Track covert / mental compulsions — mental reviewing, counting, praying, reassuring self — which are often missed because they're invisible.
Mental compulsions are rituals that happen in your head: reviewing whether you locked the door, mentally counting, silently praying, testing your emotional reaction to an intrusion, reassuring yourself. They're as much a compulsion as hand-washing but harder to spot. This log builds awareness.
Use when the formulation identifies covert mental rituals as a significant maintaining factor, such as mental reviewing, counting, praying, or neutralising imagery. Often overlooked in assessment, so introduce once these have been explicitly identified.
Validate that mental compulsions are just as real and exhausting as observable ones. Explain that monitoring them is the first step to interrupting the cycle, and that many clients find it relieving to have these 'invisible' symptoms acknowledged.
For clients who struggle to distinguish intrusions from compulsions, spend time in session practising the discrimination before assigning as homework. For clients with rapid or automatic mental rituals, focus on identifying triggers and post-ritual states rather than the ritual content itself.
Exercise caution with clients who have a history of psychosis or dissociative experiences, as intensive focus on mental content may be destabilising. If monitoring increases the frequency of mental rituals through heightened attention, reconsider the approach.
Mental compulsions often have a 'just right' or completion quality — help clients identify their personal markers of compulsion completion. Use the monitoring data to design response prevention strategies specifically targeting the identified mental rituals.
Suitable for clients working with ocd, mental compulsions, covert rituals, cbt, pure o, monitoring. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Build a graded exposure hierarchy for Exposure and Response Prevention therapy. List anxiety-provoking situations, rate them, and plan structured exposures.
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Track OCD episodes — intrusions, appraisals, rituals, distress, and duration — to identify patterns and measure progress.
Challenge inflated responsibility beliefs that drive OCD by examining the appraisal and generating realistic alternatives.