OCD Contamination Worksheet

Contamination fears, compulsions, avoidance, guilt rating, and self-scoring worksheet

Mark Zauss, LMHC, LPC, CCMHC, NBCC, BC-TMC, ASDCS, NATC, CCTP, CCTP II, ADHD-CCSP, C-DBT
Branded psychoeducational and self-monitoring worksheet for obsessive-compulsive symptoms related to contamination concerns.

Client Information

Client Name

Date

Age

Instructions

Use this worksheet to identify contamination triggers, the distress they create, the compulsive actions used to reduce anxiety, and the level of guilt or shame associated with these behaviors. This is not a diagnostic tool by itself. It is intended to increase self-awareness and support treatment planning.

Rate each item based on the last 7 days unless otherwise directed. Higher scores generally reflect greater interference, distress, compulsive behavior, avoidance, and guilt.

Contamination Triggers

Check any contamination fears that apply.

Germs from public surfaces Bathrooms or toilets Bodily fluids Garbage or trash Raw food or food contamination Illness from other people Shoes / outside dirt Laundry contamination Door handles / carts / phones Animal-related contamination Cleaning chemicals / toxins Cross-contamination in the home

Other contamination fears or triggers

Self-Scoring Ratings

Rate each item from 0 to 4.

Item	0	1	2	3	4
1. Frequency of contamination thoughts How often did contamination obsessions occur?	None	Rare	Sometimes	Often	Near constant
2. Distress caused by contamination thoughts How upsetting were the thoughts?	None	Mild	Moderate	High	Extreme
3. Urge to wash, clean, sanitize, or neutralize How strong was the urge to do something to feel safe?	None	Mild	Moderate	Strong	Extreme
4. Time spent on compulsions How much time was spent washing, checking, cleaning, changing clothes, or avoiding?	None	Minimal	Noticeable	Significant	Very high
5. Avoidance How much did you avoid people, places, objects, or tasks because of contamination fears?	None	Slight	Moderate	Major	Extreme
6. Interference with daily functioning How much did symptoms affect work, school, home, relationships, or routine?	None	Mild	Moderate	High	Severe
7. Resistance to compulsions How difficult was it to resist washing, cleaning, or reassurance seeking?	Easy	Slightly hard	Moderately hard	Very hard	Nearly impossible
8. Feeling of guilt, shame, or embarrassment about these actions How guilty, ashamed, or embarrassed did you feel because of these thoughts or behaviors?	None	Mild	Moderate	High	Extreme

Compulsions and Safety Behaviors

Check behaviors used to reduce distress.

Excessive handwashing Rewashing after touching items Showering longer than needed Changing clothes repeatedly Cleaning objects or surfaces excessively Avoiding public restrooms Using tissues, wipes, or barriers to touch items Asking for reassurance Throwing away items due to contamination fear Mentally reviewing or neutralizing Avoiding people or places seen as contaminated Repeating routines until it feels safe

Describe your most common compulsions or safety behaviors

Trigger and Response Log

Date / Situation	Trigger	Fear / Distress (0–10)	Compulsion or Avoidance	Guilt Afterward (0–10)	What I Learned

Self-Scoring Results

Obsessions / Distress / Urges

0

Items 1–3

Compulsions / Avoidance / Interference

0

Items 4–6

Resistance + Guilt / Shame

0

Items 7–8

Total Score

0

Maximum score: 32

Severity Range

Not scored yet

0–5 minimal
6–11 mild
12–17 moderate
18–24 marked
25–32 severe

Summary / Reflection

Calculate Score Print / Save as PDF Reset

Clinical Use / Next Steps

Areas most in need of treatment focus

Exposure and Response Prevention (ERP) target ideas

Client Signature

Therapist Signature

Sources / Clinical Basis
Abramowitz, J. S., McKay, D., & Taylor, S. (Eds.). (2008). Clinical handbook of obsessive-compulsive disorder and related problems. Johns Hopkins University Press.
Foa, E. B., Yadin, E., & Lichner, T. K. (2012). Exposure and response (ritual) prevention for obsessive-compulsive disorder: Therapist guide. Oxford University Press.
Goodman, W. K., Price, L. H., Rasmussen, S. A., et al. (1989). The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006–1011.
Rachman, S. (2004). Fear of contamination. Behaviour Research and Therapy, 42(11), 1227–1255.
This worksheet is intended for psychoeducational and clinical tracking purposes and does not replace a formal diagnostic evaluation.

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