Reducing frightening thoughts is only part of what treatment for childhood anxiety and OCD is for. Getting back to ordinary life matters just as much.
A study by Sperling and colleagues examined this directly. It followed 212 children and adolescents aged 8 to 19 through an intensive, group-based outpatient CBT program at an academic hospital, delivered with family involvement. Rather than counting symptoms alone, the researchers asked whether young people were resuming daily activities: school, friendships, family routines.
Both children and parents reported significant improvement in day-to-day functioning between admission and discharge. Symptoms were tracked as well. Anxiety symptoms decreased significantly according to both children and parents, and the children also reported fewer symptoms of depression.
These two kinds of change do not always move together. A child can still notice anxious thoughts and yet sit an exam, catch the bus, or come to dinner. That shift deserves measuring in its own right rather than being treated as a by-product of symptom reduction. The study suggests short-term intensive group treatment can support that return to routine, and reasonably quickly.
If anxiety or OCD is limiting what your child can do, a psychologist experienced in these conditions can help.
OCD (obsessive-compulsive disorder) involves intrusive, unwanted thoughts (obsessions) paired with repetitive behaviours or mental rituals (compulsions) done to reduce the distress those thoughts cause. The standard first-line treatment is cognitive-behavioural therapy (CBT), often using a specific technique called exposure and response prevention (ERP), where a person gradually faces feared situations while resisting the urge to perform compulsions. Most outcome research asks a fairly narrow question: did symptoms go down, or did the person reach 'remission' (a state where they no longer meet criteria for the disorder)? Sperling et al. wanted to ask a broader question instead: did treatment help children actually resume their normal daily lives — school, friendships, family routines — regardless of whether every symptom disappeared.
What the study did
The study involved 212 children and adolescents aged 8–19 who were being treated for anxiety disorders and/or OCD. All were patients in an intensive outpatient group-based CBT program at an academic hospital, meaning they attended a concentrated, short-term program (rather than once-weekly sessions over many months) that involved both group therapy and family participation. Researchers compared functioning — how well children were managing everyday activities — at the start of treatment (admission) with functioning at the end (discharge). They also tracked anxiety symptoms and, for comparison, depression symptoms, since anxiety and depression frequently co-occur (this co-occurrence is called comorbidity).
What it found
By discharge, both the children themselves and their parents reported significant improvements in daily functioning compared to admission. Anxiety symptoms also dropped significantly, according to both child and parent reports. Children additionally reported reductions in their co-occurring depression symptoms. In other words, the intensive program was associated with young people functioning better in daily life, not just reporting fewer anxious thoughts.
Why it matters
The reasoning behind this study is worth sitting with: pushing through fear-provoking situations is, by design, uncomfortable, and doing exposure work can sometimes mean a child's *symptoms* look unchanged or even briefly worse while they're actively practising bravery. If researchers only measured symptom counts, they might miss real progress happening underneath — a child eating at a friend's house despite lingering worry, for instance. By deliberately measuring functioning as its own outcome, this study captures gains that a symptom checklist alone could overlook, and suggests that a short, intensive, family-involved CBT format can produce meaningful real-world change in a relatively compressed timeframe.
Its limits
The abstract doesn't describe a comparison or control group, so we can't be certain the improvements were caused specifically by the treatment's intensity or format rather than by time passing, by regression to the mean, or by other factors. There's also no mention of longer-term follow-up, so it's unclear whether these gains in functioning were maintained after discharge. And because participants were drawn from one hospital-based intensive program, findings may not generalise to every treatment setting, such as standard weekly outpatient therapy.
Still, the core message is a reassuring one: getting back to ordinary life doesn't have to wait until every anxious thought is gone. If OCD or anxiety is getting in the way of your child's daily life, reaching out to a psychologist who works with these conditions is a solid first step.