Pediatric Counselling
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Play therapy and art therapyVideo game therapyCognitive behavioural therapy (CBT)Exposure and response preventionMindfulness-based therapiesFamily and filial therapyCollaborative problem solvingSafety planning and harm reductionBook on JaneOCD therapy for children and youth in Vancouver.
Help your child take back control from OCD. Specialised, gentle OCD therapy for children and teens caught in unwanted thoughts and rituals, and for the parents who want to help, in person in Vancouver or online across B.C.
Your child is not alone, and neither are you.
OCD can take over a child’s day, and it can take over family life too. Whether you have noticed small rituals or an all-consuming routine, you do not have to figure out what to do on your own. OCD is common, it is not anyone’s fault, and it responds well to the right treatment.
Children with OCD often hide it, feeling ashamed or afraid of being thought strange. My job is to make it safe to talk, and to help your child see OCD as the problem, not themselves.
Pamela Wallberg, RCC
Unwanted thoughts that will not go away.
Seeing thoughts as just thoughts.
“What if I did it wrong?”
Trusting yourself again.
Having to do things again and again.
Doing things once and moving on.
Worry about germs and getting sick.
Touching and playing without fear.
Needing things to feel exactly right.
Being okay with good enough.
“Are you sure? Promise me.”
Sitting with not knowing.
Hours taken up by rituals.
Room for friends, play and sleep.
Everyone organising life around OCD.
A family that helps without feeding OCD.
My approach
Treatment that is clear, kind and effective.
Research supports CBT with exposure and response prevention as the first-line talking treatment for OCD in children and teens. I pair it with play for younger children, match everything to your child’s age, needs and interests, and involve you as parents so progress continues at home.
Together we help your child get bolder than OCD, one small step at a time.
listening to children’s voices.
Play therapy, in person or online
For younger children, play is the way in. Sand tray, dollhouse and figures, or video game therapy online, let children give OCD a name and a shape, talk back to it and practise being brave in a playful, low-pressure way.
ExploreCognitive behavioural therapy (CBT)
CBT helps children and teens understand how OCD works: the unwanted thought, the worry it sparks and the ritual that brings brief relief. We learn to see OCD as separate from your child, then build the skills to challenge it.
ExploreExposure and response prevention (ERP)
ERP is the most studied treatment for OCD. Step by step, at a pace your child helps choose, they face feared situations or thoughts without doing the ritual, and learn that the worry passes. Parents are coached to support this at home without feeding OCD.
ExploreGeller, D. A., & March, J. (2012). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(1), 98–113. link
Öst, L.-G., Riise, E. N., Wergeland, G. J., Hansen, B., & Kvale, G. (2016). Cognitive behavioral and pharmacological treatments of OCD in children: A systematic review and meta-analysis. Journal of Anxiety Disorders, 43, 58–69. link
Freeman, J., et al. (2014). Family-based treatment of early childhood obsessive-compulsive disorder: The Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children (POTS Jr). JAMA Psychiatry, 71(6), 689–698. link
Peris, T. S., Rozenman, M. S., Sugar, C. A., McCracken, J. T., & Piacentini, J. (2017). Targeted family intervention for complex cases of pediatric obsessive-compulsive disorder: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 56(12), 1034–1042. link
Lebowitz, E. R., et al. (2013). Family accommodation in pediatric anxiety disorders. Depression and Anxiety, 30(1), 47–54. link
Pediatric OCD Treatment Study (POTS) Team (2004). Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder. JAMA, 292(16), 1969–1976. link
Kelty Mental Health Resource Centre (BC Children’s Hospital): Obsessive Compulsive Disorder (OCD). link
Kelty Mental Health Resource Centre (BC Children’s Hospital): Understanding OCD: When to Seek Help for Your Child. link
Read the researchTelling them apart
A special interest, hyperfixation or OCD?
Neurodivergent children, including many autistic and ADHD children, can have intense interests, routines and repetitive behaviours that look like OCD from the outside. They are not the same, and the difference matters for what helps.
A simple question: is it bringing joy, or relieving fear? Here is how they usually differ.
How it feels
Special interest or hyperfixation
Enjoyable, absorbing and energising. Your child often lights up talking about it.
OCD
Distressing and unwanted. It feels like something they have to do, not something they want to do.
What drives it
Special interest or hyperfixation
Curiosity, comfort and joy. Learning more about it is rewarding.
OCD
Fear, doubt or a sense that something bad will happen. Doing the ritual brings brief relief from anxiety.
