Obsessive compulsive disorder - OCD treatment and therapy from NOCD

8 free therapy worksheets to support your mental health

Jun 21, 202413 minute read

Taking care of your mental health is an ongoing journey, and like any journey, having the right tools can make a significant difference. Many resources are available to support you on this path, from self-care practices like mindfulness and exercise to therapy and support groups. 

Among these tools, therapy worksheets offer structured exercises and activities designed to help you gain self-awareness, develop coping skills, and track your progress over time. Below, we discuss four different areas of therapy and subsets of mental health and how they can support you in your own mental health journey. 

You can also download our printable worksheets, designed to help identify your thoughts, feelings, and underlying patterns. 

Keep in mind that while therapy worksheets can be valuable tools, they should not be considered a replacement for professional help. A licensed therapist can provide personalized guidance, support, and accountability throughout your mental health journey. They can tailor interventions to your specific needs and ensure you are using worksheets effectively within a comprehensive treatment plan.

Acceptance and commitment therapy (ACT) 

Acceptance and commitment therapy (ACT) is a type of psychotherapy focused on accepting difficult thoughts and feelings without judgment and committing to taking action towards a life rooted in your values. ACT utilizes various tools and practices to achieve this, including:

  • Mindfulness exercises: These exercises train you to focus on the present moment without judgment, allowing you to observe your thoughts and feelings without getting hooked by them or falling into rumination
  • Defusion techniques: These techniques help you detach from unhelpful thoughts and beliefs, preventing them from controlling your behavior.
  • Values identification: This process helps you identify what truly matters to you in life, providing a direction for your actions.

1. Clarifying values

Clarifying your values is a crucial step in ACT therapy. Values are the core principles that guide your life and what you strive for. By identifying your values, you can make decisions and take actions that align with what’s truly important to you.

Aligning your actions with what matters most to you can lead to a greater sense of purpose and direction in life. Values also provide a clear framework for navigating challenges. When faced with difficult choices, connecting back to your core principles can offer strength and motivation to persevere on a path that feels right for you. 

Example practice: Questions to clarify your values

  1. What qualities do I admire most in others?
  2. What activities bring me the most joy and fulfillment?
  3. If I could have anything in life, what would it be?
  4. What kind of legacy do I want to leave behind?
  5. What would my ideal life look like?

2. Recognizing cognitive distortion

Our thoughts can sometimes be misleading and unhelpful. ACT helps you identify these cognitive distortions, which are negative thinking patterns that can contribute to emotional distress. 

An example of a cognitive distortion is all-or-nothing thinking, where you see things in extremes, jumping to negative conclusions without any evidence they’ll come true. Catastrophizing is another cognitive distortion in which you exaggerate the meaning or importance of a negative event or circumstance.

Example practice: Identifying cognitive distortions

  • Write down a recent situation that caused you distress. What led to the event, and what caused the negative emotions you experienced? 
  • Describe the emotions and automatic thoughts you had as a result of the situation. How intense were the emotions? How much did you believe these thoughts and feelings at the time? 
  • Examine your thoughts for any distortions. Look for signs of all-or-nothing thinking, catastrophizing, or conclusions you jumped to based on your feelings. 
  • Next, challenge your distorted thoughts. Ask yourself if there’s evidence to support your thoughts and whether there might be alternative explanations.
  • Reframe your thoughts in a more adaptive way. If you had initially considered the worst-case scenario, what is the best-case scenario? How likely are these scenarios to occur? 

Download our printable ACT worksheets below to work through these lessons yourself. 

Download ACT therapy worksheets

Mindfulness and meditation 

Mindfulness and meditation are practices that cultivate present-moment awareness and acceptance. By focusing on the here and now without judgment, you can learn to observe their thoughts and feelings without getting caught up in them. This approach can be highly beneficial for managing stress, anxiety, intrusive thoughts, and negative thought patterns. 

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There are various ways to practice mindfulness and meditation, including: 

  • Guided meditations: These audio or video recordings lead you through a structured meditation practice, focusing your attention on your breath, bodily sensations, or surrounding environment.
  • Mindfulness exercises: These activities can be as simple as focusing on your breath during everyday tasks like eating or walking. The goal is to cultivate a heightened awareness of your present experience.
  • Body scan meditation: This practice involves systematically directing your attention to different parts of your body, noticing any physical sensations without judgment.

