Obsessive Compulsive Disorder (OCD) including Body Dysmorphic Disorder (BDD)
Avoidance Hierarchy (Archived)
Archived
Behavioral Experiment
Worksheets
Behavioral Experiment (Portrait Format)
Worksheets
Catastrophizing
Information handouts
Checking Certainty And Doubt
Information handouts
Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)
Information handouts
Cognitive Behavioral Model Of Intolerance Of Uncertainty (Hebert, Dugas, 2019)
Information handouts
Cognitive Behavioral Model Of Obsessive Compulsive Disorder (OCD: Salkovskis, Forrester, Richards, 1998)
Information handouts
Cognitive Behavioral Treatment Of Childhood OCD: It's Only A False Alarm: Therapist Guide
Treatments That Work®
Cognitive Behavioral Treatment of Childhood OCD: It's Only a False Alarm: Workbook
Treatments That Work®
Disqualifying The Positive
Information handouts
Embracing Uncertainty
Exercises
Emotional Reasoning
Information handouts
Exposure And Response (Ritual) Prevention For Obsessive Compulsive Disorder: Therapist Guide
Treatments That Work®
Exposure And Response Prevention
Exercises
Exposure Practice Form
Exercises
Exposure Session Record
Worksheets
Facing Your Fears And Phobias
Guides
Fear Ladder
Worksheets
Habituation
Information handouts
Intolerance Of Uncertainty
Information handouts
Intrusion Record
Worksheets
Intrusive Memory Record
Worksheets
Intrusive Thoughts Brain Metaphor
Information handouts
Intrusive Thoughts Images And Impulses
Exercises
Jumping To Conclusions
Information handouts
Maximizing The Effectiveness Of Exposure Therapy
Information handouts
Obsessive Compulsive Disorder (OCD) Formulation
Worksheets
OCD Diary
Worksheets
OCD Hierarchy
Exercises
Recognizing Obsessive Compulsive Disorder (OCD)
Information handouts
Self-Monitoring Record (Universal)
Worksheets
Theory A / Theory B
Worksheets
Theory A / Theory B (Archived)
Archived
Therapy Blueprint (Universal)
Worksheets
Therapy Blueprint For OCD
Worksheets
Thought Suppression And Intrusive Thoughts
Information handouts
Treating Your OCD With Exposure And Response (Ritual) Prevention: Workbook
Treatments That Work®
Uncertainty Beliefs – Experiment Record
Worksheets
Understanding Body Dysmorphic Disorder
Guides
Understanding Obsessive Compulsive Disorder (OCD)
Guides
Unhelpful Thinking Styles
Information handouts
What Is Body Dysmorphic Disorder (BDD)?
Information handouts
What Is Exposure Therapy?
Information handouts
What Keeps Body Dysmorphic Disorder (BDD) Going?
Information handouts
What Keeps Obsessive Compulsive Disorder (OCD) Going?
