OCD Workbook

Living with OCD can bring unique challenges, especially when it comes to managing intrusive thoughts,
repetitive behaviors, and anxiety. However, with the right tools and strategies, it is possible to build
effective habits, reduce the impact of compulsions, and navigate daily life with greater ease. This
workbook is designed to provide practical worksheets that target key areas of OCD management,
helping you to develop skills that enhance your emotional well-being and sense of control.

Here is a brief introduction to each worksheet included in this workbook:

Hierarchy of Fears

This worksheet is designed to help you manage OCD by gradually confronting the fears or situations that trigger
your anxiety or compulsions. By listing your fears from least to most anxiety-provoking, this approach provides
you with a step-by-step plan to face these challenges at a pace that feels manageable.

Understanding the OCD Cycle

This worksheet is designed to help you identify the key components of your OCD patterns, including triggers,
intrusive thoughts, anxiety, and compulsions. By mapping out this cycle, you can gain greater insight into how it
works and develop strategies to break it.

Cognitive Restructuring

This worksheet is designed to help you manage OCD by pinpointing and challenging unhelpful thought patterns
that fuel anxiety, stress, or compulsions. By exploring these thoughts and replacing them with more balanced,
realistic alternatives, this technique helps lessen the hold of intrusive thoughts and promotes a calmer, more
positive mindset.

Setting SMART Goals

This worksheet is designed to help manage OCD by setting Specific, Measurable, Achievable, Relevant, and Time-
bound goals. This structured approach makes it easier to break down overwhelming obsessions or compulsions
into manageable steps, helping to reduce anxiety and keep you focused.

PLEASE Take Care of Yourself

This worksheet is created to help you manage OCD by focusing on taking care of your physical and emotional
well-being. By practicing PLEASE, you can lower your anxiety levels and reduce the impact of intrusive thoughts.

Self-Care Inventory

This worksheet is designed to help you assess and prioritize your self-care routine to better manage OCD
symptoms. Consistent self-care can lower overall stress levels, making it easier to cope with anxiety and intrusive
thoughts.

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 Hierarchy of Fears
When dealing with OCD, it’s normal to feel overwhelmed by obsessions and the compulsions that
follow. One way to begin managing this is by creating a hierarchy of fears. Think of it as a roadmap
that helps you identify and rank your fears—from those that cause a little anxiety to those that feel
really intense. This worksheet will guide you through the process of gradually working through
each fear, starting with the least challenging. By taking small steps, you can begin to weaken the
grip of obsessions and compulsions and feel more in control over time.

STEP 1: What is your primary fear?

Example: Fear of becoming contaminated.

STEP 2: List smaller fears that are related to your primary fear.

1. Touching a doorknob.

2. Using a public restroom.

3. Shaking hands with someone.

4. Eating without washing hands.

5. Sitting on a public bench.

STEP 3: Rank these fears from 1 (low anxiety) to 10 (high anxiety).

Situation That Triggers Your Fear Anxiety Level

1. Touching a doorknob. 4

2. Using a public restroom. 9

3. Shaking hands with someone. 6

4. Eating without washing hands. 10

5. Sitting on a public bench. 5

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 Hierarchy of Fears

STEP 4: Plan your exposures, starting with the least anxiety-provoking step.

Anxiety Anxiety
Fear Being Conquered Coping Skills I Will Use Due Date Before After

Touching a doorknob. Counting backwards 5/1 entering work 7 5

Sitting on a public bench. Listen to music, progressive muscle relaxation 5/7 walking home 6 4

Shaking hands with someone. Focus on conversation, visualization 5/11 at work 8 2

Using a public restroom. Positive self-talk, listen to music 5/17 @ the park 10 7

Eating without washing hands. 54321 method, positive self-talk 5/21 before lunch 10 8

Journal: Here are some questions to ask yourself throughtout the exposure process.

What was my
experience with
this step?

Were the coping

skills I used
effective?

Do I need to
break down any
steps further or
add new steps?

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 Hierarchy of Fears

STEP 1: What is your primary fear?

STEP 2: List smaller fears that are related to your primary fear.

STEP 3: Rank these fears from 1 (low anxiety) to 10 (high anxiety).

