The AACAP's practice parameters for OCD recommends cognitive behavioral therapy, and more specifically ERP, as first line treatment for youth with mild to moderate severity OCD and combination psychotherapy and pharmacotherapy for severe OCD.
According to the AACAP's guidelines on OCD, cognitive-behavioral therapy, specifically exposure and response prevention (ERP), is recommended as an initial treatment for youth with mild to moderate OCD. For more severe cases, a combination of psychotherapy and pharmacotherapy is advised.