Red flags & when to go in person for Obsessive-Compulsive Disorder (OCD) - Mild to Moderate

Audience: pediatric

Obsessive-Compulsive Disorder (OCD) is a condition where children may have repeated thoughts and behaviors they feel they must do. Mild to moderate OCD can often be managed with support from healthcare providers, including through telemedicine visits. However, some signs mean an in-person visit is important. These include when symptoms suddenly get worse, when the child has trouble doing daily activities like school or self-care, or if they have thoughts about hurting themselves. Telemedicine can help with education, monitoring symptoms, and guiding treatment plans, but it cannot replace hands-on evaluations or emergency care. Parents and caregivers should watch for warning signs and seek in-person help if needed. This guide explains when to use telemedicine and when to see a healthcare provider in person for a child with mild to moderate OCD.

Red flags — go in person / ER

• Sudden worsening of OCD symptoms interfering with daily life — seek in-person evaluation promptly.
• Thoughts of self-harm or harm to others — go to emergency care or urgent in-person visit immediately.
• Physical injury from compulsive behaviors (e.g., skin damage from excessive washing) — arrange in-person medical assessment.

What telemedicine can do

• Providing education about OCD symptoms and management.
• Monitoring symptom changes and treatment response.
• Adjusting medications for mild to moderate symptoms.
• Supporting families with coping strategies and therapy guidance.

What telemedicine cannot do

• Emergency situations such as suicidal thoughts or severe self-harm risk.
• Severe worsening of symptoms needing physical examination.
• Diagnosing new or complex mental health conditions requiring in-person assessment.
• Managing physical complications from OCD behaviors that require hands-on care.

What is Mild to Moderate OCD in Children?

Obsessive-Compulsive Disorder (OCD) causes children to have unwanted, repeated thoughts (obsessions) and actions (compulsions) they feel they must perform. Mild to moderate OCD means these symptoms happen often but do not completely stop the child from doing daily activities. Children may wash hands repeatedly, check things many times, or have strict routines. These behaviors can cause stress but may be managed with help from healthcare providers.

When Telemedicine Can Help

Telemedicine visits allow families to talk with healthcare providers about OCD symptoms without going to a clinic. Providers can offer education about OCD, suggest coping strategies, and adjust treatment plans. Telemedicine is useful for regular check-ins, medication management, and supporting families in managing symptoms at home. It can help reduce travel and wait times, making care more accessible.

Red Flags That Need In-Person Care

Sometimes OCD symptoms get worse or cause serious problems. It is important to see a healthcare provider in person if your child:

In-person visits allow for thorough evaluation and urgent treatment if needed.

Preparing for a Telemedicine Visit

Before a telemedicine visit for OCD, prepare by:

After the Telemedicine Visit: What to Do Next

After the telemedicine visit, follow the provider's advice carefully. This may include:

Keep communication open with your healthcare team to support your child's progress.

How to prepare for your tele-visit

• List your child's OCD symptoms and when they occur.
• Note any recent changes in behavior or mood.
• Prepare a list of current medications and dosages.
• Find a quiet, private space for the telemedicine visit.
• Ensure your device has a stable internet connection.
• Have a trusted adult available to assist during the visit if needed.

After your tele-visit

• Follow the healthcare provider's instructions on medication and therapy.
• Practice recommended coping skills and exercises regularly.
• Schedule and attend follow-up appointments as advised.
• Monitor your child's symptoms and mood closely.
• Seek in-person care promptly if any red flags or emergencies arise.

FAQs

Can telemedicine diagnose OCD in children?

Telemedicine can help healthcare providers understand symptoms and suggest if OCD is likely, but a full diagnosis often requires an in-person evaluation to observe behaviors and rule out other conditions.

Is it safe to manage mild to moderate OCD through telemedicine?

Yes, many children with mild to moderate OCD can be safely supported through telemedicine for education, monitoring, and treatment adjustments, provided there are no urgent warning signs.

When should I take my child to see a doctor in person?

If your child's OCD symptoms suddenly worsen, interfere with daily life, or if they have thoughts of self-harm, you should seek in-person medical care promptly.

Can therapy be done through telemedicine for OCD?

Yes, many therapy types, including cognitive-behavioral therapy (CBT), can be effectively delivered through telemedicine to help children manage OCD symptoms.

What should I do if my child refuses telemedicine visits?

If your child is uncomfortable with telemedicine, discuss this with your healthcare provider. They may suggest in-person visits or ways to make virtual visits easier for your child.

Sources

1. Obsessive-Compulsive Disorder — MedlinePlus, U.S. National Library of Medicine.
2. Obsessive-Compulsive Disorder (OCD) in Children and Teens — American Academy of Child & Adolescent Psychiatry (AACAP).
3. Obsessive-Compulsive Disorder (OCD) — Centers for Disease Control and Prevention (CDC).
4. Obsessive-Compulsive Disorder (OCD) - Symptoms and Causes — Mayo Clinic.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you have concerns about your child's health or safety, please seek immediate in-person evaluation from a healthcare professional.