.28,Default,,0000,0000,0000,,of an anxiety disorder such as generalized anxiety
Dialogue: 0,0:20:39.45,0:20:42.68,Default,,0000,0000,0000,,or social anxiety fears or separation fears.
Dialogue: 0,0:20:42.73,0:20:48.16,Default,,0000,0000,0000,,We also see it occur quite commonly with Tourette's or Tick Disorders and ADHD.
Dialogue: 0,0:20:48.68,0:20:53.14,Default,,0000,0000,0000,,In adolescence or in older children or adolescents or adults,
Dialogue: 0,0:20:53.29,0:20:55.47,Default,,0000,0000,0000,,co-incurring depression is also quite common.
Dialogue: 0,0:20:55.48,0:20:58.68,Default,,0000,0000,0000,,In fact, most children with OCD or the majority of children
Dialogue: 0,0:20:58.87,0:21:00.16,Default,,0000,0000,0000,,with OCD
Dialogue: 0,0:21:00.39,0:21:04.45,Default,,0000,0000,0000,,will present for treatment or come into clinics with one other disorder
Dialogue: 0,0:21:04.46,0:21:07.75,Default,,0000,0000,0000,,and some kids will even come in with two or more other disorders.
Dialogue: 0,0:21:07.77,0:21:08.27,Default,,0000,0000,0000,,Ok.
Dialogue: 0,0:21:08.81,0:21:12.63,Default,,0000,0000,0000,,So, for some parents, it sounds like they report that
Dialogue: 0,0:21:12.92,0:21:17.00,Default,,0000,0000,0000,,they've noticed this in their children for a long period of time,
Dialogue: 0,0:21:17.28,0:21:20.42,Default,,0000,0000,0000,,and it might get worse as they get older or stress might make it
Dialogue: 0,0:21:20.74,0:21:22.34,Default,,0000,0000,0000,,more noticeable.
Dialogue: 0,0:21:22.59,0:21:23.82,Default,,0000,0000,0000,,For other parents,
Dialogue: 0,0:21:23.83,0:21:27.46,Default,,0000,0000,0000,,they might just suddenly notice that their child is experiencing
Dialogue: 0,0:21:27.47,0:21:31.50,Default,,0000,0000,0000,,problems with obsessions or compulsions or it's impacting their life.
Dialogue: 0,0:21:31.51,0:21:31.82,Default,,0000,0000,0000,,So,
Dialogue: 0,0:21:31.83,0:21:35.50,Default,,0000,0000,0000,,if a parent is first noticing these problems are really coming to the
Dialogue: 0,0:21:35.51,0:21:40.26,Default,,0000,0000,0000,,realization that it might be impacting their child or their adolescent life.
Dialogue: 0,0:21:40.27,0:21:41.74,Default,,0000,0000,0000,,What's the first step for them?
Dialogue: 0,0:21:42.47,0:21:43.33,Default,,0000,0000,0000,,Well, the first step,
Dialogue: 0,0:21:43.34,0:21:48.49,Default,,0000,0000,0000,,if you suspect that your child may have OCD or another problem is to not panic
Dialogue: 0,0:21:48.78,0:21:49.81,Default,,0000,0000,0000,,and not overreact,
Dialogue: 0,0:21:49.82,0:21:53.20,Default,,0000,0000,0000,,especially not in front of the child because that can be very upsetting to the child.
Dialogue: 0,0:21:53.51,0:21:57.89,Default,,0000,0000,0000,,But if a parent sees something that doesn't seem right or a change in the 
Dialogue: 0,0:21:57.90,0:21:58.16,Default,,0000,0000,0000,,child,
Dialogue: 0,0:21:58.75,0:22:00.93,Default,,0000,0000,0000,,I think it would be important for the parent just
Dialogue: 0,0:22:00.94,0:22:03.11,Default,,0000,0000,0000,,to talk to the child about it. Again,
Dialogue: 0,0:22:03.12,0:22:05.31,Default,,0000,0000,0000,,not in an alarmist fashion, but maybe, you know,
Dialogue: 0,0:22:05.33,0:22:07.53,Default,,0000,0000,0000,,I've just noticed that you seem to worry about
Dialogue: 0,0:22:07.81,0:22:11.33,Default,,0000,0000,0000,,this or that a little bit more than you used to. Do you want to talk about it?
Dialogue: 0,0:22:11.34,0:22:12.88,Default,,0000,0000,0000,,Can you tell me what's going on?
Dialogue: 0,0:22:13.07,0:22:15.14,Default,,0000,0000,0000,,And try to get some information from the child.
Dialogue: 0,0:22:15.15,0:22:15.65,Default,,0000,0000,0000,,Now,
Dialogue: 0,0:22:15.66,0:22:18.61,Default,,0000,0000,0000,,commonly children and may not want to talk about it or may not want to
Dialogue: 0,0:22:18.62,0:22:20.54,Default,,0000,0000,0000,,say anything either because they're embarrassed or
Dialogue: 0,0:22:20.54,0:22:22.28,Default,,0000,0000,0000,,they don't want to upset their parents.