Situation That Triggers Your Fear Anxiety Level

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 Hierarchy of Fears

STEP 4: Plan your exposures, starting with the least anxiety-provoking step.

Anxiety Anxiety
Fear Being Conquered Coping Skills I Will Use Due Date Before After

Journal: Here are some questions to ask yourself throughtout the exposure process.

What was my
experience with
this step?

Were the coping

skills I used
effective?

Do I need to
break down any
steps further or
add new steps?

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 The Cycle of OCD
Obsessive-compulsive disorder (OCD) often follows a repetitive cycle called the "cycle of OCD." This
cycle begins with a trigger, which can be either internal (like emotions, memories, or sensory
experiences) or external (such as social situations, specific places, or disruptions in routine).

Once a trigger occurs, the first phase of the cycle starts with obsessions. Obsessions are intrusive,
distressing thoughts that create anxiety or discomfort. To relieve this distress, someone with OCD
moves into the next phase: compulsions. Compulsions are actions or mental rituals aimed at reducing
the uncomfortable feelings caused by obsessions. After completing these compulsions, there’s a sense
of temporary relief—until the next trigger arises, restarting the cycle.

Understanding how this cycle plays out in your own experience

is a powerful first step toward breaking free from it.

.1 .2
A
N N
IO Unwanted, Obsessions
X
SS

IE
recurring intrusive cause fear that
SE

T
Y
thoughts that cause results in anxiety.
OB

distress. The content You then feel the need

of the obsession varies to do something to
depending on the lessen the anxiety,
type of OCD. leading to compulsions.

After performing a Compulsions may be

compulsion there is relief, observable behaviors
causing these behaviors or mental rituals,
TEM

to become reinforced. such as checking

N

Relief is short-lived locks, excessive

IO
PO

however, until the hand-washing, or

LS
R

R next obsession reassurance-

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Y occurs. P
RE seeking. M
LI CO
.4 EF .3

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 The Cycle of OCD

PART 1: Identify Your Triggers

Triggers can arise in many areas of your life. Below, list your OCD triggers in
each area. Triggers typically provoke obsessions, defined as unwanted and
recurring intrusive thoughts that cause anxiety or distress.

Home Work/School

Examples: clutter in the home, disruption in Examples: pressure with deadlines, fear of
routine poor performance

Social Situations Relationships

Examples: being in close proximity to others, Examples: concern for safety of loved ones or
social interactions significant others

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 The Cycle of OCD

PART 2: Identify Your Obsession/Intrusive Thought

Obsessions are unwanted and distressing ideas, thoughts, or impulses. They are often experienced as
intrusive thoughts and are typically brought on by triggers such as the ones you listed in the above
worksheet. Below, list the obsessions that you notice come up for you in order from most distressing
to least distressing.

Examples: Unwanted thoughts or images, fears related to germs,

intense needs for order, fears of forgetting something, or fear of
being responsible for something terrible happening

Most Distress

Least Distress

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 The Cycle of OCD

PART 3: Identify the Emotions Related to Your Obsessions

Check off the emotions that you commonly feel in response to obsessions that you experience.

Anxious Insecure Indifferent

Sad Overwhelmed Pressured

Disgusted Inferior Exposed

Guilty Frustrated Inadequate

Worried Critical Scared

Confused Annoyed Lonely

Isolated Withdrawn Nervous

Powerless Resentful Disdain

Ashamed Furious Violated

Vulnerable Disappointed Startled

Embarrassed Perplexed Stressed

Frightened Curious Bitter

Helpless Content Mad

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 The Cycle of OCD
PART 4: Understanding the Compulsions
Compulsions are repeated behaviors that an individual feels driven to perform. They are intended to
reduce anxiety or prevent a feared outcome from happening. Compulsions can be observable
behaviors and actions or they can be mental rituals. Below, write down compulsions that you notice
yourself performing. Examples have been provided to help you start; check off any of the example
compulsions you find yourself engaging in and add your own to the list.

Cleaning Compulsions

Washing hands in a ritualized or excessive Excessively cleaning faucets, floors,

way counters

Checking Compulsions

Repeatedly checking that the door is Checking that you did not harm someone
locked without knowing it

Repeating Compulsions

Spending excessive amount of time Repeating routine activities like turning off
rewriting or rereading things a light switch, walking in and out of a door

Other Compulsions

Counting objects such as floor or ceiling Spending excessive time straightening

tiles papers, pens, books, etc.

