Intrusive Thoughts Worksheet

What is the theory behind this Intrusive Thoughts Worksheet?

Intrusive thoughts are random thoughts, images or sensations that pop up in our minds out of nowhere. They can be about the most absurd things, but since most of us do not give them attention they quickly fade away. However, for people with Obsessive Compulsive Disorder, these intrusive thoughts have such an overtly negative and disturbing theme that it becomes impossible to dismiss them. Thus to lessen the resulting anxiety people with OCD are compelled to ‘neutralise’ these thoughts with ritualistic actions called compulsions. 

How will the worksheet help?

The worksheet will help individuals with OCD  to identify their triggers, themes and emotions associated with their intrusive thoughts. It can also help clients who are disturbed by intrusive thoughts without an OCD diagnosis.  The responses will help therapists determine treatment goals and objectives and also prepare the individual for further Cognitive Restructuring exercises. 

How to use the worksheet?

Instruct the client to use this worksheet when they have an unwanted intrusive thought that is causing significant distress. Instruct them to write the content of the thoughts, the situation that the thought occurred in the resulting emotional distress and its intensity. They also have to record how many time the thought occurred in a 24 hour period. 

Intrusive Thoughts Worksheet

Trying to avoid intrusive thoughts increases their frequency and the intensity of the associated emotions. The first step towards dealing with them is not active avoidance but confrontation. Whenever you feel disturbed by an intrusive thought that keeps coming back, use the table below to note down details that can help you in learning how to overcome them.

What is the thought about? What is the  general theme of the thought? What were you doing prior to having this thought? What other significant detail can you mention about your situation at the time?What emotions did it bring up?
Rate your emotions on a scale of 1 – 10
How distressing was the thought?
Rate on a scale of   1 – 10
Add this symbol  ⓧ every time the thought occurs throughout the day. 


Clark, A.D. (2005) Intrusive Thoughts in Clinical Disorders: Theory, Research, and Treatment. Guilford Publications.

You can download this worksheet here.

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