CBT for OCD: Common Subtypes

Principles hold across subtypes

Exposure and Response Prevention (ERP) targets obsessions and the urge to ritualize. The goal is learning safety and tolerance of uncertainty by approaching triggers and allowing discomfort to rise and fall without rituals.

Subtypes and full guides

• Contamination — touch doorknobs then delay washing; sit with uncertainty about germs.
• Checking — lock the door once and leave; delay reassurance or photo checking.
• Harm — handle safe objects while labeling thoughts as thoughts.
• Symmetry/Ordering — intentionally misalign items and resist fixing.
• Taboo Thoughts — write/read the thought; practice non‑engagement with mental rituals.
• Scrupulosity — uncertainty practice within values; limit confession and reassurance.
• Relationship OCD (ROCD) — reduce checking/comparison; act by values not certainty.

Hierarchy design and safety are key—work with a clinician to tailor steps.

Journaling prompts

1. Trigger → obsession → ritual urge → what I did instead → learning.
2. Peak anxiety __/100, time to drop by half __ minutes, ritual delay __ minutes.
3. One values‑aligned action I took instead of ritualizing.

Pair with brief logs in How to Journal.

When to seek care

Complex presentations or high risk require clinician‑guided ERP and monitoring.