Unlike physiological illnesses OCD is a dysfunctional behaviour and many future events could change the outcome. Though I should add there might be a genetic factor, although I say this tentatively because many behaviours are simply passed on through family role modelling, beyond this to the best of my knowledge no OCD gene has been identified.

It is most interesting that the parents should choose to come rather than bring their daughter as well. Here lays one of the problems with self reporting. If we are to accept what clients and relatives say at face value then the matter is closed if they report they are no longer in need of assistance. However I would be very interested in the parents at this stage, children going through puberty can create a variety of manipulative situations and this may be the case here. I have had a few emails from Joop, and the geographical location and circumstances may involve cultural differences which may have to be taken into account. Here certain behaviours may be seen as the norm, where in other parts of the world they be seen as problematic, Joop would be best judge of this. However if the circumstances and culture are not an issue, Joop will have to judge whether any further action can or needs to be taken.

Experience tells me that OCD is closely related to an underlying anxiety that the client cannot identify the cause of. At the age of 12 and considering the circumstances Joop has outlined, I would suggest, if at all possible, one last meeting with the young girl, followed by another with her parents without the child. I would not question the child's recovery or her choice to stop the therapy. But I would satisfy one of two theories. 1/ that this is a manipulation, that is a use of her antecedents to produce some kind of gain. Or, 2/ She is dealing with heightened levels of anxiety related to puberty.

In the first theory her parents may need some help in parenting methods. In theory 2, her parents will still need some parenting help, as their daughter needs to have the changes she is going through explained to her. If her parents are as compliant as the story suggests, they would find talking to their child about 'adult' issues, very difficult.

Of course both theories may be wrong, however they do seem to be the most likely based on the story so far.