Therapy Blueprint for Obsessive Compulsive Disorder (OCD) - a reflective worksheet to help understand and manage symptoms.

This worksheet is a personal reflection tool, so there is no single "correct" answer like in a math problem. Instead, you need to fill it out based on your own experiences or a case study you are learning about.

Below is a sample completion of the worksheet using a common example of OCD (fear of germs/contamination). You can use this as a guide to write your own answers if you are working on a personal plan, or to understand what kind of information goes in each box.

Sample Completed Worksheet

The problems
*What brought you to therapy?*
*What intrusive thoughts / images / doubts / urges were bothering you?*

> I came to therapy because I was spending hours every day washing my hands and cleaning my room. I couldn't leave the house without feeling like I was dirty.
>
> Intrusive thoughts: "If I touch that doorknob, I will get sick and die," or "My hands are covered in invisible bacteria right now."
> Urges: A strong feeling that I *had* to wash my hands immediately after touching anything outside my bedroom.

***

What kept them going?
*What kept the problems going? What were you doing to cope with your fears?*
*What did you think it said about you that you had these thoughts / images / urges / doubts?*
*Consider: beliefs, compulsions, safety behaviours, avoidance, selective attention.*

> Compulsions (Coping): Washing my hands until they were raw, using hand sanitizer every 10 minutes, and changing clothes immediately after coming home.
> Avoidance: I stopped going to the park or touching public railings because I was afraid of germs.
> Beliefs: I believed that if I didn't wash my hands, something terrible would happen to me or my family. I thought having these thoughts meant I was "crazy" or "weak."
> Safety Behaviors: Asking my mom to open doors for me so I wouldn't have to touch them.

***

Knowledge and skills
*What do you know now about intrusive thoughts?*
*What did you learn about OCD that was helpful?*
*What strategies or techniques did you learn?*
*Describe any behavioural experiments that you completed (in session or outside).*

> Knowledge: I learned that everyone has strange or scary thoughts sometimes, but people with OCD get stuck on them. The thoughts are just "brain noise," not facts.
> Strategies: I learned about ERP (Exposure and Response Prevention). This means facing the fear (touching a doorknob) and *not* doing the compulsion (washing hands).
> Behavioral Experiments:
> 1. Touched a library book and waited 30 minutes before washing my hands. Nothing bad happened.
> 2. Shook hands with a friend and did not use hand sanitizer at all. I felt anxious at first, but the anxiety went down on its own after an hour.