Question: My son, age 15, was diagnosed with OCD about 2 years ago. He also has been diagnosed with depression. A few months ago, he had a psychotic episode and was hospitalized briefly. He takes Risperdol and Zoloft. His mood is much improved and some of the obvious OCD symptoms are under control. However, he still has a big problem: he steals (always small stuff that he can well afford). Is this an OCD symptom or something unrelated? What can be done?
Answer 1: I have worked with several other children who have “stealing” behavior which in process resembles a hoarding behavior (very strong urge- feels like would be impossible to resist). Provided that a child feels remorse for the behavior, and wants to prevent it from happening again, then treating it as a compulsion where boss back strategies and ritual prevention practice are used, should be effective. As with other OCD symptoms, you tackle the problem hierarchically, exposing to the smallest challenge first, then advancing to the next level. For example a child may do an exposure in a 5 and 10 store first, and then advance to an electronics store where the items are more tempting. During these exposures, (usually with assistance) the child is saying to himself on purpose- “take it!” and then practicing resisting the urge. The coach is nearby to make sure that the exposure is a success. Continued near the bottom of this page.
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Answer 2: The behavior of stealing is very unusual in OCD but could be a compulsion. I would start by asking him why he does it.