Chapter 13 - Addressing Family Accommodation in Childhood Obsessive-Compulsive Disorder

Abstract

Parents of children with OCD modify their own behavior to help their child avoid or alleviate distress related to their OCD symptoms, a process termed family accommodation. Family accommodation can help a child to feel better in the short term but is associated with more severe symptoms in the longer term and places considerable burden on parents and other family members. High levels of family accommodation also predict poorer treatment outcomes for the child. It is important to assess the frequency and nature of family accommodation when evaluating childhood OCD and reducing family accommodation should be integrated into treatment planning. This chapter reviews the theoretical and empirical knowledge relating to family accommodation of childhood OCD, describes the phenomenology of family accommodation, presents measures for assessing family accommodation, and provides strategies for addressing family accommodation through parent-based treatment.