Dialogue: 0,0:22:22.28,0:22:27.30,Default,,0000,0000,0000,,But if the parent continues to feel that there's something that concerns them,
Dialogue: 0,0:22:27.44,0:22:29.23,Default,,0000,0000,0000,,it would be important to contact
Dialogue: 0,0:22:29.24,0:22:31.23,Default,,0000,0000,0000,,again, a qualified mental health professional,
Dialogue: 0,0:22:31.24,0:22:34.07,Default,,0000,0000,0000,,somebody that is an experienced child and 
Dialogue: 0,0:22:34.72,0:22:34.75,Default,,0000,0000,0000,,adolescent
Dialogue: 0,0:22:34.76,0:22:37.70,Default,,0000,0000,0000,,psychologist or psychiatrist or social worker that has
Dialogue: 0,0:22:37.71,0:22:39.66,Default,,0000,0000,0000,,experience working with OCD or
Dialogue: 0,0:22:39.67,0:22:41.02,Default,,0000,0000,0000,,other kinds of disorders.
Dialogue: 0,0:22:41.19,0:22:45.98,Default,,0000,0000,0000,,Do kids go through phases where they'll have obsessions or compulsions?
Dialogue: 0,0:22:46.27,0:22:47.08,Default,,0000,0000,0000,,Meaning,
Dialogue: 0,0:22:47.64,0:22:49.42,Default,,0000,0000,0000,,when a parent first notices it,
Dialogue: 0,0:22:49.43,0:22:52.20,Default,,0000,0000,0000,,is that the time to contact a mental health
Dialogue: 0,0:22:52.21,0:22:55.06,Default,,0000,0000,0000,,professional or should parents wait to see the course?
Dialogue: 0,0:22:55.39,0:23:00.14,Default,,0000,0000,0000,,If parents see some different kind of a behavior, odd behavior in their child,
Dialogue: 0,0:23:00.51,0:23:02.11,Default,,0000,0000,0000,,it probably makes sense to watch it for a
Dialogue: 0,0:23:02.12,0:23:05.01,Default,,0000,0000,0000,,little bit of time and not overreact too soon.
Dialogue: 0,0:23:05.02,0:23:08.53,Default,,0000,0000,0000,,I mean, unless the behavior is clearly problematic,
Dialogue: 0,0:23:08.84,0:23:10.17,Default,,0000,0000,0000,,but in
Dialogue: 0,0:23:10.73,0:23:14.23,Default,,0000,0000,0000,,if there's something that looks a little bit different and maybe
Dialogue: 0,0:23:14.24,0:23:16.64,Default,,0000,0000,0000,,the parent isn't sure if it's something that serious or not,
Dialogue: 0,0:23:16.65,0:23:18.55,Default,,0000,0000,0000,,maybe to watch it for a little while because
Dialogue: 0,0:23:18.56,0:23:21.40,Default,,0000,0000,0000,,most kids go through different stages of something where they
Dialogue: 0,0:23:21.41,0:23:23.59,Default,,0000,0000,0000,,may be a little more anxious or a little
Dialogue: 0,0:23:23.60,0:23:28.05,Default,,0000,0000,0000,,less anxious or a little sad sometimes or have 
Dialogue: 0,0:23:28.20,0:23:30.63,Default,,0000,0000,0000,,more active or whatever that might be. And that kind of
Dialogue: 0,0:23:30.73,0:23:33.19,Default,,0000,0000,0000,,normal in kids, but just to watch
Dialogue: 0,0:23:33.54,0:23:35.99,Default,,0000,0000,0000,,and continue to monitor and if things don't get
Dialogue: 0,0:23:36.00,0:23:38.14,Default,,0000,0000,0000,,better or if things look a little bit worse,
Dialogue: 0,0:23:38.20,0:23:40.66,Default,,0000,0000,0000,,then it might be time to seek out help.
Dialogue: 0,0:23:40.68,0:23:43.64,Default,,0000,0000,0000,,The recommendation would be that if a parent sees something
Dialogue: 0,0:23:43.66,0:23:46.84,Default,,0000,0000,0000,,that looks like it is interfering with the child's life
Dialogue: 0,0:23:47.56,0:23:50.64,Default,,0000,0000,0000,,in terms of school or friends or family functioning,
Dialogue: 0,0:23:50.98,0:23:55.52,Default,,0000,0000,0000,,is distressing or disturbing to the child, or is upsetting to them,
Dialogue: 0,0:23:55.53,0:23:57.28,Default,,0000,0000,0000,,that would be the time to
Dialogue: 0,0:23:57.49,0:24:00.60,Default,,0000,0000,0000,,seek some kind of professional help.
Dialogue: 0,0:24:00.73,0:24:01.12,Default,,0000,0000,0000,,Ok.
Dialogue: 0,0:24:01.25,0:24:03.62,Default,,0000,0000,0000,,Well, thank you for your time and for answering questions.
Dialogue: 0,0:24:03.63,0:24:09.24,Default,,0000,0000,0000,,I'm sure that many parents will be happy to review this information and
Dialogue: 0,0:24:09.25,0:24:11.16,Default,,0000,0000,0000,,to share their concerns with the qualified
Dialogue: 0,0:24:11.17,0:24:12.84,Default,,0000,0000,0000,,mental health professional in their area.
Dialogue: 0,0:24:12.85,0:24:15.10,Default,,0000,0000,0000,,So, thank you again. Oh, it's my pleasure. Thank you.