Intrusive Thoughts, Images, and Impulses

Explore common intrusive thoughts, images, and impulses with clients using this worksheet.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Overview

Intrusive and distressing thoughts, images, and impulses are a feature of obsessive-compulsive disorder (OCD). They are also commonly experienced in the general population, typically without distress. This information handout describes common intrusive cognitions.

Why Use This Resource?

Understanding and normalizing intrusive thoughts can benefit clients, particularly those diagnosed with obsessive compulsive disorder (OCD). This worksheet:

Outlines common intrusive thoughts within the general population.
Reduces anxiety by normalizing these experiences.
Helps undermine problematic appraisals associated with intrusions.

Key Benefits

Educational

Describes common intrusive thoughts and their prevalence.

Reassuring

Clients with OCD find it helpful knowing their experiences are common.

Normalizing

Encourages clients to reconsider unhelpful evaluations of their intrusions.

Who is this for?

Obsessive Compulsive Disorder (OCD)

This resource is designed to help clients with intrusive and unwanted thoughts, images and impulses that are often distressing.

Integrating it into your practice

Inform

Describe intrusions experienced by the general population.

Normalize

Use the worksheet to illustrate that intrusive thoughts are common.

Discuss

Discuss the role of problematic appraisals of intrusions in OCD.

Reflect

Encourage clients to reflect on their own experiences in light of the presented data.

Theoretical Background & Therapist Guidance

Intrusive thoughts, images and impulses suddenly appear in consciousness and are often experienced as distressing. They are common in non-clinical populations but, when appraised as having the potential to cause harm or as being the personal responsibility of the individual, may escalate into an obsession. Intrusive thoughts, images and impulses is a psychoeducation worksheet which details the results of a study investigating the frequency of such experiences in a student population (Purdon & Clark, 1993). Clients with OCD may find it reassuring to know the frequency with which 'normal' populations experience intrusive thoughts, which may go some way to undermining unhelpful appraisals.

This worksheet has been designed to help clients engage with their beliefs about how common intrusive thoughts, images, and impulses are. Clients can be encouraged to guess the frequency at which 'normal' groups endorse each item before discovering the 'real' answers on the second page. These facts can be used to inform therapeutic discussions about clients' self-beliefs.

What's inside

Introduction to the resource.
Guidance for using the resource with clients.
Key references and suggestions for further reading.

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FAQs

These are unexpected, involuntary thoughts or urges that can be distressing but are not uncommon among the general population.

It provides reassurance by demonstrating that intrusive thoughts are common, potentially reducing associated anxiety and challenging maladaptive appraisals.

How This Resource Improves Clinical Outcomes

Using this worksheet in therapy sessions helps clients:

Recognize that intrusive thoughts are common.
Develop more adaptive evaluations of these intrusions.
Feel less anxious and fearful about having intrusive thoughts.

Clinicians Who Use This Resource Also Use

Understanding Obsessive Compulsive Disorder (OCD)

References And Further Reading

Berry, L. M., & Laskey, B. (2012). A review of obsessive intrusive thoughts in the general population. Journal of Obsessive-Compulsive and Related Disorders, 1(2), 125-132.
Purdon, C., & Clark, D. A. (1993). Obsessive intrusive thoughts in nonclinical subjects. Part I. Content and relation with depressive, anxious and obsessional symptoms. Behaviour Research and Therapy, 31(8), 713-720.
Purdon, C., & Clark, D. A. (1994). Obsessive intrusive thoughts in nonclinical subjects. Part II. Cognitive appraisal, emotional response and thought control strategies. Behaviour Research and Therapy, 32(4), 403-410.
Purdon, C., & Clark, D. A. (1999). Metacognition and obsessions. Clinical Psychology & Psychotherapy, 6(2), 102-110.