Information handouts
Your Stone Age Brain
Information handouts
Assessment
OCD
- Vancouver Obsessional Compulsive Inventory (VOCI) download archived copy
- Yale Brown Obsessive Compulsive Scale – Second Edition (YBOCS-II) | Storch, E. A., Rasmussen, S.A., Price, L.H., Larson, M.J., Murphy, T.K., Goodman, W.K. | 2010
- Self Report Version link to the International OCD Foundation archived version of IOCDF.org
- Obsessive Compulsive Inventory (OCI) download scoring grid
- Relationship Obsessive Compulsive Inventory (ROCI) download archived copy
- Partner Related Obsessive Compulsive Symptom Inventory download archived copy
BDD
- Cosmetic Procedure Screening (COPS)
downloadarchived copy - Body Image Questionnaire (BIQ)
downloadarchived copy - Danesh, M, Beroukhim, K., Nguyen, C., Levin, E., & Koo, J. (2015). Body dysmorphic disorder screening tools for the dermatologist: A systematic review. Pract Dermatol, 2, 44-49. download archived copy
Intervention
Treatment guides
- NICE guidelines for OCD and BDD (November 2005) download
- Treatment of patients with OCD (APA guidelines, 2007) download
- Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders (2014) download archived copy
- A psychological perspective on hoarding – DCP good practice guidelines download archived copy
- Treatment manual for OCD download
Information handouts
- OCD information booklet download archived copy
- What you need to know about OCD download archived copy
- OCD UK Support organisation for sufferers in the UK
- Helpforhoarders.co.uk
- Compulsive-hoarding.org has lots of information about hoarding
- IntrusiveThoughts.org
Exercises, Worksheets & Workbooks
- Self-help ERP exercises download archived copy
- OCD identification and self-help download
- Assessment and treatment of relationship-related OCD symptoms download archived copy
Self-Help Programmes
Caring less about your looks
- The impact of appearance overconcern download archived copy
- What keeps appearance concerns going download archived copy
- Appearance focused attention download archived copy
- Body checking and reassurance seeking download archived copy
- Appearance altering behaviors download archived copy
- Avoidance and safety behaviors download archived copy
- Overvaluing appearance and self-management planning download archived copy
Overcoming body dysmorphia
- Understanding body dysmorphic disorder (BDD) download
- What keeps BDD going? download
- Reducing appearance preoccupation download
- Reducing checking and reassurance seeking download
- Overcoming negative predictions, avoidance, and safety behaviours download
- Adjusting appearance assumptions download
- Self-managment planning download
Presentations
- New directions in implementing exposure and response prevention: an inhibitory learning perspective – workshop presented by Jonathan Abramowitz in 2018 download archived copy
- Cognitive Therapy for Contamination-Related OCD: ERP and Beyond – Workshop presented by Adam Radomsky in 2011 download archived copy
- Interoceptive exposure: an underused weapon in the arsenal against obsessions and compulsions – workshop presented by Jonathan Abramowitz in 2018 download archived copy
- Family affair: involving a partner or spouse in exposure and response prevention for OCD – workshop presented by Jonathan Abramowitz in 2018 download archived copy
- A couple-based approach to CBT for BDD – workshop by Lillian Reuman and Jonathan Abramowitz in 2016 download archived copy
- Body dysmorphic disorder | David Veale | 2017 download archived copy
Recommended Reading
OCD
- Clark, D. A., & Rhyno, S. (2005). Unwanted intrusive thoughts in nonclinical individuals. Intrusive thoughts in clinical disorders: Theory, research, and treatment, 1-29 download archived copy
- Doron, G., & Derby, D. (2015). Assessment and treatment of relationship-related OCD symptoms (ROCD): a modular approach. Handbook of Obsessive-Compulsive Disorder across the Lifespan. Hoboken, NJ: Wiley (Forthcoming). download archived copy
- Gillihan, S., Williams, M. T., Malcoun, E., Yadin, E., Foa, E. B. (2012) Common pitfalls in exposure and response prevention (EX/RP) for OCD. Journal of Obsessive-Compulsive and Related Disorders, 1, 251-257 download
- Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), 793-802
downloadarchived copy - Mataix-Cols, D., et al (2010). Hoarding disorder: A new diagnosis for DSM-V? Depression and Anxiety, 27, 556-572.
downloadarchived copy - Salkovskis, P. (1999). Psychological treatment of obsessive–compulsive disorder. Behaviour Research and Therapy, 37, S37-S52 download archived copy
- Salkovskis, P. M. (2007). Psychological treatment of obsessive–compulsive disorder. Psychiatry, 6(6), 229-233 download archived copy
- Veale, D. (2007). Cognitive behavioural therapy for obsessive compulsive disorder. Advances in Psychiatric Treatment. 13, 438-446 download archived copy
- Veale, D., Freeston, M., Krebs, G., Heyman, I., & Salkovskis, P. (2009). Risk assessment and management in obsessive–compulsive disorder. Advances in psychiatric treatment, 15(5), 332-343. download archived copy
BDD
- Danesh, M., Beroukhim, K., Nguyen, C., Levin, E., & Koo, J. (2015). Body dysmorphic disorder screening tools for the dermatologist: A systematic review. Pract Dermatol, 2, 44-49. download archived copy
- Krebs, G., de la Cruz, L. F., & Mataix-Cols, D. (2017). Recent advances in understanding and managing body dysmorphic disorder. Evidence-Based Mental Health, 20(3), 71-75. download archived copy
- Veale, D. (2004). Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image ,1, 113-125 download archived copy
- Veale, D. (2001). Cognitive-behavioural therapy for body dysmorphic disorder. Advances in Psychiatric Treatment, 7, 125-132 download archived copy
What Is Obsessive Compulsive Disorder?