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 The Cycle of OCD
PART 5: How to Break the Cycle
Compulsions typically provide temporary, short-term relief to distress from obsessions until the next
time a trigger is encountered. Then, the cycle starts all over again. To gain long-term relief instead of
short-term relief, the cycle of OCD needs to be broken.

Building your awareness by identifying obsessions and compulsions, like you have in the above
worksheets, is a great first step to breaking the cycle of OCD! Below are ideas for how to get out of this
OCD cycle and find long-term relief.

A crucial step in breaking the cycle of OCD is learning to sit with anxious feelings without engaging in
compulsive behavior. Compulsions maintain this cycle by giving short-term relief to distress and over
time your brain begins to rely on compulsions as the way to reduce these feelings, rather than sitting
through this distress without a compulsion.

An its
on
xi ow
-
et
Co

y n
ty

de
pu
xie

cr
lsi

ea
An

on

sin
g

When you ride out the wave of anxiety without participating in a compulsion, the urges to engage in
compulsions will decrease. It may feel overwhelming at first, but with practice it can become easier.
Working with a therapist who specializes in OCD can help you through this process, and teach you
coping skills to work through anxiety without performing compulsions.

Coping Strategies to Reduce Anxiety

To sit with anxiety without participating in a compulsive behavior, it can be helpful to learn new coping
strategies. Below are examples of these strategies; circle which ones you would like to try:

Take a few deep breaths. Try to inhale through your nose for a count of 4, hold your breath for a count
of 4, and then exhale slowly through your mouth for a count of 6. Repeat as many times as you need to
feel calmer.

Implement progressive muscle relaxation by slowly tensing each muscle group for 5 seconds, then
releasing. This can help ease any tension you may feel in your body.

Incorporate mindfulness of your body sensations by engaging in a body scan. Spend between 15-30
seconds scanning each part of your body, starting with your feet and moving up through the body and
noticing any physical sensations that stand out to you.

Ground yourself with the 5-4-3-2-1 method. Identify 5 things you can see, 4 things you can touch, 3
things you can hear, 2 things you can smell, and 1 thing you can taste.

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 Cognitive Restructuring
Cognitive restructuring is a CBT technique that involves recognizing negative and unhelpful
thoughts, examining the evidence for and against these thoughts, and developing more helpful
alternative thoughts. For someone with OCD, cognitive restructuring can help challenge and
change the intrusive and obsessive thoughts that contribute to anxiety and compulsive behaviors.

Here is an example of how a

NEGATIVE negative thought causes negative
THOUGHT emotions and behaviors. Using
What you think cognitive restructuring to change
the thoughts can change the
Example: "If I touch the
doorknob, I will get sick." emotions and behaviors.

Triggering
Event
NEGATIVE Touching a Public
Doorknob
NEGATIVE
BEHAVIOR EMOTION
What you do What you feel

Example: I repeatedly wash my Example: I feel extremely

hands to avoid contamination. scared and panicky.

BALANCED
THOUGHT
What you think
Example: “I've touched doorknobs before
& did not get sick. Even if I did get sick, I
would recover as I have before."
If you challenge the negative
thought with a balanced thought,
balanced emotions and behaviors Triggering
follow. Those balanced behaviors
Event
lead to more balanced thoughts, and BALANCED Touching a Public
Doorknob
BALANCED
the positive cycle continues. BEHAVIOR EMOTION
What you do What you feel
Example: I will only wash my Example: I feel less anxious and
hands when necessary, and trust more in control.
that one wash is enough.

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 Cognitive Restructuring

THOUGHT EMOTION BEHAVIOR

What you think in a situation. How you feel. How you act in the situation.
Ex: "If I don't check the door multiple Ex: Intense fear and worry Ex: Repeatedly checking the door
times, someone will break in." about safety. to ensure it's locked.

It’s important to understand that our automatic thoughts affect our feelings and influence our behavior.
By critically evaluating the evidence for their obsessive thoughts and considering more balanced perspectives,
individuals with OCD can reduce the intensity and frequency of their obsessions and compulsions, leading to
improved mental well-being and daily functioning.

