Purpose 🎯

Help clients distinguish intrusive thoughts, doubts, images, or urges from the compulsive behaviors OCD demands in response.

Let’s Talk About It 🗣️

Create two columns:

What OCD Says

• Intrusive thoughts
• Doubts
• Images
• Urges
• “What if” questions
• Feared meanings

What OCD Makes Me Do

• Checking
• Reassurance seeking
• Researching
• Reviewing
• Avoiding
• Comparing
• Confessing
• Mental neutralization

Ask:

• What is the thought or doubt?
• What does OCD ask you to do about it?
• What happens if you do not perform the response?

If the Conversation Gets Stuck 💡

• Is this the fear itself, or the action OCD wants you to take?
• Does this behavior aim to reduce uncertainty?
• Is the response visible, mental, or both?

Telehealth / Whiteboard Version ⚖️

Use a two-column chart and sort examples into “OCD says” and “OCD makes me do.” Add arrows to show how one leads to the other.

Why This Works 🌱

Sorting obsessions and compulsions helps clients understand the OCD process and identify treatment targets for response prevention.

Clinical Pearl 🧠

Compulsions are not always visible. Mental review, reassurance, checking feelings, and trying to “figure it out” can all maintain OCD.

Documentation Language 📝

Therapist utilized an obsession and compulsion sorting intervention to support client in differentiating intrusive thoughts, doubts, images, and urges from behavioral and mental compulsions.

Clinical Focus: Obsession Identification, Compulsion Identification, OCD Psychoeducation