1. Keep cool at home. Use a quiet, calm manner.

2. Lower expectations temporarily. Compare progress this month to last month, rather than last year or next year. Patient's progress must be compared to themselves, not others.

3. Overlook rituals and checking. See these as coping strategies. Don't participate in rituals.

4. Don't be judgmental of the behavior. Accept it as the best the patient can do right now.

5. Do not pressure the patient to verbalize anxiety (it only makes matters worse).

6. Help channel energy into activities such as jogging, swimming, and dancing. Activity is more likely to calm the patient down than talking it out.

7. Allow verbal expression of rage and anger. Listen to what the patient says. Try not to be defensive.

8. Help the patient develop confidence in his or her own decisions and choices by allowing him or her enough time to make them. Never make decisions for another person (unless a young child) but help the person to make them.

9. Do not confront the patient with what he or she says or does. Reflect on the feelings behind the action and allow for further discussion.

10. Do not pressure the patient to stop compulsions, but stick to the time allocated by the therapist. If the patient is not in therapy, then cut down slowly on the time of the activity.

11. Always explain changes. Make only reasonable demands.

12. Limits calm things down. Everyone needs to know what the rules are. Set limits on the amount of time he or she talks beyond ten minutes. Conversation beyond ten minutes may not be productive. Do not restrict rituals.

13. Ignore what you can't change. Let some things slide. Never ignore violence or suicidal threats.

14. Say what you have to say clearly, calmly, and in a positive way.

15. Carry on business as usual. Reconnect with friends, hobbies and family routines.

16. Watch out for street drugs or alcohol. They make symptoms worse.

17. Pick up on early negative changes and signs and consult with the patient's therapist and/or doctor.

18. Solve problems step-by-step. Make changes gradually. Work on one thing at a time.

19. Don't get involved in the behavior therapy program unless asked to do so by the patient and his or her therapist.