About this worksheet
'Not just right' OCD (also called Tourettic OCD or sensory-based OCD) is driven by a sensory-feeling wrongness rather than a feared outcome. Clients redo, retouch, retype, or realign until it 'clicks.' There is often no articulable reason and no feared consequence — the feeling is the whole thing. Because there is no clear catastrophic thought to challenge, treatment differs slightly from harm or contamination OCD. The exposure is deliberate imperfection — leaving things crooked, saying the sentence 'wrong,' walking without symmetric footfalls — while sitting with the 'not right' feeling without correcting it. This sheet catalogs where the feeling shows up, plans specific deliberate-imperfection exposures with SUDS tracking, and picks one thing to leave crooked for a week. It works particularly well in clients with co-occurring autism or Tourette's, where sensory just-right is prominent and 'feeling right' is a genuine somatic experience rather than a fear. Requires ERP training. May pair with habit reversal training (HRT) or ComB for BFRB overlap.
When to use it
- Symmetry, ordering, counting, or Tourettic OCD.
- Rereading loops, retyping compulsions, redoing motor acts.
- Co-occurring autism or Tourette's, where sensory just-right is prominent.
- Where there is no articulable feared consequence — the feeling itself is the driver.
How to use it
- 1
Catalogue where 'not right' shows up
Objects, movements, words, reading, clothing. The checklist prompts recognition of behaviors clients often haven't named.
- 2
Plan deliberate imperfection exposures
Specific, small, unpleasant. A crooked frame. An unbalanced sentence. Typing without correcting the typo. SUDS-rated.
- 3
Sit with the wrongness
The client's job is to feel the 'not right' without correcting it. Duration matters — 20–45 minutes is typical for the feeling to lose intensity.
- 4
Pick one long-duration exposure
One room, one object, one behavior left 'wrong' for a week. Extended exposures build tolerance faster than repeated short ones.
- 5
Notice 'good enough' becoming habit
The eventual goal — 'good enough' as a felt state, not just a decision. Track it in session.
Frequently asked questions
What is 'just-right' OCD?+
A subtype in which compulsions are driven by a sensory 'wrongness' feeling rather than a feared outcome. Clients redo, realign, retype, or repeat actions until the feeling clicks. Also called Tourettic OCD or sensory-based OCD.
How is it different from symmetry OCD?+
Overlapping — symmetry / ordering OCD is one presentation of the broader 'just-right' pattern. Both are driven by the sensory feeling rather than a feared consequence.
Does deliberate imperfection actually help?+
Yes. It is the ERP equivalent for sensory-driven OCD. Extended exposure to the 'wrong' state without correction is what teaches the nervous system that the feeling passes on its own.
Is this related to autism or Tourette's?+
It often co-occurs. Sensory just-right is common in autism, and Tourettic OCD by definition involves premonitory sensations similar to Tourette's tics. Treatment principles overlap but should be adapted.
Is this worksheet free?+
Yes. Free printable PDF. Sign in to send as a secure client link.
Worksheet — Just-Right / Symmetry OCD Worksheet — provided by TherapistAssist for clinical use. Not a substitute for assessment or treatment.
