488From D. A. Clark (2004, p. 179). Copyright 2004 by The Guilford Press. Reprinted inCognitive Therapy of Anxiety Disorders: Scienceand Practiceby David A. Clark andAaron T. Beck. Permission to photocopy this appendix is granted to purchasers of this book for personal use only (see copyright page for details).aPPENDIX 11.1
Daily Record of Primary ObsessionName:Date:Primary obsession: Instructions:In consultation with your therapist, please record the obsessional thought, image, or impulse that is most troubling for you at thistime. Record the approximate number of times you experienced the obsession on a particular day. Then complete the rating scales for each daywhich indicate your most typical experience of the obsession for that day. This form should be completed at bedtime each evening.Day of Weekapproximate Frequency
of Obsession during the Dayaverage Distress of
Obsession(0 = none to100 = extreme, panic-like )Intensity of Effort to Control Obsession(0 = no effort to control to 100 = franticeffort to stop thinking the obsession)Intensity of Urge to Engage in Compulsion or Neutralization
(0 = no urge to 100 = irresistible urge)SundayMondayTue sdayWednesdayThursdayFridaySaturdaySundayMondayTue sdayWednesdayThursdayFridaySaturday