Mindfulness and meditation help us to reframe negative thoughts instead of judging ourselves for having them. Much like we wouldn’t turn away the pain of a young child or close friend, mindfulness teaches us to validate our feelings and allow them to pass through us. 

3. Learning self compassion 

Self-compassion involves treating yourself with kindness and understanding, especially during challenging times. It’s about acknowledging your imperfections and vulnerabilities without harsh self-criticism. This fosters emotional resilience and allows you to navigate difficulties with greater ease.  Many mindfulness and meditation exercises incorporate techniques for developing self-compassion.

Example practice: Loving-kindness meditation

  1. Find a quiet place and sit comfortably. Close your eyes or soften your gaze. Take a few slow, deep breaths, focusing on the sensation of your breath entering and leaving your body. 
  2. Silently repeat a phrase of loving-kindness towards yourself, such as “May I be kind to myself” or “May I be happy and healthy.” Focus on the feeling of goodwill behind the words.
  3. Continue for a few minutes, allowing the feelings of kindness to wash over you.
  4. After some time, you can gently shift the focus to someone you care about, repeating a similar phrase of loving-kindness directed towards them. Notice the difference in how it feels.
  5. Finally, bring your awareness back to yourself and repeat the self-compassion phrase for a few more moments.

4. Living in the present

Mindfulness and meditation practices heavily emphasize living in the present moment. This involves focusing your awareness on what’s happening right now without dwelling on the past or worrying about the future.  

Our minds naturally tend to wander, but by gently bringing your attention back to the present, you can reduce stress, improve focus, and recognize and halt negative thought patterns that may be hindering you. There are many exercises you can incorporate to cultivate present-moment awareness.

Example practice: Living in the present

  1. Find a comfortable seated position and take a few deep breaths.
  2. Notice your body and take note of how it feels. Is your jaw clenched? Are your shoulders tense? 
  3. Focus on your breath by taking slow, deep breaths and actively releasing any tension in your body. You can slowly count as you breathe in and out to help you focus on relaxing into your posture.
  4. As you focus on your breath, notice when your mind wanders. When you notice yourself focusing on a thought, simply accept it and turn your attention back to your breathing.
  5. Avoid judging yourself for any wandering thoughts. Instead, acknowledge them and then let them go.

Download our printable mindfulness and meditation worksheets below to work through these lessons yourself. 

Download mindfulness and meditation worksheets

Self-care and well-being 

Self-care is the practice of intentionally taking actions that nourish your physical and mental well-being. While self-care often gets confused with the ideas of indulgence, it’s really about prioritizing activities that replenish your energy, reduce stress, and help you build emotional resilience. This can include things like: 

  • Establishing a well-rounded, nourishing diet
  • Prioritizing physical activity, like daily walks
  • Maintaining healthy sleep hygiene
  • Spending time in nature
  • Scheduling regular doctor visits
  • Learning to set healthy boundaries

Ultimately, self-care focuses on promoting your overall well-being, both physically and mentally, so you can cultivate a more balanced approach to life. 

5. Setting boundaries

Setting healthy boundaries is a crucial aspect of self-care. It involves establishing clear limits on what you are willing to accept in your interactions with others. This can be anything from saying “No” to additional work requests to disengaging from emotionally draining conversations. By setting boundaries, you protect your mental and emotional well-being, preventing burnout and fostering a greater sense of control over your life.

Example practice: The “No, thank you” exercise 

  1. Choose a situation where you often feel pressured to say yes, even when you don’t want to.
  2. Practice saying “No, thank you” in a firm but polite voice. You can add a brief explanation if you feel comfortable, such as “I appreciate the offer, but I have too much on my plate right now.”
  3. Repeat this exercise in different scenarios until setting boundaries feels more natural and comfortable.

6. Practicing gratitude 

Practicing gratitude involves actively focusing on the positive aspects of your life, both big and small. It’s about acknowledging the good things you have, the people who support you, and the experiences that bring you joy. When you shift your focus towards appreciating what you have, you cultivate a more positive outlook and build resilience in the face of challenges.

Example practice: Morning gratitude journal

  1. Find a notebook or journal you enjoy using.
  2. Each morning before you start your day, take a few minutes to write down 3-5 things you are grateful for. These can be anything from a supportive friend, a good conversation, a positive circumstance, or a delicious meal you recently had. 
  3. Briefly reflect on why you are grateful for each item on your list.
  4. Over time, rereading your entries can be a powerful reminder of the positive aspects of your life, even during challenging times.