Thought:

Is my thought
factual?

What evidence
do I have for
and against
my thought?

What would
someone else
say about the
situation?

Is it possible to
view this
situation
differently?

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 Setting SMART Goals
SMART Goals is a structured goal-setting method that can help with managing specific obsessions or compulsions.
Making goals Specific, Measurable, Achievable, Relevant, and Time-bound can make it easier to stay focused and monitor
progress. Each milestone reached can bring a sense of accomplishment, which may help counter some of the negative
feelings that come with OCD. Rather than feeling stuck in the cycle of obsessions or compulsions, this approach offers a
clear, structured path forward.

What is your goal? Write down exactly what you want to achieve.

S
Avoid vague goals like "reduce compulsive checking”. Be clear and
detailed about what you expect to accomplish.

Specific I want to limit how many times I check the stove before I leave the house. Right now, I check
it about three times. My goal is to check it only once.

How will you measure your progress? Do you want to use a clock,

M
calendar, or behavior chart? Do you want to measure your goal by
hours, weeks, or days?
Measurable I’ll keep a daily journal where I write down each time I check the stove.

Is your goal realistic? Aim for a goal that is challenging but still

A
manageable. What steps can you take to make your goal achievable?

Yes, I think it’s realistic. I won’t try to stop checking all at once, but I’ll start by reducing
Achievable it to two times a day, then down to one.

R
Does this goal align with your broader objectives? Ensure that your
goal is relevant and meaningful to your overall life or career goals.
Reflect on the value and impact of achieving this goal.
Relevant
This goal is important because my compulsive checking is causing me anxiety and making me
late for things. Reducing this behavior will help me feel more in control and improve my daily
routine.

T
What is your deadline for achieving this goal? Set a specific date by
which you plan to achieve your goal. Identify immediate actions you
can take to begin your progress.
Time-Bound
I want to reach my goal of checking the stove only once by the end of the next four weeks.
I’ll check my progress each week to make sure I’m on track.

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 Setting SMART Goals
What is your goal?

S Specific

How will you measure your progress?

M Measurable

Is your goal realistic?

A Achievable

Does this goal align with your broader objective?

R Relevant

What is your deadline for achieving this goal?

T Time-Bound

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 Setting SMART Goals

Be Flexible Celebrate Milestones

If you're struggling to reach a goal, don't be Reward yourself for every step or milestone
afraid to adjust it. It’s okay to change the you reach, no matter how small. This could be
timeline, make the goal smaller, or alter the as simple as taking a break, enjoying a favorite
steps as needed. treat, or planning a fun activity.

Give Yourself Enough Time Stay Patient & Be Kind to Yourself

Make sure you have enough time to achieve
Progress may be slow, and setbacks can
your goals without feeling overwhelmed. It's
happen. Remind yourself that change takes
better to allow extra time and feel
time, and be kind to yourself if things don't go
accomplished than to set an unrealistic
perfectly.
deadline and feel discouraged.

What obstacles have I encountered, and how have I handled them?

What progress have I made so far? What am I proud of?

What support or resources might help me continue making progress?

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 DBT PLEASE Skill
The PLEASE skill in Dialectical Behavior Therapy (DBT) is a helpful acronym for remembering essential
aspects of mental and physical well-being. For individuals with OCD, maintaining overall health can
significantly impact the management of intrusive thoughts and compulsive behaviors. This worksheet will
guide you through applying the PLEASE skill to create a foundation of well-being.

Treat Physical Illness

PL Make sure to look after your overall physical health by having regular
check-ups, staying active, and following any medical advice. Taking care
of your body helps keep your mind stable and healthy.

Balanced Eating

E Try to eat regular, healthy meals. Good nutrition can help keep your mood
steady and give you the energy you need, making you less likely to feel
upset or stressed.

A
Avoid Mood-Altering Substances

Stay away from substances like alcohol and drugs that can affect your
mood and thinking. Avoiding these helps you think clearly and manage
your emotions better, which is important for your mental health.

S
Balanced Sleep
Getting enough sleep is very important for handling your emotions well.
Try to keep a regular sleep schedule. Good sleep helps your mind work
properly and keeps your emotions steady, reducing the chances of feeling
moody or upset.

