OCD Therapy for Children and Teens, Online Across Texas

Little Dove Psychology treats OCD in children, teens, and college students with exposure and response prevention (ERP), the core of cognitive behavioral therapy for OCD, by secure video anywhere in Texas and the other PSYPACT participating states. Our clinicians are in network with Aetna, Blue Cross Blue Shield of Texas, and Optum/UnitedHealthcare (including Oscar plans administered by Optum), and most families have a first session the same week they call. Parents are part of treatment from the first session, because the way a loving family responds to OCD is one of the things that keeps it going, and one of the things that can change fastest.

What does OCD look like in a child or teen?

OCD has two parts. Obsessions are unwanted thoughts, images, or urges that show up uninvited and feel awful: germs and contamination, something bad happening to a parent, a thought that feels wrong or "bad," or a nagging sense that things are not just right. Compulsions are what a child does to make that feeling stop: washing, checking, redoing, counting, confessing, arranging, or asking the same reassuring question again and again.

Kids are often very good at hiding it. Parents tend to notice the side effects first: homework that takes hours because of erasing and rewriting, forty-minute showers, a bedtime routine that has grown to an hour. Many older kids know the rituals make no sense and still cannot stop. Ordinary childhood routines bend. OCD does not.

What is exposure and response prevention (ERP)?

Exposure and response prevention is the specific form of cognitive behavioral therapy with the strongest evidence for OCD in children and teens. Exposure means facing the thought or situation that sets off the obsession, on purpose, in small steps. Response prevention means not doing the compulsion afterward. Anxiety rises and comes down on its own, and the brain learns that the feeling is survivable and the ritual was never what kept anyone safe.

None of this is sprung on a child. We build a ladder together, from the easiest step to the hardest, and your child helps decide what goes on it and when we climb. For moderate or severe OCD, medication alongside ERP is sometimes part of the picture. We do not prescribe, and when medication is on the table we coordinate with your pediatrician or psychiatrist.

Why do parents matter so much in OCD treatment?

Because nearly every family of a child with OCD ends up accommodating it. Answering the same question for the tenth time, rewashing a clean shirt, saying goodnight in exactly the right words. Every parent does this, out of love. The trouble is that accommodation works exactly like a compulsion: relief right now, a stronger OCD next week.

In parent sessions we map what the family is doing for the OCD, pick one or two accommodations to pull back first, and plan how to say it warmly: "I can see this feels awful. I'm not going to answer that one, and I know you can handle this feeling." Your child hears the plan in advance, so nothing feels like an ambush. More on this in our page on parent coaching for an anxious child.

Does ERP for OCD work over video?

Yes, and for OCD the home setting is often an advantage. OCD's triggers live at home: the bathroom sink, the light switch, the backpack that has to be packed a certain way. In an office we can only talk about those things. By video, exposures happen in the real room, with a parent nearby learning how to coach the next one after the session ends. Published research on video-delivered ERP for young people is encouraging, and I have been doing telehealth since I helped launch the telehealth mental health program at Children's Wisconsin.

What if OCD symptoms started suddenly, after strep or another infection?

If obsessions, compulsions, tics, or severe food restriction appeared abruptly, over days rather than months, and especially after strep throat or another infection, call your pediatrician first. Sudden onset like that is a medical question before it is a psychological one; some children are evaluated for conditions called PANS or PANDAS. Our teen mental health guide explains how clinicians sort this out.

How long does OCD therapy take?

For severe anxiety and OCD, six to twelve months of treatment is typical. Milder or more focused OCD can move faster. Sessions space out as your child starts running exposures on their own; the goal is a kid who can handle OCD without us.

Who treats OCD at Little Dove Psychology?

Dr. Donald Caudle, PhD, a clinical neuropsychologist on our team, treats OCD in children, teens, and young adults, along with anxiety disorders, PTSD, ADHD, and depression. On the free consultation Dr. Kroll matches your family with the clinician whose training, schedule, and insurance fit.

How it works at Little Dove

1. A free 15-minute consultation with Dr. Kroll. Dr. Kristin Kroll, PhD, the founder, speaks with every family herself. She will ask what the rituals look like and how much of the day they take. Then she matches you with the clinician who fits.
2. A benefits check. Read us the plan name on your card and we verify your benefits and give you the expected cost before anything is scheduled. Our clinicians are in network with Aetna, Blue Cross Blue Shield of Texas, and Optum/UnitedHealthcare (including Oscar plans administered by Optum), and we match you with a clinician your plan covers. We do not accept Medicaid or CHIP. Self-pay is $225 a session with a licensed psychologist or $150 with a licensed psychological associate, with superbills and HSA/FSA accepted. See Fees & Insurance.
3. A start within days. Five days on average from first contact to first appointment; most families start the same week.
4. 60-minute virtual sessions. Secure video with evening and weekend times, for families located anywhere in Texas or the other PSYPACT participating states during the session.
5. Measures every four weeks. Brief validated questionnaires at intake and every four weeks after, reviewed with you. How we measure progress.

Frequently asked questions about OCD therapy for kids and teens

What is the best therapy for a child with OCD?

Cognitive behavioral therapy with exposure and response prevention (ERP) has the strongest evidence for OCD in children and teens. The child gradually faces what triggers the obsession and practices not doing the compulsion, while parents learn to reduce accommodation at home.

Can my child do ERP therapy for OCD online in Texas?

Yes. Little Dove Psychology provides OCD therapy by secure video to children, teens, and college students anywhere in Texas and the other PSYPACT participating states. Exposures happen in the real places at home where OCD shows up.

Do you take insurance for OCD therapy?

Yes. Our clinicians are in network with Aetna, Blue Cross Blue Shield of Texas, and Optum/UnitedHealthcare (including Oscar plans administered by Optum), and we match you with a clinician your plan covers on the free consultation. We do not accept Medicaid or CHIP. Self-pay families can use a superbill for out-of-network reimbursement.

What ages do you treat for OCD?

We treat OCD in children, teens, and college students, and in adults as well. Younger kids get more parent coaching and playful exposure ladders; teens and young adults get more direct skill-building.

How long does OCD therapy take for a child?

For severe anxiety and OCD, six to twelve months of treatment is typical, and milder OCD can move faster. Sessions are 60 minutes, weekly at first, and space out as your child runs exposures independently.

Should I stop reassuring my child with OCD?

Gradually, and with a plan. Reassurance and other accommodations bring short-term relief but strengthen OCD over time. In parent sessions we choose which accommodations to reduce first and practice responding with warmth and confidence instead.

Can therapy treat OCD that started suddenly after strep (PANDAS)?

Sudden OCD symptoms after strep or another infection are a medical question first, so start with your pediatrician, who may evaluate for PANS or PANDAS. ERP can help alongside medical care.

Dr. Kristin Kroll, PhD is a licensed psychologist and the founder of Little Dove Psychology, a virtual group practice based in Austin, Texas (Little Dove Consulting PLLC). Her clinical background includes pediatric hospital settings at Children's Wisconsin and an academic appointment at the Medical College of Wisconsin, and she is the author of Pediatric Psychology in Clinical Practice (Cambridge University Press, 2020). Patterns described on this page are general clinical patterns, not specific cases. This page is general information, not advice about your child. In a crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911.