Download our printable self-care and well-being worksheets below to work through these lessons yourself. 

Download self-care worksheets

Exposure and response prevention (ERP) therapy for OCD

Exposure and response prevention (ERP) therapy is designed to address the intrusive thoughts and compulsive behaviors that define OCD. ERP works by gradually exposing you to the situations and thoughts you fear in a controlled environment while preventing you from engaging in your usual compulsions. This process helps break the cycle of anxiety and reassurance that fuels OCD, leading to a significant reduction in symptoms and improved overall well-being. 

It’s important to note that ERP should always be done with the guidance of a trained specialist. If you attempt to start ERP on your own, you run the risk of reinforcing compulsive behaviors, exposing yourself to extreme anxiety or distress too early, or missing key symptoms. Use these worksheets only under with the guidance and supervision of a therapist with specialized training in OCD.

7. Identifying core fears

While specific obsessions in OCD can vary widely, they often stem from a deeper, underlying fear that drives the anxiety and compulsive behaviors. Identifying these core fears is crucial for effective treatment, as they represent the ultimate consequence you’re trying to avoid through compulsions. Common core fears in OCD include:

  • Fear of harm: Often the root of harm OCD, this could manifest as a fear of causing harm to oneself or others, leading to compulsions like excessive checking or cleaning.
  • Fear of contamination: This fear often manifests in contamination OCD and can be related to germs, dirt, or bodily fluids, leading to excessive hand washing or cleaning rituals.
  • Fear of losing control: This fear often involves intrusive thoughts or urges that are perceived as unacceptable, leading to compulsions aimed at suppressing or neutralizing them.
  • Fear of uncertainty: This fear stems from an intolerance for ambiguity and the inability to guarantee specific outcomes, leading to compulsions to achieve absolute certainty.

Example Practice: The “Why” Ladder

The “Why” Ladder is a simple exercise to help you identify core fears. It’s important to emphasize that the “why” ladder does NOT seek to answer why your thoughts or obsession are occurring, but instead asks why you respond to them the way you do. Here’s how it works:

  1. Start by writing down one of your obsessions.
  2. Ask yourself, “Why does this thought bother me?” and write down the answer.
  3. Repeat the “Why” question, digging deeper into the underlying fear that fuels your anxiety.
  4. Continue asking “Why” until you reach a point where you can no longer identify a further reason for your fear. This often reveals the core fear driving your OCD symptoms.

By understanding your core fears, you can begin to challenge their validity and address them through therapy techniques like ERP therapy.

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8. Understanding mental compulsions  

Mental compulsions are repetitive mental acts people with OCD engage in to temporarily reduce the anxiety triggered by their obsessions. Unlike physical compulsions, these mental rituals, known to be a component of Pure Obsessional OCD, occur internally and can be harder to recognize. Common types of mental compulsions include:

  • Rumination: This involves repeatedly replaying scenarios or thoughts in your head, often focusing on negative possibilities or past mistakes.
  • Mental reviewing: This involves constantly reviewing past actions or conversations, seeking reassurance that nothing bad happened.
  • Neutralizing thoughts: This involves silently repeating phrases or performing mental calculations to neutralize the perceived “badness” of intrusive thoughts.
  • Distraction: This involves engaging in excessive mental activities to avoid intrusive thoughts, such as mentally listing things or singing songs.

Understanding these mental compulsions is crucial because they, like physical compulsions, reinforce the OCD cycle. While they may provide temporary relief, they ultimately prevent you from facing your fears and experiencing true improvement.

Example Practice: Redirecting attention 

  1. Take some time to reflect on your thoughts and mental habits.
  2. Notice any repetitive thought patterns or mental rituals you engage in when experiencing anxiety.
  3. Ask yourself: “What purpose does this thought or action serve?”
  4. If the answer involves reducing anxiety or neutralizing a negative thought, it might be a mental compulsion.
  5. Next time you recognize yourself entering into a mental compulsion, acknowledge the thought (rather than trying to suppress it), then gently redirect your focus elsewhere, such as to a preferred topic, thought, or activity. 

Download our printable ERP therapy worksheets below to work through these lessons yourself. 

Download ERP therapy worksheets

Find support on your mental health journey

If you struggle with OCD, working with a trained therapist who specializes in ERP is a great place to start. Learn more about NOCD’s accessible, evidence-based approach to treatment to see if it’s right for you.

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