E
Exercise Daily
Exercise can lift your mood, reduce stress, and improve your overall
emotional well-being. It also helps your body produce endorphins, which
make you feel happier.

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 DBT PLEASE Skill
PHYSICAL ILLNESS: Take care of your physical health.
Track your progress daily for a week to see if you are attending to your
physical health on a regular basis or if there is room for improvement.

M T W T F S S
Scheduled and attended doctors appointments

Took medications

Took a shower and washed face

Brushed my teeth

Moved my body

Ate nutritious food

Went outside

Drank enough water

Limited time on social media

Cleaned the house

Spoke to another person

What challenges did you face when taking care of your physical health and how can you overcome them?

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 DBT PLEASE Skill

BALANCED EATING: What we eat contributes to our mental health.

Keep track of the foods you consume for several days and how you feel
after you eat them. The more specific you can be about how you feel after
eating, the better!

Food Consumed How I Felt After Eating it

1.

2.

3.

4.

5.

6.

7.

8.

9.

Which foods made you feel the best & what foods do you want to avoid going forward?

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 DBT PLEASE Skill

AVOID MOOD Evaluate your use of substances that may affect your mood.
ALTERING Substances such as alcohol, non-prescription medications, drugs, and caffeine can
SUBSTANCES: affect your ability to regulate your emotions. One of the keys to emotional stability is
to take medication as prescribed and avoid substances used for self-medicating.

What mood altering substances do you use?

What are your personal reasons for avoiding mood altering substances?

What steps can you take to reduce or eliminate these substances?

What challenges might you face and how can you overcome them?

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 DBT PLEASE Skill
BALANCED SLEEP: Getting enough sleep is important to your mental health.
You should strive for 7 to 9 hours of sleep per night and establish good
sleep habits to help regulate your mood.

With a sleep diary, you can log your bedtime, night awakenings, and morning wake-up times. This helps you see your sleep
patterns and overall sleep duration, as well as how often your sleep is disrupted. Additionally, a sleep diary helps you track
activities affecting your sleep. You’ll note when you exercise, nap, take medication, or consume caffeine or alcohol.

INSTRUCTIONS: (1) Write the date and type of day: Work, School, or Day Off. (2) Put the letter “C” in the box when you
have coffee, cola or tea. Put “M” when you take any medicine. Put “A” when you drink alcohol. Put “E” when you exercise.
(3) Put a “B” in the box to show when you go to bed. Put a “Z” in the box that shows when you think you fell asleep. (4)
Put a “Z” in all the boxes that show when you are asleep at night or when you take a nap during the day. (5) Leave boxes
empty to show when you wake up at night and when you are awake during the day. SAMPLE ENTRY BELOW:

P.M. A.M.

Date Type of Day 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11

7/12 Work C E A M B Z Z Z Z Z Z Z

P.M. A.M.

Date Type of Day 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11

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 DBT PLEASE Skill

EXERCISE DAILY: Exercise is a great way to balance your mood.

Though it can be challenging to incorporate exercise into your daily routine,
completing it can make you feel better physically and mentally. Even 20-30
minutes of brisk walking can be beneficial.

DATE & TIME TYPE OF EXERCISE DURATION INTENSITY

Which workouts did you enjoy the most & want to do more?

What challenges did you face and how can you overcome them?

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 Self-Care Inventory
Self-care is any technique that enhances your well-being and replenishes your mind and body. For example,
practicing daily gratitude, laughing with a loved one, and taking daily walks can boost your mood and improve
overall well-being. A self-care routine is not one-size-fits-all but requires experimenting with different strategies
to understand what works best for you.

This worksheet is designed to help you explore a variety of specific self-care activities that can improve your
well-being. You will be asked to rank each activity on a scale from 1-3 to determine how well you are currently
engaging in these practices. After ranking, you can “star” the activities you would like to do more often. The goal
of this worksheet is to help you recognize the different types of self-care available to you, identify what you are
doing well, and pinpoint areas where you can improve to feel better overall.

Ranking

1 I rarely engage in this, and it is not a regular part of my routine.

2 I occasionally engage in this, but it is not consistent.

3 I regularly engage in this, and it is a frequent part of my routine.

I want to do this more frequently.

1 2 3 Physical Self-Care: Improving your physical health.

