Intrusion Record

The Intrusion Record is a structured tool designed to collect information about how clients experience intrusive thoughts and images.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Fillable version (PDF)

A fillable version of the resource. This can be edited and saved in Adobe Acrobat, or other PDF editing software.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Editable version (DOC)

An editable Microsoft Word version of the resource.

Overview

What sets intrusive thoughts in obsessive compulsive disorder (OCD) apart is the significance that individuals with OCD attach to them. The Intrusion Record is a cognitive behavioral therapy (CBT) worksheet designed to capture the occurrence and meaning of intrusive thoughts and images.

Why Use This Resource?

Self-monitoring is a cornerstone of cognitive-behavioral therapy, supporting both assessment and intervention. This resource assists clients in observing and recording important information that can:

Enhance awareness and insight into intrusions, their meaning, and associated coping strategies.
Inform case conceptualizations, treatment planning, and intervention.
Provide a measure of change during treatment.
Support and encourage client-therapist collaboration.

Key Benefits

Structured

Provides a clear, organized format for capturing clients' experiences.

Insightful

Promotes awareness of the factors contributing to intrusive thoughts and images.

Engaging

Encourages active participation in therapy.

Flexible

Can be used to support assessment, intervention, and symptom monitoring.

Who is this for?

Obsessive Compulsive Disorder (OCD)

Unwanted thoughts or images that trigger compulsive behaviors or mental rituals.

Post-Traumatic Stress Disorder (PTSD)

Trauma-related images, memories, and meanings that intrude into everyday life.

Depression

Repetitive, intrusive thoughts about worthlessness, failure, or hopelessness.

Health Anxiety

Intrusive thoughts about having or developing serious illnesses.

Integrating it into your practice

Introduce

Explain the benefits and rationale for self-monitoring.

Identify

Agree targets for recording, including intrusions, associated meanings, and coping strategies.

Practice

Provide instructions and rehearse self-monitoring with the client.

Review

Review the client's completed self-monitoring record.

Adjust

Modify self-monitoring based on progress, shifting focus as needed.

Theoretical Background & Therapist Guidance

The Intrusion Record is a form for capturing the content and meaning of intrusive thoughts and images. A key concept when working with cognitive intrusions is that it is often not the intrusion itself which is bothersome, but the meaning that the individual ascribes to the intrusion. For example, a client with OCD may have an intrusion of their children getting ill, but be most bothered by the idea that they would be responsible were that to happen. This worksheet can be used to train clients to capture both the content of an intrusion, and the meaning that they associate with that intrusion. The intrusion record was designed for working with OCD-type intrusions (thoughts, images, urges, or obsessions), but may be equally appropriate for working with intrusions in PTSD where peri-traumatic or post-traumatic meanings may be attached to an image.

What's inside

An introduction to intrusions and self-monitoring.
Therapist guidance for introducing the resource to clients.
References and further reading for learning more about intrusive images.

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FAQs

An intrusion involves unwanted thoughts, images, or urges that spontaneously appear and provoke distress.

Self-monitoring involves systematically observing and recording specific targets that are related to the client's difficulties.

It supports client engagement, informs case conceptualization and treatment planning, and provides an ongoing measure of clients’ difficulties.

How This Resource Improves Clinical Outcomes

Integrating self-monitoring records into therapy supports:

Improved understanding and management of intrusions.
Data-driven insights for more effective treatment planning and intervention.
Increased client engagement and insight into their difficulties.

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References And Further Reading

Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychological Review, 117(1), 210.

Rachman, S. (2007). Unwanted intrusive images in obsessive compulsive disorders. Journal of Behavior Therapy And Experimental Psychiatry, 38(4), 402-410.

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