An analysis of response prevention and flooding procedures in the treatment of adolescent obsessive compulsive disorder.

Flooding and response prevention have been widely used in the treatment of adult obsessive compulsive disorder but have been overlooked in favor of less restrictive procedures when treating children. The present case investigates the utility of these procedures in an adolescent with severe compulsive handwashing. Treatments were introduced hierarchically to minimize subject distress; graded exposure decreased the frequency of handwashing, but flooding was required to eliminate the compulsion. Guidelines for the ethical use of flooding and exposure therapies with children are offered.