The Big Picture
Some people experience upsetting thoughts that keep returning or feel a strong need to repeat certain actions. When these thoughts and actions interfere with daily life and relationships, they may be part of obsessive–compulsive and related disorders.
A client may repeat an action to relieve stress, even when they find the behaviour upsetting. Stopping can cause extreme stress and anxiety. As a CCA, you can help by listening, offering steady support, noticing repeated behaviours, and following the client’s care plan.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- An obsession is a persistent thought or desire. A compulsion is an uncontrollable urge to perform an action.
- Repeated behaviours can help a client relieve stress. Stopping them may cause intense anxiety.
- Related disorders include hoarding disorder, body dysmorphic disorder, hair pulling, and skin picking.
- Report repeated behaviours you observe to your supervisor.
- Listen without minimizing or arguing about the client’s experiences, and avoid helping behaviours that keep the client away from anxiety-causing situations.
- Follow the care plan, encourage normal activities, and recognize small accomplishments.
Jump to:
Course Notes: Key Ideas You Need to Know
1. Understanding Obsessions, Compulsions, and Anxiety
Obsessive–compulsive and related disorders are mental health disorders involving repeated obsessions and compulsions that interfere with daily activities and relationships.
Three important terms help explain these disorders.
What Is an Obsession?
An obsession is a thought or desire that persists.
An obsession may involve violent thoughts and is usually disturbing to the person. A person may try to ignore them or manage them by performing the same action repeatedly.
Examples of obsessions include:
- Fearing that one’s thoughts will cause harm to someone.
- Repeatedly thinking about or being preoccupied with hurting another person.
Key fact: An obsession involves a persistent thought or desire.
What Is a Compulsion?
A compulsion is an uncontrollable urge to perform an action.
A person may feel driven to repeat certain behaviours to relieve stress. The person may be unable to stop without experiencing extreme stress and anxiety.
Common compulsions include:
- Repeated washing or cleaning: Washing hands, bathing, or cleaning household items over and over.
- Repeated checking: Checking several times each day whether the stove is off or the windows are locked.
- Repeating words or sounds: Repeating a name, phrase, or tune.
- Behaviours involving possessions: Being preoccupied with throwing away items of little value or, at the opposite extreme, excessive hoarding.
Key difference: An obsession involves a persistent thought or desire. A compulsion involves an uncontrollable urge to act.
What Is Anxiety?
Anxiety is a vague, uneasy feeling that occurs in response to stress.
For clients with obsessive–compulsive disorder (OCD), repeated behaviours may help relieve stress. Trying to stop these behaviours can leave the person feeling extremely stressed and anxious.
Understanding this connection helps explain why a client may continue repeating behaviours even when those behaviours are upsetting.
2. Hoarding Disorder
Hoarding disorder involves persistent anxiety and distress about parting with possessions or animals.
The person experiences difficulty parting with them regardless of their actual value.
Possible Effects of Hoarding
Hoarding can affect a client’s health, living environment, and relationships.
Possible concerns include:
- Accumulation of dust, mould, or excrement .
- Cramped living conditions.
- Health concerns related to these conditions.
- Strained relationships with significant others.
Number to remember: About 75% of clients with hoarding disorder also live with an anxiety disorder.
3. Other Obsessive–Compulsive and Related Disorders
Several other disorders belong to this group. Each involves a different type of preoccupation or repetitive behaviour.
| Disorder | What It Involves |
|---|---|
| Body dysmorphic disorder | Being preoccupied with perceived flaws in one’s body that other people cannot observe. |
| Trichotillomania (hair pulling) disorder | Feeling the need to pull out one’s own hair, resulting in hair loss and significant personal and social distress. |
| Excoriation (skin picking) disorder | Feeling the need to repeatedly pick one’s own skin, causing skin lesions and significant personal and social distress. |
| Substance/medication-induced obsessive–compulsive and related disorder | Body-related repetitive behaviours triggered by exposure to or intoxication from a substance or medication. |
4. Supporting a Client With OCD or a Related Disorder
Supporting a client involves understanding the person’s experiences, responding respectfully, and following the care plan.
Listen and Show Interest
A client with OCD may already recognize that their thoughts or behaviours do not make sense.
Do not minimize these experiences or try to argue the person out of an obsession or compulsion. Arguing does not help.
Instead:
- Show that you enjoy spending time with the client.
- Listen to what the client says.
- Show genuine interest in the client’s life.
- Maintain a positive attitude.
A positive experience may encourage further positive experiences.
Avoid Unhelpful Helping Behaviours
Sometimes, an action that seems helpful can make it harder for a client to practise healthy coping skills.
For example, ensuring that a client avoids things that cause anxiety may make coping more difficult in the long run.
Avoid: Ensuring that the client avoids things that cause anxiety as a form of help with OCD.
Instead: Focus on the feelings behind the client’s behaviours.
The goal of this approach is to offer support without making it harder for the client to practise healthy coping skills.
Provide a Safe, Stable Environment
Signs of OCD can become more difficult to manage during stressful times.
Even happy occasions can cause stress.
To support the client:
- Provide a safe, secure, and stable environment.
- Recognize situations when the client may need extra support.
