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Childhood OCD can present in a number of ways, including the need for elaborate bedtime rituals. These rituals may include repeating certain actions or words, checking and rechecking that things are done properly, or taking an excessive amount of time to complete tasks, asking parents multiple questions over and over, and needing items in certain ways. Sometimes these behaviors can be normal childhood routines, however, if these behaviors occur nightly, cause significant distress, and seem compulsive or excessive, it may be a sign of childhood OCD.

At GroundWork Counseling, often, parents will discuss a nighttime routine that they describe as “never ending”, “exhausting” and distressing. Often nighttime routines associated with OCD can begin as benign requests or routines that begin to grow in length, repetitions and severity until they become exhausting for the entire family. It is important to remember that these behaviors are not intentional or manipulative, and often can be overwhelming and distressing for children.

Common OCD Nighttime Rituals in Children:

  • Children confessing to parents over and over
  • Behaviors that must be done in a certain order, or must be restarted
  • Demanding parents respond in a certain way (the same exact phrases must be said each night)
  • Children seeking reassurance about health related concerns at nighttime (this can be accompanied by fears of death, vomiting, etc)
  • Redoing actions over and over
  • Doing things a certain number of times (good and bad numbers)
  • Sensory issues (needing to change pajamas multiple times, blankets or not feeling “right”
  • Rituals/Actions that must be performed in order to insure safety or self or parents
  • Peeing repetitively (feeling their bladder is never empty enough)

If your child is exhibiting ritualistic behaviors at nighttime, it may be a sign that he/she has could be struggling with OCD. The good news is, with the right help and support OCD is a treatable and manageable disorder; often without the need of pharmaceuticals. Early intervention and evidence-based therapy with a pediatric OCD specialist can help families find effective ways of supporting their child and systematically stopping nighttime compulsive behaviors. At GroundWork Counseling, our pediatric OCD specialist provides a two prong approach to working with children with nighttime rituals related to Obsessive Compulsive Disorder (OCD).

Our Evidence-based approach for childhood nighttime rituals related to OCD:

  1. Evaluation – At the time of initial evaluation, our OCD specialist works to identify your child’s unique fears, compulsions, and symptoms. An OCD diagnosis would be confirmed via evaluations and interviews prior to beginning Treatment for Anxiety & OCD”>ERP therapy.
  2. Working with your child – Our first step is to help your child understand their OCD and the fears behind their rituals. We work with both children and families to create a personalized exposure and response prevention (ERP) plan that addresses your child’s specific fears and compulsions. ERP will help them gain a sense of mastery over their OCD and relearn a new healthy bedtime routine that is not driven by their fears.
  3. Supporting the family & parent training – We believe in creating an individualized treatment approach that also includes parent training and family education to ensure the long-term success of your child’s treatment and how you can support your child as they engage in exposure therapy. We support parents by reviewing family accommodations, and implanting change in parenting approaches that change the relationship between parents and their child’s compulsive demands.

Our Approach

Our trained and experienced pediatric OCD therapists at GroundWork Counseling are here to support, educate and guide families and children struggling with nighttime rituals and OCD. We believe in providing a supportive, and non-judgmental environment that encourages children to learn the skills they need to change and manage their OCD. With the right help and support, children can have happy and peaceful nights without compulsive behaviors or rituals.

At GroundWork, we provide pediatric OCD therapy to all families residing in Florida. Our therapist work with children ages 9+, however, for those families with younger children, we provide parenting support and guidance so that these behaviors can be addressed effectively even for young children via ERP techniques taught to parents.

If you’re seeking OCD therapy for your child; we suggest using this guideline when selecting a therapist to gauge their training, and expertise, as only 1% of mental health providers in the country have the appropriate ERP training to provide children and families the appropriate, evidence-based care needed to treat the complexity of OCD.

If you suspect your child may be struggling with nighttime rituals associated with OCD; we’re here to help your family overcome this difficult challenge, and help you return to a functional bedtime routine that feels calm once again.

Schedule With An Child OCD Therapist  


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Contact Us & Location
GroundWork Cognitive Behavioral Therapy
341 N Maitland Ave #330
Maitland, FL 32751


411 Congress St #3292
Portland, ME 04101

Burlington, VT 05043

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Virtual / Telehealth appointments available for individuals residing in: Florida, Maine, Vermont, South Carolina & Montana

In-person appointments available in Central Florida. By appointment only.

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