Engaging in regular physical activity such as walking, running, yoga, or strength training.

Ensuring you get enough restful sleep each night to rejuvenate your body.

Eating a balanced and nutritious diet, including plenty of fruits, vegetables, and grains.

Drinking enough water throughout the day to stay hydrated.

Maintaining good hygiene practices such as bathing, brushing teeth, and grooming.

Attending regular check-ups and following medical advice from healthcare professionals.

Taking time to relax and unwind, through activities like taking a bath and getting a massage.

Limiting or avoiding the use of alcohol, tobacco, and other substances.

Spending time outdoors in natural sunlight to enhance vitamin D levels and improve mood.

Paying attention to your body’s needs, such as stretching when tense or resting when tired.

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 Self-Care Inventory
1 2 3 Emotional Self-Care: Processing & expressing your emotions.

Participating in activities you enjoy to boost your mood and provide a sense of fulfillment.

Spending time with friends and family to build support and reduce feelings of isolation.

Practicing mindfulness to stay present and manage negative thoughts.

Writing down thoughts and feelings to process emotions and gain insights.

Keeping a gratitude journal or reflecting on things you are thankful for.

Using positive affirmations to counter negative self-talk and build self-esteem.

Using music to relax, uplift your mood, or express your emotions.

Expressing your emotions through art, music, writing, or other creative outlets.

Set achievable goals and celebrate your progress, no matter how small.

Regular sessions with a therapist or counselor to explore and address emotional challenges.

1 2 3 Social Self-Care: Fostering & maintaining healthy relationships.

Spending time with people you like and make you feel good about yourself.

Asking for help from friends or family when you’re feeling down or overwhelmed.

Learning to say no and establishing boundaries to protect your emotional well-being.

Participating in support groups to gain insight and emotional support from others.

Participating in clubs or organizations that align with your interests to meet new people.

Giving your time to help others in your community to foster connection and purpose.

Going to social gatherings, parties, or community events to build your social network.

Scheduling regular get-togethers, such as a weekly coffee date, or a monthly dinner.

Actively listening when talking with others, which helps strengthen your relationships.

Scheduling intentional alone time with your romantic partner.

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 Self-Care Inventory

Professional Self-Care: Maintaining a healthy work-life balance and

1 2 3
pursuing career development opportunities.

Clearly defining work hours and sticking to them to ensure a healthy work-life balance.

Stepping away from work to recharge, through daily short breaks and using vacation time.

Talking to a supervisor or HR about mental health challenges (if it feels safe).

Exploring available support options, such as employee assistance programs (EAP).

Organizing and prioritizing work tasks to manage workload effectively and reduce stress.

Ensuring your work environment is comfortable and conducive to productivity.

Establishing achievable work goals and celebrating small accomplishments.

Being kind to yourself during work and avoiding excessive self-criticism.

Building positive relationships with coworkers for mutual support and camaraderie.

1 2 3 Spiritual Self-Care: Nurturing your spirit and providing purpose.

Practicing meditation to connect with your inner self and find peace and clarity.

Engaging in prayer or other forms of communication with a higher power.

Spending time in nature to experience connection to the world around you.

Regularly reflecting on what you are thankful for to cultivate an appreciative mindset.

Reading inspirational books, scriptures, or quotes to uplift and inspire your spirit.

Participating in spiritual or religious community activities.

Engaging in artistic activities, such as painting, music, or writing.

Performing acts of kindness and service to others, fostering a sense of purpose.

Acting in accordance with your morals to create a sense of integrity in your life.

Spending time with the people who give your life meaning.

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 Additional Resources to Support
Your Mental Health Journey
It can be hard to know where to begin looking for support in your mental health journey.
Getting a referral from a primary care physician is a reliable first step. Also, sometimes family
and friends have experienced similar issues and have professionals they would recommend.
The experts at ChoosingTherapy.com are here to help as well, with resources we have
reviewed and recommend. Our strict editorial standards ensure our reviews are fair, honest,
thorough, and based on firsthand experience.

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Apps can be great way to monitor mood, track sleep, journal, and
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Therapist Directory
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therapist directory can be very helpful. Using the filters, you can
refine your search until you find a therapist who feels like a
perfect fit.

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