OCD Assessment Process
How our assessment process works, the screening tool we use, and what happens next depending on the result.
We want our assessment process to be straightforward, honest, and genuinely useful, whatever the outcome. This guide explains exactly how it works, from initial screening through to what happens if OCD looks likely, and what happens if it does not.
How assessment works
Our process starts with a validated screening questionnaire. This is not a diagnosis in itself, it is a structured way of understanding whether your symptoms are consistent with OCD and how significant their impact is, which then informs the most appropriate next step for you.
Screening questionnaire
You complete the OCI-R, a validated, widely used screening tool for OCD symptoms.
Result reviewed
A clinician reviews your score and responses alongside a brief discussion of your situation.
Signposting
Depending on the result, we either signpost you to a full formal assessment with a doctor, or suggest a more suitable pathway if OCD appears unlikely.
Clear next steps
Whatever the outcome, you leave with a clear explanation of what we found, why, and what your options are.
The OCI-R screening tool
We use the OCI-R (Obsessive-Compulsive Inventory – Revised) as our screening tool. It is one of the most widely used and validated self-report questionnaires for OCD symptoms, used in both clinical practice and research internationally.
What it covers
The OCI-R is an 18-item questionnaire covering six areas (subscales) commonly affected in OCD. You rate how much each has bothered or distressed you over the past month.
Washing
Concerns about contamination and excessive washing or cleaning
Checking
Repeated checking of locks, appliances, or actions already completed
Ordering
A need for symmetry, exactness, or things to feel "just right"
Obsessing
Intrusive, unwanted thoughts, including harm, taboo, or distressing themes
Hoarding
Difficulty discarding possessions, even those with little value
Neutralising
Mental acts (counting, repeating phrases, mental review) used to reduce distress
A screening tool, not a diagnosis. The OCI-R is very good at identifying who is likely to benefit from a full clinical assessment, but a score above the usual threshold does not confirm OCD, and a lower score does not completely rule it out. It is a starting point for a clinical conversation, not the end point.
What happens next
What happens after screening depends entirely on your individual result and presentation. We do not follow a single fixed path for everyone.
If OCD appears likely
We will signpost you to a full, formal assessment with one of our doctors. This is a structured clinical conversation, not a further questionnaire, and is where an actual diagnosis can be made if appropriate.
If OCD appears unlikely
We will explain why, and suggest a more suitable pathway, for example, an assessment for generalised anxiety, health anxiety, or another condition that may better fit what you are experiencing, so you are not left without direction.
The full assessment
A full OCD assessment is a thorough, unhurried clinical interview with one of our doctors. It explores the nature, frequency, and impact of your obsessions and compulsions, how long you have experienced them, and considers other conditions that can present similarly.
A thorough assessment typically covers:
- The specific content and pattern of your obsessions and compulsions
- How much time they take up and how much distress they cause
- The impact on work, relationships, and day to day functioning
- Other possible explanations, including anxiety, depression, autism, or (rarely) psychosis
- Any relevant family history or significant life events
Our commitment to honesty
Whatever the outcome of screening or a full assessment, we will always be honest with you and explain all of the options available, clearly and without jargon.
We do not leave people without direction. If OCD is not the right explanation for what you are experiencing, we will tell you clearly why, and help you understand what we think is actually going on and where to go next.
Age & diagnosis
We follow gold-standard UK best practice guidance. In line with this, we generally only assess and diagnose OCD in adults aged 18 and over.
Exceptional circumstances
In exceptional circumstances, we may consider assessment below the age of 18. This would generally only apply where there is a significant, demonstrable impact on quality of life, or where someone is imminently due to turn 18. Any decision to assess below 18 is made on a case by case basis, taking into account the individual's specific circumstances, and is not something we do routinely.
Getting started
If you would like to start with our screening questionnaire, or discuss anything in this guide, please get in touch.
Once assessed, our treatment options and the evidence behind them are covered in our OCD treatment guide.