Helping Professionals Series: A San Diego Child Psychologist shares about working with OCD.
Dr. Willa Marquis, PSY30756
San Diego Child Psychologist & OCD Treatment Specialist
I was so excited to have interviewed Dr. Willa Marquis, a San Diego OCD Treatment specialist to share her expertise in the diagnosis and treatment of OCD.
Dr. Willa Marquis is a licensed clinical psychologist who specializes in child and adolescent anxiety and OCD treatment. She completed her doctorate in Clinical Psychology at UCLA and postdoctoral training at the UCSD School of Medicine/Rady Children's Hospital. Dr. Marquis and her team provide evidence-based care to children, teens, and adults with anxiety and OCD through her practice, Marquis Child Psychology, in San Diego, CA.
When Dr. Marquis moved to San Diego, she provided consultation to other therapists through the Rady Children’s Anxiety and OCD Clinic and later served as a Clinical Supervisor at Rogers Behavioral Health. In early 2020, she opened her private practice specializing in OCD and anxiety therapy for children and teens.
Learn more about Dr. Marquis from our interview below!
Who are your favorite types of clients to work with?
Probably no surprise here, but I am very passionate about working with children with OCD. I find that many children with OCD are empathic, sensitive children, who often view their sensitivity as a bad thing because it can make them feel their emotions really intensely.
One of my favorite parts of therapy is for children to learn that there are many amazing sides to their sensitivity. Once they become more confident in their ability to face their fears, they may recognize this sensitivity as a part of what makes them a loyal friend, a creative artist, a passionate student, or whoever they might be apart from the OCD!
Why did you choose OCD as one of your specialties?
My first experience with treating OCD was over 10 years ago during my graduate training at UCLA, at the UCLA Child OCD Intensive Treatment Program. In my first few weeks, I remember being struck by the creativity involved in treating OCD, and also by the profound ways therapy was changing lives for children and their parents.
I saw many children who had been unable to engage in daily life activities like school and self-care, had felt isolated from family and friends, and had felt hopeless that this fear would never fade go on to feel so empowered and connected when graduating from therapy. It’s also just a really fun, active therapy, especially with kids and teens!
What do you wish parents and caretakers knew about childhood OCD?
Many caregivers of children with OCD struggle with either OCD or anxiety themselves, and I’ve had many caregivers share with me that they feel responsible – either through their genes or through their parenting - for the suffering their children are experiencing.
I wish these caregivers knew that not only is this not their fault, but they can in fact be a huge asset to their children’s healing, walking alongside and understanding them in a way that many caregivers wouldn’t be able to! I also can’t emphasize enough the gift these caregivers are giving their kids by bringing them to treatment early. Developing a new approach towards OCD from a young age can set children on a very different path.
What happens during a first appointment with you?
My first appointment is primarily about gathering information so that we can collaborate to create a treatment plan together. I usually encourage both caregivers and kids to be present, and I spend some time with kids, some time with caregivers, and some time all together.
The last 5 minutes of my first (and every!) session with kids is called Choice Time, where they get to decide what we do. Sometimes it’s a game, sometimes we draw, and sometimes they share a new favorite song they’re loving these days. I know that therapy isn’t always easy, and Choice Time is a great time for us to have fun and connect.
Could you share how you work with children struggling with OCD?
When I’m working with a child with OCD, the main tool that I use is an evidence-based treatment called Exposure and Response Prevention (ERP) Therapy. OCD works in a cycle that involves a scary or uncomfortable thought, which leads to anxiety, and ultimately to some sort of action (i.e., compulsion) that makes the worry go away…but only temporarily. With ERP, we use real-life practice to support a child in gradually facing their fears without doing the behavior.
Many kids tell me that they know their fear doesn’t make sense, but that no matter what anyone tells them, the feeling is so intense that it isn’t worth the risk. With real-life practice, they’re able to truly learn and become confident that the thing they were afraid of either won’t happen or won’t be as bad as they thought it would be, and that they were much more able to handle hard feelings than they thought they would be.
At the same time, a large part of my approach is working directly with parents and caregivers. I may be with the children one hour per week, but the caregivers are with them the rest of the time! Many parents tell me that they have tried many approaches and know they’re not working, but they’re feeling really stuck in how to best support their children.
I use therapy approaches like SPACE (Supportive Parenting for Anxious Childhood Emotions) to help guide parents in walking that line between supporting their children while also giving them independence to develop skills and confidence in managing anxiety on their own.
How can a child’s OCD impact the entire family?
Many caregivers tell me that they feel like they’re walking on eggshells around their children, and that a lot of time and energy is spent by everyone in the family to avoid triggering a child’s OCD. A parent might be spending hours engaged in an elaborate bedtime routine with their child’s OCD, or they may be interrupting their workday to answer calls or do school pick-ups because of OCD fears.
Siblings may be a target of OCD fears, making family outings, family vacations, or movie nights at home times of stress and sadness rather than fun and bonding. One of the first steps in our treatment is to identify all the ways OCD is making life hard for a child and their family, and to band together as a team against OCD!
What resources do you recommend for families who would like to learn more about OCD?
The International OCD Foundation (IOCDF) is a great resource for information about OCD, and there are many conferences and events through the IOCDF for children with OCD and their families. Natasha Daniels, LCSW has a great YouTube channel with videos for parents and kids about anxiety and OCD.
Parents can learn more about helpful parenting techniques within anxiety and OCD in the book Breaking Free of Child Anxiety and OCD by Dr. Eli Lebowitz.
What tips do you have for parents and caretakers with children struggling with OCD, who also have other children at home?
I would encourage caregivers to keep in mind that a child with OCD doesn’t need a parent who is anxiety-free - they need a parent who is modeling that they can feel worried or scared and still gradually face their fears to live the life they want.
Furthermore, I would encourage caregivers to be patient with themselves and their children and to recognize that the process of building this new approach to anxiety and fears will take time, but will ultimately lead to a more united family.
Is there anything else you would like to share about providing OCD treatment for children?
Many parents of children with OCD worry that their child will feel ashamed, or feel that something is wrong with them, if they receive the label of an OCD diagnosis. On the contrary, I have seen many children feel a lot of comforted learning that they’re not alone, and having some understanding about these tricky and scary thoughts in their minds. The diagnosis can in and of itself be a relief to kids and teens with OCD (see my blog post on diagnosing OCD for more about this).
Share one fun fact about you that most people don’t know.
I am from New Orleans, and though I’m far from home, I still love cooking jambalaya and red beans and rice.
What’s one of your favorite things to do in San Diego?
I love walking with a beautiful view, particularly Cabrillo National Monument and Sunset Cliffs.
How can people contact you to learn more about your services for OCD treatment in San Diego?
Interested families are welcome to submit an inquiry form on my practice website.