OCD Worksheets

Living with OCD can bring unique challenges, especially when it comes to managing intrusive
thoughts, repetitive behaviors, and anxiety. However, with the right tools and strategies, it is
possible to build effective habits, reduce the impact of compulsions, and navigate daily life with
greater ease. This workbook is designed to provide practical worksheets that target key areas
of OCD management, helping you to develop skills that enhance your emotional well-being
and sense of control.

Here is a brief introduction to each worksheet included in this package:

Page 1-4: Hierarchy of Fears

The Hierarchy of Fears worksheet is designed to help you manage OCD by gradually confronting the fears or
situations that trigger your anxiety or compulsions. By listing your fears from least to most anxiety-provoking, this
approach provides you with a step-by-step plan to face these challenges at a pace that feels manageable.
Working through your hierarchy helps you build confidence, reduce avoidance behaviors, and ultimately lessen
the power of these fears, giving you a greater sense of control and calm in your daily life.

Pages 5-6: Cognitive Restructuring

The Cognitive Restructuring worksheet is designed to help you manage OCD by pinpointing and challenging
unhelpful thought patterns that fuel anxiety, stress, or compulsions. By exploring these thoughts and replacing
them with more balanced, realistic alternatives, this technique helps lessen the hold of intrusive thoughts and
promotes a calmer, more positive mindset.

Pages 7-9: SMART Goals

The SMART Goals worksheet is designed to help manage OCD by setting Specific, Measurable, Achievable,
Relevant, and Time-bound goals. This structured approach makes it easier to break down overwhelming
obsessions or compulsions into manageable steps, helping to reduce anxiety and keep you focused.

Pages 10-15: PLEASE Skill

The PLEASE Skill worksheet is created to help you manage OCD by focusing on taking care of your physical and
emotional well-being. By practicing PLEASE, you can lower your anxiety levels and reduce the impact of intrusive
thoughts. When you take care of your body and mind, you’re more equipped to handle OCD symptoms and
navigate daily life with greater ease and confidence.

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 Hierarchy of Fears
When dealing with OCD, it’s normal to feel overwhelmed by obsessions and the compulsions that
follow. One way to begin managing this is by creating a hierarchy of fears. Think of it as a roadmap
that helps you identify and rank your fears—from those that cause a little anxiety to those that feel
really intense. This worksheet will guide you through the process of gradually working through
each fear, starting with the least challenging. By taking small steps, you can begin to weaken the
grip of obsessions and compulsions and feel more in control over time.

STEP 1: What is your primary fear?

Example: Fear of becoming contaminated.

STEP 2: List smaller fears that are related to your primary fear.

1. Touching a doorknob.

2. Using a public restroom.

3. Shaking hands with someone.

4. Eating without washing hands.

5. Sitting on a public bench.

STEP 3: Rank these fears from 1 (low anxiety) to 10 (high anxiety).

Situation That Triggers Your Fear Anxiety Level

1. Touching a doorknob. 4

2. Using a public restroom. 9

3. Shaking hands with someone. 6

4. Eating without washing hands. 10

5. Sitting on a public bench. 5

Scan to learn more

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about ERP for OCD:
 Hierarchy of Fears

STEP 4: Plan your exposures, starting with the least anxiety-provoking step.

Anxiety Anxiety
Fear Being Conquered Coping Skills I Will Use Due Date Before After

Touching a doorknob. Counting backwards 5/1 entering work 7 5

Sitting on a public bench. Listen to music, progressive muscle relaxation 5/7 walking home 6 4

Shaking hands with someone. Focus on conversation, visualization 5/11 at work 8 2

Using a public restroom. Positive self-talk, listen to music 5/17 @ the park 10 7

Eating without washing hands. 54321 method, positive self-talk 5/21 before lunch 10 8

Journal: Here are some questions to ask yourself throughtout the exposure process.

What was my
experience with
this step?

Were the coping

skills I used
effective?

Do I need to
break down any
steps further or
add new steps?

Scan to learn more

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about ERP for OCD:
 Hierarchy of Fears

STEP 1: What is your primary fear?

STEP 2: List smaller fears that are related to your primary fear.

STEP 3: Rank these fears from 1 (low anxiety) to 10 (high anxiety).

Situation That Triggers Your Fear Anxiety Level

Scan to learn more

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about ERP for OCD:
 Hierarchy of Fears

STEP 4: Plan your exposures, starting with the least anxiety-provoking step.

Anxiety Anxiety
Fear Being Conquered Coping Skills I Will Use Due Date Before After

Journal: Here are some questions to ask yourself throughtout the exposure process.

What was my
experience with
this step?

Were the coping

skills I used
effective?

Do I need to
break down any
steps further or
add new steps?

Scan to learn more

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4 about ERP for OCD:
 Cognitive Restructuring
Cognitive restructuring is a CBT technique that involves recognizing negative and unhelpful
thoughts, examining the evidence for and against these thoughts, and developing more helpful
alternative thoughts. For someone with OCD, cognitive restructuring can help challenge and
change the intrusive and obsessive thoughts that contribute to anxiety and compulsive behaviors.

