Client Questionnaire

Examples include: • Being in a crowd • Standing in a line • Being alone away from home or alone at home • Crossing a bridge • Traveling in a bus, train or car

Examples include: • Speaking in public • Eating in public or with others • Writing while someone watches • Being in social situations

Examples include: • Were you afraid that you would act on some impulse that would be really shocking? • Did you worry a lot about being dirty, contaminated or having germs? • Did you worry a lot about contaminating others, or that you would harm someone even though you didn’t want to? • Did you have any fears or superstitions that you would be responsible for things going wrong? • Were you obsessed with sexual thoughts, images or impulses? • Did you hoard or collect lots of things? • Did you have religious practice obsessions?

Examples include: • Washing or cleaning excessively • Counting or checking things over and over • Repeating, collecting, or arranging things • Other superstitious rituals

Examples include: • Serious accidents • Sexual or physical assault • Terrorist attack • Being held hostage • Kidnapping • Fire • Discover a body • Sudden death of someone close to you • War • Natural disaster

Examples include: • Dreams • Intense recollections