- Try to plan ahead for those situations.
- Encourage rest, which can help refresh the client.
Key fact: Stressful situations can make OCD behaviours harder to manage, even when the occasion is positive.
Follow the Care Plan
Always follow the client’s care plan.
The plan may include specific directions about medication containers and access.
For example, a care plan may state that:
- The client cannot have access to medication bottles.
- The client may take medication only from a dosette or blister-packaged container.
Important: These restrictions are examples of directions that may appear in a client’s care plan. Follow the directions that apply to the individual client.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition gives an example in which a care plan limits a client to medication from a dosette or blister pack. In Nova Scotia, this example does not set a medication rule for every client or automatically authorize a CCA to assist with any medication.
Nova Scotia’s current Continuing Care Assistant Occupational Standards of Practice state that a CCA may help a client open prescribed daily routine medication when the client cannot do so independently. Assistance with medication that is not part of a prescribed daily routine must meet specific practice requirements or be delegated by a regulated health professional. A regulated health professional provides the detailed directions needed for medication assistance.
Why this matters in Nova Scotia: Follow the individual’s care plan and the requirements that apply in your workplace. The type of medication container alone does not determine what assistance a CCA may provide.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 9, 2026
Encourage Normal Activities and Daily Care
Encourage the client to continue normal activities and perform ADLs .
Provide assistance as needed with:
- Bathing.
- Preparing meals.
- Taking in adequate fluids.
These activities and supports can help maintain the body’s homeostasis and prevent other health issues.
Recognize Small Accomplishments
Managing OCD behaviours can require considerable courage and hard work.
A small improvement may represent an important accomplishment for the client.
Recognize the client’s efforts and progress. Continue offering positive, respectful support.
5. What the CCA Should Observe and Report
As a CCA caring for a client with OCD, pay attention to repeated behaviours.
Examples include repeated checking, washing, cleaning, or saying the same words.
Report: If you observe repeated behaviours, report them to your supervisor.
Remember that these behaviours may help the client relieve stress. The person may not be able to stop without feeling extremely stressed and anxious.
Respond with understanding while carrying out your reporting responsibility.
Nova Scotia CCA Note
Sorrentino tells support workers to report repeated OCD behaviours to their supervisor. In Nova Scotia, current CCA standards also require CCAs to watch for changes in a client’s behaviour, emotional state, and other needs while providing care. They report changes according to the care plan and the directions established by a regulated health professional.
This is part of an observational point-of-care assessment, which means observing the client and surroundings before, during, and after care. It is not a nursing assessment. A CCA does not perform a comprehensive evaluation to make decisions about new care interventions. CCAs document daily care according to employer requirements.
Why this matters in Nova Scotia: You observe and report changes while following the care plan. You do not take on the nurse’s assessment responsibilities.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 9, 2026
Exam Clue Words
Pay attention to these words when reviewing CCA responsibilities.
- Report: When you observe repeated behaviours in a client with OCD, tell your supervisor. Recognizing that the behaviour helps relieve stress does not replace reporting.
- Avoid: Do not minimize the client’s thoughts or behaviours, argue about them, or ensure the client avoids anxiety-causing situations as a form of help.
- Follow the care plan: Directions about access to medication bottles or using specific medication containers depend on the individual client’s care plan.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| An obsession and a compulsion are the same thing. | An obsession is a persistent thought or desire. A compulsion is an uncontrollable urge to act. |
| Helping a client avoid anxiety-causing situations is always helpful. | This can make healthy coping harder to practise. Focus on the feelings behind the behaviours instead. |
| Every client with OCD must avoid medication bottles. | A client’s care plan may contain this restriction. Follow the individual care plan. |
Fast Review
Use these points to check the most important information before an exam.
- Obsessive–compulsive and related disorders involve recurrent obsessions and compulsions that interfere with daily life and relationships.
- An obsession is a persistent thought or desire. A compulsion is an uncontrollable urge to perform an act.
- Obsessions may involve fears that one’s thoughts will harm someone or repeated thoughts about hurting another person.
- Common compulsions include repeated washing, checking, repeating words or tunes, and behaviours involving throwing away or hoarding possessions.
- Hoarding disorder involves persistent anxiety and distress about parting with possessions or animals, regardless of value.
- About 75% of clients with hoarding disorder also live with an anxiety disorder.
- Body dysmorphic disorder involves perceived body flaws. Trichotillomania involves hair pulling, while excoriation disorder involves skin picking.
- Substance/medication-induced obsessive–compulsive and related disorder involves body-related repetitive behaviours triggered by substance or medication exposure or intoxication.
- Report repeated behaviours you observe in a client with OCD to your supervisor.
- Do not minimize or argue about a client’s obsessions or compulsions. Avoid helping behaviours that make practising healthy coping skills harder.
- Offer a safe, secure, stable environment. Recognize when stress may create a need for extra support.
- Follow the care plan, encourage ADLs and normal activities, assist with daily care as needed, and recognize the client’s accomplishments.
Final Pep Talk
There are several similar-sounding disorders in this topic, so give yourself time to learn what makes each one different. Focus first on the difference between obsessions and compulsions, then review the ways a CCA can respond with understanding and appropriate support.