When it is interrupted
Special interest or hyperfixation
Disappointment or frustration, and often a return to it later with enthusiasm.
OCD
Strong anxiety or distress until the ritual is finished, or “just right.”
What it looks like
Special interest or hyperfixation
Collecting facts, building, drawing, gaming or talking about a favourite topic, often in great depth.
OCD
Repeating, checking, washing, counting or seeking reassurance, often with little link to what the child enjoys.
Effect on life
Special interest or hyperfixation
Often a source of skills, friendships and confidence, even when it takes a lot of time.
OCD
Takes time from sleep, school, friends and play, and children often feel ashamed or trapped.
How the child describes it
Special interest or hyperfixation
“I love this.” “I could do this all day.”
OCD
“I hate this, but I have to.” “I can’t stop.”
It can be both.
OCD occurs more often in autistic children, and a child can have a deep, joyful interest and OCD at the same time. Repetition alone does not mean OCD, and a child can find some rituals calming, such as stimming or familiar routines, without it being a problem. What I look for is distress, fear-driven urges and impact on daily life.
If you are not sure, an assessment can sort it out. A formal diagnosis comes from a physician, psychiatrist, nurse practitioner or psychologist, and I work alongside your child’s care team. Treatment is adjusted for neurodivergent children, for example with visual supports, clear steps and respect for the interests that bring them joy.
What OCD can look like
OCD shows up differently in every child, and a child can have more than one pattern. A formal diagnosis comes from a physician, psychiatrist, nurse practitioner or psychologist, and I work alongside your child’s care team.
Contamination and washing
Intense fear of germs, dirt or getting sick, leading to repeated hand washing, avoiding places or needing things cleaned in a certain way.
Checking and doubt
Needing to check again and again that the door is locked, homework is done or nothing bad has happened, because the doubt never feels settled.
Symmetry and “just right”
Needing things lined up, even or exactly right, or repeating an action until it feels right. Small things can take a very long time.
Unwanted, upsetting thoughts
Sudden thoughts or images that clash with who your child is and cause great distress. Having them does not mean anything about your child, and they can be treated.
Counting, ordering and rituals
Mental or physical routines, such as counting, tapping, repeating words or doing things in a set order, to keep a feared outcome away.
Reassurance seeking
Asking the same questions over and over. Giving the answer brings brief relief, but OCD returns. Parents learn how to respond kindly without feeding the cycle.
Let’s connect
Taking the first step is often the hardest. I’m here to answer your questions and help you decide whether this is the right path for your child.
Let’s chatFree 15-min consultation
Common questions
Do you offer OCD therapy for children and youth in Vancouver?+
Yes. I provide OCD therapy for children and youth in person in Vancouver, and online across B.C. Treatment is built around cognitive behavioural therapy with exposure and response prevention (ERP), delivered with play-based methods for younger children and with parents involved. A free 15-minute call is the first step.
How do I know if it is OCD or just habits and quirks?+
Many children have routines and favourite ways of doing things. It points to OCD when the thoughts or rituals take up an hour or more a day, cause real distress, or get in the way of school, friends, sleep or family life. A free call is a good place to talk it through.
What is ERP, and will it be too hard for my child?+
ERP means gradually facing a feared situation or thought without doing the ritual. It is done in small steps, at a pace your child helps choose, and always starts with learning and building skills. Many children are surprised by how quickly the worry rises and then falls.
What should I do when my child asks for reassurance?+
It is natural to want to comfort them, and a kind, short response is fine. When the same questions repeat, answering can strengthen OCD over time. I coach parents on warm ways to respond that support your child without feeding the cycle.
Will my child need medication?+
That decision belongs to your child’s physician or psychiatrist, and I am happy to work alongside them. CBT with ERP is the first-line treatment for most children with mild to moderate OCD. For more severe OCD, research supports considering medication together with CBT (POTS Team, 2004, JAMA, 292(16), 1969–1976).
Can OCD get better?+
Yes. Many children and teens improve substantially with the right treatment, and families often feel relief just from understanding what is happening. OCD can ebb and flow, so we also plan for how to handle setbacks.
Trusted resources
More help for families in B.C.
Free, evidence-informed information from Kelty Mental Health at BC Children’s Hospital. These links open in a new tab.
Information on this page is provided by Pamela Wallberg, MA, RCC, Registered Clinical Counsellor. Last updated October 2026. This page is general information and is not a substitute for individual care.
Related: ERP for OCD · Anxiety · CBT