Family Therapy for OCD: How can SPACE Treatment Help?
Like many disorders, OCD doesn’t just impact the person diagnosed, but the whole family too. It can be a challenge for parents to balance being involved without unintentionally growing their child's symptoms. Sometimes parent-focused skills are needed alongside a child’s individual treatment. If you are a parent of a child with OCD, SPACE treatment may be a missing piece in their journey towards recovery.
What is SPACE?
SPACE, Supportive Parenting for Anxious Childhood Emotions, is a treatment model created by Dr. Eli Lebowitz. This treatment differs from individual therapy as it targets parent behaviors. The aim is to create more collaboration and support between parent and child. A main emphasis is in reducing accommodation behaviors often seen in OCD. A therapist trained in SPACE treatment will be able to get an idea of family dynamics and provide tools for healthier family interactions. Though the focus is still on the child, they don’t typically need to be present. Sessions are mainly with parents.
Who is SPACE for?
SPACE is for children and teens with anxiety and OCD. Some of the diagnoses that can improve from this treatment are generalized anxiety disorder, panic disorder, social anxiety disorder, and obsessive-compulsive disorder. It can also be helpful for those with specific phobias. Kids and teens with school refusal or separation anxiety can also benefit from SPACE.
Sometimes children and adolescents may need more support than what is provided by individual therapy. Their anxiety may not decrease through targeting their symptoms alone. Children who are not seeing improvement may be engaging in compulsions, avoidance, or reassurance-seeking at home that involves the family. SPACE can be useful in creating communication and boundaries, especially if your child is struggling to make progress in their current treatment.
Why are parent-skills important for OCD
Working with you, as parents, can indirectly improve your child’s OCD symptoms. This is not to say you are at fault or to blame for their disorder. All it means is there are certain tools and strategies that you can use that are proven to help them. Unlike getting your child on the right path in other areas of life, you likely don’t have a handbook on how to manage their anxiety or OCD. The instinct that most parents have is to take their child out of situations that cause distress. If your child asks for something and you know it reduces their anxiety, you are more likely to give it to them. This all comes from a place of love and best intentions. The tough part is, these behaviors maintain your child’s anxiety in the long run, even though it reduces it in the moment.
Pulling back on these kinds of behaviors is a tricky thing. You might have a lot of conversations with your child or teen where anxiety is involved. Maybe you allow them to avoid things they are scared of without realizing it. If you have tried putting a pause on these behaviors before, you might have been met with resistance. Seeing your child struggle without the help you give them is so hard, which understandably leads to a cycle of accommodation. They feel anxious, they ask you a question, you reassure them, and they feel better. Getting out of this cycle is where SPACE treatment can come in.
What does treatment with SPACE look like?
Initially, a therapist trained in SPACE will explain to you how anxiety works, especially in children and teens. Depending on the disorder, your child’s thoughts and behaviors will be different, but the anxiety process is similar. They will share the role parents take on and how your boundaries can be crossed if your child is asking a lot from you. This is where you will have space to share the ways your life is impacted by your child’s anxiety. Maybe you want your child to have more independence but are unsure how to separate yourself from them. The following are two core features of SPACE that can help with this.
More Support
Support can mean something different to each family. The ways that you show it or talk to your child can vary. An important first step is noticing the language you use when talking to or about your child. Maybe you have a hard time understanding their fears and say things like, “it doesn’t make sense for you to be scared of this”. Reframing this as “I know this is scary, but you can get through this” is a more supportive statement. When talking about your child in session, you may feel that they can’t function without your help. Reframing this belief into something like: “my role is to guide and support them, but there are things they can handle on their own” may be more helpful.
Reflecting on ways to reframe statements can be an important part of treatment. Discussing things you have said to your child and the kind of reaction they had can give both you and the therapists an idea for next steps. Between sessions, you may practice talking to your child in a way that makes them feel understood. Altering how you speak to your child or teen when they’re struggling is one way to make them feel more supported.
Less Accommodation
A critical reason why more support is necessary is because you’ll also be working on reducing accommodation. Your therapist will explain what that looks like. Although accommodating a child is something almost all parents do, it can become an issue when it is time-consuming and interferes with family life. Figuring out which things are normal to help with versus things that have become overtaken by their anxiety can be useful. Some examples of accommodation might be: letting them stay home if they fear being away from you, washing or wiping things down, answering questions in a way that eases anxiety, or excessive help with school or activities.
You might be tasked with making a list of how often accommodation behaviors occur during the day. This will allow you and the therapist to collaborate and decide which behavior to start limiting. This might be a behavior that is challenging to maintain. Or it could be something that relates to a goal you have for your child. In any case, breaking things into manageable steps is helpful.
You and Your Child Working as a Team
Between sessions, you will be using the tools from therapy as you interact with your child. You and the therapist will come up with a plan of action. Making sure your child knows about this plan is critical. You will be guided through the best way to share the changes that will happen, either in conversation or in writing. It may be a brief statement that has supportive words, is firm about your commitment to changes, and encourages them that you will get through this together.
As resistance or tough emotions may be a part of this process, SPACE treatment is designed to help you through this. You and the therapist can make updates to the plan as challenges come up. Limiting accommodation and increasing support can be a work in progress; there will be ups and downs. As you and your child get into a rhythm of new ways to approach anxiety together, positive changes may happen more often. As a parent, consistency is one of the most important things you can bring to the process. Following through with the treatment plan is proven to help children thrive.
How can SPACE help OCD?
SPACE treatment is an effective, evidence-based method to help kids and teens. It can be as impactful as individual therapy for managing OCD and anxiety disorders. By working with parents directly, therapists can get a picture of how the family is involved. They can help you create a plan that will help your child succeed while taking some pressure off of you as well.
The skills learned in SPACE treatment can create healthier boundaries between family members. It can help you get your child on a path towards greater independence. SPACE can bridge the gap between what your child is doing in individual treatment and the extra support they may need at home.
SPACE Treatment at Resilience Counseling San Diego
At Resilience Counseling, our team of OCD therapists specialize in treating OCD and anxiety. We understand how tough it can be to balance being there for your child and pulling back on accommodation. Not only do we help kids and teens, but we work with families as well. Providing support and creating plans with parents is something that helps our clients thrive. We use SPACE treatment to guide parents and caregivers in creating lasting change for both their child and themselves.
Our treatment has a foundation of compassion and collaboration. At Resilience Counseling we use evidence-based strategies like ERP, SPACE and CBT when working with individuals who have OCD and anxiety disorders. Our goal is to make an impact beyond just reducing symptoms. Whether that’s helping families have healthier interactions or getting a child on a path to recovery, we meet you where you are at. To learn more about how we can help your family, schedule a free consultation today.
Resilience Counseling: Katherine Pica OCD Therapist - San Diego, CA
Katherine Pica clinical director and owner of Resilience Counseling. She supervises all the therapists at Resilience Counseling. She has been practicing since 2007 for over 18 years! Trained in ERP for OCD and EMDR for Trauma. Katherine brings years of experience to the OCD therapist team! Our team is available in San Diego, CA for sessions in person and all over California for virtual therapy.
SPACE & OCD Therapy
San Diego, CA
Disclaimer : The Content is not intended to be a substitute for professional and or medical advice, diagnosis, and or treatment. It is important to always seek the advice of your physician or other qualified health provider with any questions you may have regarding a mental health and/or medical condition. Never disregard any professional medical advice or delay in seeking it because of something you have read on the Resilience Counseling website. If you think you may have a medical emergency, call your doctor or 911 or local emergency number immediately.
