Positive Family Interaction Therapy for OCD


At the October 2012 annual meeting of the American Academy of Child and Adolescent Psychiatry, Tara S. Peris, PhD, reported on the preliminary success of PFIT (positive family interaction therapy) when used in conjunction with standard CBT (cognitive-behavioral therapy) for those with a primary diagnosis of treatment-resistant pediatric OCD. Families in the study also had an assessment of poor family functioning. I recommend reading more about this study, which also talks about the criteria used to identify dysfunctional families.

All I can say is, “Yay!” If you’ve been reading my blog for a while, then you probably know I am a big proponent of family involvement in therapy. When children have obsessive-compulsive disorder, it is crucial  that their parents, indeed their whole families, understand the disorder, and learn the proper ways to interact and respond to the OCD sufferer. When Dan first told me he had OCD, I followed my mother’s instincts, and did whatever I could do reduce his anxiety at the time. I had no idea I was enabling him and contributing to the strength of his disorder, because I had little to no understanding of how OCD operates. I needed to become educated. I have no doubt my entire family would have benefited from PFIT.

In regards to the study, I find it interesting that dysfunctional families were singled out, as I think it would be difficult to find a family who isn’t dysfunctional when dealing with severe OCD. I’ve written about how important it is for health professionals to realize they are dealing with families in a weakened state. Not only were my husband and I confused and distressed by what was happening to our son, we were also terrified. It’s hard not to be dysfunctional when your child spends entire days just laying on the floor, doing absolutely nothing.

I think PFIT is definitely a step in the right direction, but I would like to see it made available to all families and loved ones of those who suffer from obsessive-compulsive disorder. While this study does not include children with mild to moderate OCD, or families who are not classified as dysfunctional, I believe every family who has a loved one with OCD could benefit from learning how to deal with the disorder, as well as with each other. It sure couldn’t hurt.

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10 Responses to Positive Family Interaction Therapy for OCD

  1. Jennifer says:

    Thank you for this. For those of us who live with this “beast” daily any positive support we can get is a breath of fresh air. It often seems surreal when you look at what your loved one has to manage on a day to day basis. It is easy for others to judge when they don’t navigate these waters daily, so labelling a family “dysfunctional” is almost a cruel statement. Thank you for your understanding and sharing your thoughts.

  2. ocdtalk says:

    Thank you for your insight, Jennifer, and I think you make an excellent point. I cringe at the word dysfunctional but used it for lack of a better one. But really, most “dysfunctional” families in this situation are actually loving and caring and trying to do the very best they can for their loved one under extremely trying circumstances. They need to be supported and educated, not judged.

  3. 71º & Sunny says:

    Thanks for this great info, Janet. I so agree with you – when OCD is severe, of course the family is in a dysfunctional state! I think the most normally well rounded and well functioning family would be in disarray when a child becomes afflicted with something like OCD.

    Though it was not a specific program in my case, and even though I am an adult, I involved my family in my recovery. I knew it was the only way I would truly get better. Both my husband and my mom have attended multiple therapy sessions with me. They have both read books I recommended, and they have both accompanied me to support group meetings and OCD workshops.

    OCD is such an all encompassing illness that I think it often requires a comprehensive approach to treatment that is support by family and friends. I’m lucky that I have people in my life that were willing to do that for me.

  4. ocdtalk says:

    Thanks for your comment, Sunny. I probably didn’t make it clear enough in the post, but I totally agree that it doesn’t matter if you are a child or not. Everyone with OCD benefits from family involvement; the whole family actually benefits. It breaks my heart when I hear from people who say their families have no interest in learning about OCD or don’t “believe in it.” Can you imagine? It’s hard enough to have the disorder, but then not to have the support of those who supposedly care about you must be devastating.

  5. Tina Barbour says:

    Thank you for sharing this information. I, too, think it would benefit the child with OCD if the whole family is part of the therapeutic program. One person in the family with OCD affects the whole family, and all could benefit from learning more about OCD and understanding how it works.

  6. ocdtalk says:

    You are so right,Tina. OCD affects the whole family! Thanks for commenting.

  7. You mentioned in your articles that you “…and did whatever I could do reduce his anxiety at the time. I had no idea I was enabling him and contributing to the strength of his disorder…”. I am very curious how you could enable him but also contribute to the strength of the OCD?? It seems to me that if you are enabling him would mean that you are giving him the ability to fight OCD and that would be the opposite of strengthing OCD?

    The reason I am curious is that my wife believes at the time when they are most anxious and anxiety ridden that we must do whatever to calm them down.I believe her counselor agrees. My wife and I sometimes disagree on that aspect, I tend to push her to fight her way away from it. I would love your prospective on it plus anyone else.

    Getting the family involved to me is very important, they are getting beat up too by this crippling disorder. I can’t imagine any family with someone with OCD (just about any degree of it or age) does not have disruption and dysfunctional ism in the family. Of course I think that most families no matter what nowadays have some dysfunctional ism in them, the world is too crazy not to.

    Thanks for the great discussion.

  8. ocdtalk says:

    Thank you so much for your comment, Dan. By enabling, I mean accommodating someone with OCD. This article may help clarify this for you:


    An example of enabling would be opening the door for someone who has a fear of germs and is afraid to touch doorknobs.. Basically, you are giving in to the demands of the obsessive-compulsive disorder, and validating the OCD sufferer’s irrational thoughts. This strengthens the OCD. Again, the article above goes into detail. In the case of the doorknob, I believe most therapists would recommend family members saying something like, “I will not open the door for you. That is what your OCD wants, and I will not be a part of it.” Of course, everyone is at a different place in treatment, but that’s the general idea. While this response will initially make the OCD sufferer’s anxiety increase, it is the way to reduce the intensity of the disorder, to take its power away. Hope this helps.

  9. lynne says:

    My 18 year old has ocd and if we don’t accommodate she will just freak out, cry etc until you have no choice except to give in

    • I’m so sorry to hear things are so difficult for your family. You do have a choice though and continuing the way you are now will not help your daughter overcome her OCD. I hope you can connect with a therapist who can help you to stop accommodating your daughter. Good luck!

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