Cognitive-behavioral therapy (CBT) is a form of psychotherapy with proven efficacy for OCD treatment in adult populations (see Franklin & Foa, 2002 for a review). More recently, several open (Benazon, Ager, & Rosenberg, 2002; March, Mulle, & Herbel, 1994; Piacentini, Bergman, Jacobs, McCracken, & Kretchman, 2002) and one controlled trial (de Haan, Hoogduin, Buitelaar, & Keijsers, 1998) have supported the effectiveness of this approach with children and adolescents diagnosed with OCD. Cognitive-behavioral therapy for adult and pediatric OCD can be broken down into two general components. First, in exposure and response prevention (ERP), patients are gradually exposed to anxiety-provoking stimuli while refraining from engaging in compulsive behaviors or rituals (Meyer, 1966). The extended exposure to anxiety-provoking stimuli causes anxiety to habituate and provides objective data that contradicts inaccurate expectations of harm and responsibility (Foa & Kozac, 1996). Second, cognitive therapy teaches the patient to identify and correct anxiety-provoking cognitions that often motivate compulsive behaviors. Objective, realistic cognitions that are not linked to obsessive-compulsive anxiety will result in reduced needs to perform compulsive acts.