Purpose of Review <p>To describe clinical strategies that can be used to enhance motivation and treatment engagement for clinicians conducting cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) for pediatric obsessive-compulsive disorder (OCD).</p> Recent Findings <p>Motivational enhancement has recently been highlighted as a key contributor to treatment outcome for pediatric patients undergoing ERP for OCD.</p> Summary <p> Pediatric OCD is a chronic and impairing condition, often treated with ERP, the gold-standard behavioral intervention. While ERP is effective, its success depends heavily on engagement and adherence, which can be difficult for youth who struggle with motivation, insight, or family-related barriers. Research has increasingly focused on methods to enhance motivation in pediatric ERP, with clinical strategies such as developmentally tailored engagement methods, systemic family interventions to reduce family accommodation (FA), intensive and/or technology-enhanced delivery formats, and integration of motivational interviewing (MI) and other adjunctive treatments demonstrating efficacy and effectiveness in improving treatment outcome.</p>