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OCD Formulation (Salkovskis)

A formulation based on Salkovskis' cognitive model of OCD — mapping intrusions, responsibility appraisals, distress, and neutralising behaviours.

Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed

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This formulation maps how OCD is maintained not by the intrusive thoughts themselves (which everyone has) but by the meaning you give them — particularly inflated responsibility. The appraisal triggers distress, which drives neutralising (rituals, avoidance, reassurance), which provides temporary relief but reinforces the belief that the intrusion was dangerous. Work through it with your therapist using a recent OCD episode.

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Salkovskis OCD Model

OCD Cognitive Model (Salkovskis, 1985)

100%

Intrusive Thought / Image / Urge

Normal — everyone has these

Responsibility Appraisal

The meaning given to the intrusion

Distress

Neutralising / Rituals / Avoidance

Temporary Relief

Increased Attention to Intrusions

Monitoring makes intrusions more frequent

Normalising

Protective Factors & Strengths

What resources, strengths, and supports might help in recovery?

Reflection

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When to use the OCD Formulation (Salkovskis)

The OCD Formulation (Salkovskis) is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for obsessive-compulsive disorder (OCD).

It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device — or download it as a print-ready PDF.

How it works

Most people work through it in around 25 minutes. It moves through four short steps:

  1. Salkovskis OCD Model
  2. Normalising
  3. Protective Factors & Strengths — What resources, strengths, and supports might help in recovery?
  4. Reflection

Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.

The CBT approach behind it

In common with other CBT methods, the OCD Formulation (Salkovskis) works by mapping how the parts of a problem connect and keep it going (formulation). The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going — and practical, testable ways to change it.

Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.

Evidence & sources

This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:

  • Salkovskis, P.M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23(5), 571-583. doi:10.1016/0005-7967(85)90105-6
  • Salkovskis, P.M. & Warwick, H.M.C. (2001). Making sense of hypochondriasis: A cognitive model of health anxiety. In G.J.G. Asmundson et al. (Eds.), Health Anxiety. Chichester: Wiley.

For use alongside professional support

Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.

If you need urgent help now:

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More Obsessive-Compulsive Disorder (OCD) worksheets

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