Distressing, intrusive thoughts, images, or impulses and repetitive mental or behavioral rituals aimed to reduce distress are the hallmark of adult and pediatric obsessive-compulsive disorder (OCD). Epidemiological studies suggest a prevalence rate of between 1 to 4% in children and adolescents (Douglass, Moffitt, Dar, McGee, & Silva, 1995; Flament, Whitaker, Rapoport, & Davies, 1988; Zohar, 1999). If untreated, OCD is related to significant social, academic, and familial impairment (Koran, Thienemann, & Davenport, 1996; Piacentini et al., 2003).