Example Of A Family Contract

One exercise that many cognitive behavior therapists use in treating OCD is the family contract.  The purpose of this contract is to develop a plan for helping you and your family members stop accommodating your loved ones OCD.   The therapist may have a sample form or blank template you can use to create your family contract.

An Example of a Family Contract

The Situation: Dad has OCD and  his obsessions involve safety issues.  In response to these obsessions, Dad engages in a number of safety rituals for several hours each morning before he goes to work.  These include checking to make sure all the doors and windows are locked and that the kitchen stove burners and all other appliances are off.  But he can’t leave the house to go to work until he has also questioned each family member multiple times about whether they have checked to make sure doors and windows are locked and the kitchen stove burners and all appliances are indeed turned off.
The Problem: Family members repeatedly reassure Dad that they have checked the door and window locks as well as the stove burners and appliance throughout the house.  They even show him how they are checking the doors and windows, the stove burners and appliances.  This behavior makes Dad feel better, but only for the short-term.
The Goal: Everyone in the family wants Dad to stop the incessant checking behavior, and they all want to stop having to help him do it.
The Plan: Over the course of the next several weeks, the family will gradually decrease the number of times they check and reassure him about doors and windows being locked and burners and appliances being off.   They will also change the way they interact with Dad -- in terms of both their actions and dialogue.   Dad will accept this course of action even though his anxiety over safety fears will increase temporarily.
The Contract: The cognitive behavior therapist who treats the person with OCD helps the family develop a written document that includes their specific goals as well as detailed strategies for achieving those goals: how much to decrease participation in Dad’s rituals at each point along a specific timeline.  The therapist also helps family members develop special wording to use (i.e., what to say) when Dad asks for reassurance to decrease his reassurance-seeking behavior and defuse his repeated questioning.  During his Cognitive Behavior Therapy sessions, Dad agrees to perform his exposure and response prevention (ERP) assignments (given by the therapist) at home within the timeline.  Dad also understands that the reductions in family reassurances are a part of his ERP therapy.   
The Review Together with Dad’s therapist, the family monitors progress. Any necessary adjustments to the contract timeline, goals or strategies being implemented are made so that everyone can be successful.
The Reward The family agrees to periodic rewards for successfully following the contract.  They decide to go out to dinner or a movie at the end of each week in which they are successful in completing the goal for the week’s contract.

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