Family members can unwittingly interfere with the success of traditional treatments. As mentioned earlier in this chapter, families can facilitate the OCD symptoms or antagonize the patient. In such cases, family therapy can be helpful. At the very least, education regarding the patients condition and the appropriate responses to that condition should be attempted. In general, family members should not assist the patient in the OCD rituals, nor should they significantly alter or compromise the quality of their lives to accommodate the symptoms of the illness. The family should be supportive of reductions in symptoms but not critical of exacerbations. Family members should avoid disparaging remarks related to the OCD. More extensive family therapy involves mutually acceptable contracts between the patient and affected family members regarding behaviors targeted for suppression. OCD behaviors outside the contract that do not compromise the lives of family members should be dealt with only in a positive and constructive manner. Family members should be aware that behavior therapy is a stepwise process and that behavior that is currently not a part of the contract can be addressed in the future. In addition to interventions directed at the OCD, internal family conflicts may need to be addressed in therapy because they can exacerbate the OCD symptoms and impair the quality of life of all concerned.