Signs and Symptoms of OCD
People with OCD experience obsessional thoughts, images, urges, and doubts. They often feel compelled to act or think in certain ways.
Obsessions are intrusive thoughts—thoughts that are unwanted and unacceptable, and which pop into our minds unbidden. Obsessions can be thoughts in the form of words, but also of images (pictures in our minds), urges or impulses, or feelings of doubt. Obsessive thoughts are experienced as unacceptable, disgusting, or senseless, and people with OCD find it hard not to pay attention to them. Examples of obsessions include:
- thoughts such as ‘My hands have been contaminated with germs’ or ‘Perhaps I am a pedophile’
- images of my family being murdered
- doubts such as ‘Have I left the stove on?’
- urges such as wanting to shout profanities
Compulsions follow from the way in which the individual interprets the intrusive thoughts. Compulsions are the reactions or mental actions that a person does in order to neutralize or ‘make safe’ following an obsession. People with OCD typically carry out compulsions in order to prevent a harm from happening for which they might be responsible, and/or to reduce any strong emotion which they feel. Exactly what someone with OCD may feel compelled to do will depend upon the meaning their intrusions have for them. Examples of compulsions might include:
- carefully washing food after having an intrusive thought about germs;
- calling family members to check they are OK after having an intrusive image about their deaths;
- going back to the house to check after doubting whether the stove was turned off;
- avoiding a public place after having an urge to shout profanities.
Prevalence of OCD
The lifetime prevalence rate of OCD in the United States is estimated to be 2.3% in adults (Kessler et al., 2005), and 1% to 2.3% in children and adolescents (Zohar, 1999).
Psychological Models and Theory of OCD
The cognitive behavioral theory of OCD proposes that when someone experiences an intrusive thought it is the appraisal—what they make of having the thought—that is most important (Salkovskis, Forrester, & Richards, 1998). Intrusive thoughts, even very unpleasant ones, are common and entirely normal. What seems to happen in OCD is that the fact of having intrusive thoughts is interpreted as being especially significant and, as a result, is especially anxiety-provoking. People with OCD are more likely to feel especially responsible for any potential harms and may feel especially strong emotion should they have intrusive thoughts about harm occurring. Compulsions are understood to be an active attempt to reduce harm. According to the cognitive model of OCD targets for intervention include:
- understanding and addressing the meaning of the intrusions;
- targeting compulsions and safety-seeking behaviors;
- modifying attentional biases.
Evidence-Based Psychological Approaches for Working with OCD
Cognitive behavioral therapy (CBT) is an evidence-based psychological treatment for OCD. Historically, CBT for OCD has involved the behavioral approach of exposure with response prevention (ERP). More cognitive approaches within CBT attempt to understand the patient’s appraisal of their intrusions and to find ways of exploring the validity and consequences of these appraisals.
Resources for Working with OCD
Psychology Tools resources available for working therapeutically with OCD may include:
- psychological models of obsessive-compulsive disorder (OCD)
- information handouts for obsessive-compulsive disorder (OCD)
- exercises for obsessive-compulsive disorder (OCD)
- CBT worksheets for obsessive-compulsive disorder (OCD)
- self-help programs for obsessive-compulsive disorder (OCD)
References
- Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.
- Salkovskis, P. M., Forrester, E., & Richards, C. (1998). Cognitive–behavioral approach to understanding obsessional thinking. The British Journal of Psychiatry, 173(S35), 53–63.
- Zohar, A. H. (1999). The epidemiology of obsessive-compulsive disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 8(3), 445–460.