Here is an example of how a

NEGATIVE negative thought causes negative
THOUGHT emotions and behaviors. Using
What you think cognitive restructuring to change
the thoughts can change the
Example: "If I touch the
doorknob, I will get sick." emotions and behaviors.

Triggering
Event
NEGATIVE Touching a Public
Doorknob
NEGATIVE
BEHAVIOR EMOTION
What you do What you feel

Example: I repeatedly wash my Example: I feel extremely

hands to avoid contamination. scared and panicky.

BALANCED
THOUGHT
What you think
Example: “I've touched doorknobs before
& did not get sick. Even if I did get sick, I
would recover as I have before."
If you challenge the negative
thought with a balanced thought,
balanced emotions and behaviors Triggering
follow. Those balanced behaviors
Event
lead to more balanced thoughts, and BALANCED Touching a Public
Doorknob
BALANCED
the positive cycle continues. BEHAVIOR EMOTION
What you do What you feel
Example: I will only wash my Example: I feel less anxious and
hands when necessary, and trust more in control.
that one wash is enough.

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about CBT for OCD:
 Cognitive Restructuring

THOUGHT EMOTION BEHAVIOR

What you think in a situation. How you feel. How you act in the situation.
Ex: "If I don't check the door multiple Ex: Intense fear and worry Ex: Repeatedly checking the door
times, someone will break in." about safety. to ensure it's locked.

It’s important to understand that our automatic thoughts affect our feelings and influence our behavior.
By critically evaluating the evidence for their obsessive thoughts and considering more balanced perspectives,
individuals with OCD can reduce the intensity and frequency of their obsessions and compulsions, leading to
improved mental well-being and daily functioning.

Thought:

Is my thought
factual?

What evidence
do I have for
and against
my thought?

What would
someone else
say about the
situation?

Is it possible to
view this
situation
differently?

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about CBT for OCD:
 Setting SMART Goals
SMART Goals is a structured goal-setting method that can help with managing specific obsessions or compulsions.
Making goals Specific, Measurable, Achievable, Relevant, and Time-bound can make it easier to stay focused and monitor
progress. Each milestone reached can bring a sense of accomplishment, which may help counter some of the negative
feelings that come with OCD. Rather than feeling stuck in the cycle of obsessions or compulsions, this approach offers a
clear, structured path forward.

What is your goal? Write down exactly what you want to achieve.

S
Avoid vague goals like "reduce compulsive checking”. Be clear and
detailed about what you expect to accomplish.

Specific I want to limit how many times I check the stove before I leave the house. Right now, I check
it about three times. My goal is to check it only once.

How will you measure your progress? Do you want to use a clock,

M
calendar, or behavior chart? Do you want to measure your goal by
hours, weeks, or days?
Measurable I’ll keep a daily journal where I write down each time I check the stove.

Is your goal realistic? Aim for a goal that is challenging but still

A
manageable. What steps can you take to make your goal achievable?

Yes, I think it’s realistic. I won’t try to stop checking all at once, but I’ll start by reducing
Achievable it to two times a day, then down to one.

R
Does this goal align with your broader objectives? Ensure that your
goal is relevant and meaningful to your overall life or career goals.
Reflect on the value and impact of achieving this goal.
Relevant
This goal is important because my compulsive checking is causing me anxiety and making me
late for things. Reducing this behavior will help me feel more in control and improve my daily
routine.

T
What is your deadline for achieving this goal? Set a specific date by
which you plan to achieve your goal. Identify immediate actions you
can take to begin your progress.
Time-Bound
I want to reach my goal of checking the stove only once by the end of the next four weeks.
I’ll check my progress each week to make sure I’m on track.

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 Setting SMART Goals
SMART Goals is a structured goal-setting method that can help with managing specific obsessions or compulsions.
Making goals Specific, Measurable, Achievable, Relevant, and Time-bound can make it easier to stay focused and monitor
progress. Each milestone reached can bring a sense of accomplishment, which may help counter some of the negative
feelings that come with OCD. Rather than feeling stuck in the cycle of obsessions or compulsions, this approach offers a
clear, structured path forward.

What is your goal? Write down exactly what you want to achieve.

S
Avoid vague goals like "reduce compulsive checking”. Be clear and
detailed about what you expect to accomplish.

Specific

How will you measure your progress? Do you want to use a clock,

M
calendar, or behavior chart? Do you want to measure your goal by
hours, weeks, or days?
Measurable

Is your goal realistic? Aim for a goal that is challenging but still

A
manageable. What steps can you take to make your goal achievable?

Achievable

R
Does this goal align with your broader objectives? Ensure that your
goal is relevant and meaningful to your overall life or career goals.
Reflect on the value and impact of achieving this goal.
Relevant

T
What is your deadline for achieving this goal? Set a specific date by
which you plan to achieve your goal. Identify immediate actions you
can take to begin your progress.
Time-Bound

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 Setting SMART Goals

Be Flexible Celebrate Milestones

If you're struggling to reach a goal, don't be Reward yourself for every step or milestone
afraid to adjust it. It’s okay to change the you reach, no matter how small. This could be
timeline, make the goal smaller, or alter the as simple as taking a break, enjoying a favorite
steps as needed. treat, or planning a fun activity.

