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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OCD Formulation (Salkovskis)
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Salkovskis OCD Model
OCD Cognitive Model (Salkovskis, 1985)
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
How the boxes connect
- Intrusive Thought / Image / Urge: leads to Responsibility Appraisal.
- Responsibility Appraisal: leads to Distress.
- Distress: leads to Neutralising / Rituals / Avoidance.
- Neutralising / Rituals / Avoidance: leads to Temporary Relief.
- Temporary Relief: Keeps going, to Increased Attention to Intrusions.
- Temporary Relief: Reinforces belief ritual was needed, to Responsibility Appraisal.
- Increased Attention to Intrusions: Increases frequency, to Intrusive Thought / Image / Urge.
Normalising
Protective Factors & Strengths
What resources, strengths, and supports might help in recovery?
Reflection
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The OCD Formulation (Salkovskis) is an interactive cognitive behavioural therapy (CBT) formulation model, 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 and client complete the model together and make sense of what it surfaces. You can preview the full formulation above, then assign it digitally for clients to revisit 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:
- Salkovskis OCD Model
- Normalising
- Protective Factors & Strengths: What resources, strengths, and supports might help in recovery?
- 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 formulation 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:
- Emergency services: 999 — if you or someone else is in immediate danger
- Samaritans: 116 123 — free, day or night, 365 days a year
- SANEline: 0800 689 5555 — 4:30pm–10:30pm, every day
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