Use the diagram in sessions or at home to map a specific OCD cycle, from the first intrusive thought, image, impulse or feeling through to the worry, anxiety and compulsion that follows. It is likely to suit CBT practitioners, counsellors, psychologists and adults or older teens who want a printable OCD formulation worksheet for clearer case conceptualisation and exposure planning.
Mapping the trigger, appraisal and safety behaviour side by side makes it easier to see how obsessive compulsive disorder is being maintained in everyday situations. The model focuses on the link between intrusive thoughts, negative appraisal, anxiety and compulsions, including checking, neutralising, avoidance and control behaviours.
The explanatory page sets out a transdiagnostic OCD cycle, covering common intrusion themes such as contamination, harm, responsibility, health, sexuality, religion, relationships and security. It also names the thinking patterns that can intensify obsessional doubt, including uncertainty avoidance, responsibility bias, thought action fusion, over-estimation of threat, catastrophic thinking and perfectionistic thinking.
The worksheet pages give space to identify the trigger or intrusion, the obsessional worry, the maintaining belief pattern and the compulsion or safety behaviour. Prompts ask what the compulsion is trying to achieve and what unintended consequences it creates, which can help clients notice short-term reassurance versus longer-term reinforcement.
Later pages introduce cognitive behavioural defusion, shifting from control and ritualising towards acceptance, normalisation and committed action. Questions invite the person to notice the obsession, reappraise it more realistically, tolerate discomfort without avoidance and choose a response linked to values and goals. It may be useful in CBT sessions, ERP preparation, supervision, psychoeducation or between-session reflection.