Give Yourself Enough Time Stay Patient & Be Kind to Yourself

Make sure you have enough time to achieve
Progress may be slow, and setbacks can
your goals without feeling overwhelmed. It's
happen. Remind yourself that change takes
better to allow extra time and feel
time, and be kind to yourself if things don't go
accomplished than to set an unrealistic
perfectly.
deadline and feel discouraged.

What obstacles have I encountered, and how have I handled them?

What progress have I made so far? What am I proud of?

What support or resources might help me continue making progress?

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 DBT PLEASE Skill
The PLEASE skill in Dialectical Behavior Therapy (DBT) is a helpful acronym for remembering essential
aspects of mental and physical well-being. For individuals with OCD, maintaining overall health can
significantly impact the management of intrusive thoughts and compulsive behaviors. This worksheet will
guide you through applying the PLEASE skill to create a foundation of well-being.

Treat Physical Illness

PL Make sure to look after your overall physical health by having regular
check-ups, staying active, and following any medical advice. Taking care
of your body helps keep your mind stable and healthy.

Balanced Eating

E Try to eat regular, healthy meals. Good nutrition can help keep your mood
steady and give you the energy you need, making you less likely to feel
upset or stressed.

A
Avoid Mood-Altering Substances

Stay away from substances like alcohol and drugs that can affect your
mood and thinking. Avoiding these helps you think clearly and manage
your emotions better, which is important for your mental health.

S
Balanced Sleep
Getting enough sleep is very important for handling your emotions well.
Try to keep a regular sleep schedule. Good sleep helps your mind work
properly and keeps your emotions steady, reducing the chances of feeling
moody or upset.

E
Exercise Daily
Exercise can lift your mood, reduce stress, and improve your overall
emotional well-being. It also helps your body produce endorphins, which
make you feel happier.

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 DBT PLEASE Skill
PHYSICAL ILLNESS: Take care of your physical health.
Track your progress daily for a week to see if you are attending to your
physical health on a regular basis or if there is room for improvement.

M T W T F S S
Scheduled and attended doctors appointments

Took medications

Took a shower and washed face

Brushed my teeth

Moved my body

Ate nutritious food

Went outside

Drank enough water

Limited time on social media

Cleaned the house

Spoke to another person

What challenges did you face when taking care of your physical health and how can you overcome them?

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 DBT PLEASE Skill

BALANCED EATING: What we eat contributes to our mental health.

Keep track of the foods you consume for several days and how you feel
after you eat them. The more specific you can be about how you feel after
eating, the better!

Food Consumed How I Felt After Eating it

1.

2.

3.

4.

5.

6.

7.

8.

9.

Which foods made you feel the best & what foods do you want to avoid going forward?

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 DBT PLEASE Skill

AVOID MOOD Evaluate your use of substances that may affect your mood.
ALTERING Substances such as alcohol, non-prescription medications, drugs, and caffeine can
SUBSTANCES: affect your ability to regulate your emotions. One of the keys to emotional stability is
to take medication as prescribed and avoid substances used for self-medicating.

What mood altering substances do you use?

What are your personal reasons for avoiding mood altering substances?

What steps can you take to reduce or eliminate these substances?

What challenges might you face and how can you overcome them?

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 DBT PLEASE Skill
BALANCED SLEEP: Getting enough sleep is important to your mental health.
You should strive for 7 to 9 hours of sleep per night and establish good
sleep habits to help regulate your mood.

With a sleep diary, you can log your bedtime, night awakenings, and morning wake-up times. This helps you see your sleep
patterns and overall sleep duration, as well as how often your sleep is disrupted. Additionally, a sleep diary helps you track
activities affecting your sleep. You’ll note when you exercise, nap, take medication, or consume caffeine or alcohol.

INSTRUCTIONS: (1) Write the date and type of day: Work, School, or Day Off. (2) Put the letter “C” in the box when you
have coffee, cola or tea. Put “M” when you take any medicine. Put “A” when you drink alcohol. Put “E” when you exercise.
(3) Put a “B” in the box to show when you go to bed. Put a “Z” in the box that shows when you think you fell asleep. (4)
Put a “Z” in all the boxes that show when you are asleep at night or when you take a nap during the day. (5) Leave boxes
empty to show when you wake up at night and when you are awake during the day. SAMPLE ENTRY BELOW:

P.M. A.M.

Date Type of Day 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11

7/12 Work C E A M B Z Z Z Z Z Z Z

P.M. A.M.

Date Type of Day 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11

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 DBT PLEASE Skill

EXERCISE DAILY: Exercise is a great way to balance your mood.

Though it can be challenging to incorporate exercise into your daily routine,
completing it can make you feel better physically and mentally. Even 20-30
minutes of brisk walking can be beneficial.

DATE & TIME TYPE OF EXERCISE DURATION INTENSITY

Which workouts did you enjoy the most & want to do more?

What challenges did you face and how can you overcome them?

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