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