The literature on evaluated methods of psychotherapy for the treatment of obsessive-compulsive disorders (OCD) in children and adolescents is reviewed and the following cognitive-behavioral treatment modules are described: psychoeducation, exposure with response prevention, family-based interventions, and cognitive as well as meta-cognitive techniques. Behavior therapy, especially exposure with response prevention, has been shown to be an effective treatment. Severe cases require a combined therapy with serotonin-reuptake inhibitors, while "thought stopping" cannot be recommended as an effective therapy for obsessions. New cognitive and meta-cognitive approaches should be evaluated to determine whether they might advance treatment. Controlled therapy studies are needed in order to evaluate the different effects and underlying efficacy factors of, as well as the indications and contraindications for different strategies of treatment for obsessive-compulsive disorder in childhood and adolescence.