“ 
    “did I lock the door?” 
     
                             “did I lock the door?” 
                                   
                                   
      “did I lock the door?” 
                                   
          Treating Obsessive Compulsive Disorder with EMDR Therapy             
       Informed by Exposure & Response Prevention and Ego State Therapy 
                        Worksheets and Forms 
      1.  Yale-Brown OCS:  Obsessions ………………………………………………………………………………………………………....   1 
      2.  Yale-Brown OCD: Compulsions ……………………………………………………………………………………………………….   3 
      3.  Yale-Brown OCD: Severity Rating Scales ………………………………………………………………………………………….   4 
      4.  Therapist Script for OCD Assessment In Practicum Day 1 ……………………………………………………………….    5 
      5.  Monitoring at Home ………………………………………………………………………………………………………………………    6 
      6.  Therapist Script for Introducing E&RP – Practicum Day 2 ………………………………………………………………    7 
      7.  About OCD ……………………………………………….…………………………………………………………………………………..   10 
      8.  About Exposure and Response Prevention …………………………………………………………………………………...   11 
      9.  Exposure and Response Prevention Record Sheet ………………………………………………………………………..   12 
                     
                            Sandra Paulsen, Ph.D. 
             Bainbridge Institute For Integrative Psychology, Bainbridge Island, Washington 
                 www.bainbridgepsychology.com                   sandra@paulsenphd.com 
                                    
          YALE-BROWN OBSESSIVE COMPULSIVE SCALE (http://www.ocdtypes.com/ybocs_ocd_scale.php) 
    Name:                      Date:                     
                 Obsessions: Unwanted Thoughts, Fears, and Recurring Worries 
         Past  Aggressive/Harming Obsessions 
     Current  Only 
            Fear might harm self 
            
            Fear might harm others 
            
            Violent or horrific images 
            
            Fear of blurting out obscenities or insults 
            
            Fear of doing something else embarrassing 
            
            Fear will act on unwanted impulses (e.g., to stab friend) 
            
            Fear will steal things 
            
            Fear will harm others because not careful enough (e.g., accidentally running over someone with car) 
            
            Fear of being responsible for something else terrible happening (e.g., fire, burglary) 
            
            Other worries about causing harm 
            
         Past  Contamination Obsessions 
     Current  Only 
            Concerns or disgust with bodily waste or secretions (e.g., urine, feces, saliva) 
            
            Concern with dirt or germs 
            
            Excessive concern with of environmental contaminants (e.g., asbestos, radiation, toxic waste) 
            
            Excessive concern with household items (e.g., cleansers, solvents) 
            
            Excessive concern animals (e.g., insects) 
            
            Bothered by sticky substances or residues 
            
            Concerned will get ill because of contaminant 
            
            Concerned will get others ill by spreading contamination 
            
            No concern with consequences of contamination other than how it might feel 
            
            Other contamination worries 
            
         Past  Sexual Obsessions 
     Current  Only 
            Forbidden or unacceptable sexual thoughts/images/impulses 
            
            Sexual worries about children or incest 
            
            Sexual worries involving homosexuality (i.e., becoming gay) 
            
            Inappropriate or aggressive sexual behavior toward others 
            
            Other sexual worries 
            
         Past  Hoarding/Saving Obsessions 
     Current  Only 
            Hoarding or saving worries (not hobbies or concern with objects with monetary or sentimental value) 
            
                                                             Page 1 
            Fears of mistakenly discarding important things along with unimportant items 
            
         Past  Moral or Religious Obsessions (Scrupulosity) 
     Current  Only 
            Excessive concern with sacrilege or blasphemy (offending God) 
            
            Excessive concern with right/wrong, morality 
            
            Other concern about morality or religion 
            
         Past  Obsessions with Need for Symmetry or Exactness 
     Current  Only 
            Accompanied by magical thinking (e.g., concerned that mother will have accident unless things are in 
            
            the right place). 
            Not accompanied by magical thinking (just feels uncomfortable) 
            
         Past  Somatic Obsessions 
     Current  Only 
            Concern with illness or disease 
            
            Excessive concern with body part or aspect of appearance (not including weight) 
            
            Other body related obsessions 
            
         Past  Miscellaneous Obsessions 
     Current  Only 
            Need to know or remember 
            
            Fear of saying certain things or words 
            
            Fear of not saying just the right thing 
            
            Fear of losing things 
            
            Intrusive non-violent images 
            
            Intrusive nonsense sounds, words, or music 
            
            Bothered by certain sounds/noises, more than other people 
            
            Lucky/unlucky numbers 
            
            Colors with special significance 
            
            Superstitious fears 
            
            Other worry or fear not listed 
            
     
                      
                                                             Page 2 
     
                  Compulsions: Repetitive Behaviors and Rituals 
         Past  Cleaning/Washing Compulsions 
    Current  Only 
            Excessive or ritualized handwashing 
            Excessive or ritualized showering, bathing, tooth brushing, grooming, or toilet routine 
            Excessive cleaning of household items or other inanimate objects 
            Other measures to prevent or remove contact with contaminants 
            Other cleaning ritual not listed 
         Past  Checking Compulsions 
    Current  Only 
            Checking locks, stoves, appliances, etc. 
            Checking that did/will not harm others 
            Checking that did/will not harm self 
            Checking that nothing terrible did/will happen 
            Checking that did not make mistakes 
            Checking body for signs of unwellness or unwanted symptoms 
            Other checking not listed 
         Past  Repeating Rituals 
    Current  Only 
            Re-reading or re-writing 
            Need to repeat routine activities (in/out door, up/down chair) 
            Other repeating ritual not listed 
         Past  Counting Compulsions 
    Current  Only 
            Counting Compulsions 
         Past  Ordering/Arranging Compulsions 
    Current  Only 
            Compulsive ordering or arranging 
         Past  Hoarding Collecting Compulsions 
    Current  Only 
            Compulsive hoarding or collecting or shopping (e.g., piles up old newspapers, sorts through 
           garbage, collects free thing) 
         Past  Mental Compulsions 
    Current  Only 
            Special words, images, numbers, repeated mentally to neutralize something bad (e.g., 
           lucky numbers) 
            Special prayers (short and long) silently repeated in a set manner (e.g. God is good) 
            Mental counting 
                                                        Page 3