ABOUT THIS EPISODE
Four years in, and we're going back to basics.
In this episode of Breaking the Rules, Celin and Tori walk through the full OCD assessment process from the ground up - because with new listeners joining and so much focus on treatment in recent episodes, it felt like the right time to start at the beginning.
How do you actually assess for OCD? What does a comprehensive clinical interview look like? When do you bring in psychometrics? And what happens when the OCD isn't responding to ERP the way it should?
Celine and Tori cover the full assessment process — from taking a developmental history to using the Y-BOCS, working through the DSM-5 criteria, and navigating differential diagnosis. They also discuss PANDAS and PANS: the rare but important condition where OCD is triggered by an infection, why ERP alone won't work, and how asking one simple question about recent illness can completely change a treatment pathway.
Whether you're a clinician new to the OCD space, refreshing the fundamentals, or someone who's wondered how OCD gets diagnosed — this one's for you.
In this episode, you'll learn:
- Why a full developmental history is non-negotiable — even with adult clients
- The two age of onset clusters for OCD and why they matter
- How to use the Y-BOCS as an interview tool rather than a take-home questionnaire
- Why scoring the Y-BOCS isn't enough — and what you still need to check
- Jonathan Grayson's Freedom from OCD scale as an alternative for clinicians new to the space
- The DSM-5 criteria for OCD explained in plain language
- How to differentiate OCD from anxiety disorders, autism, OCPD, and other co-occurring conditions
- What the insight specifier really means — and why good insight doesn't mean mild OCD
- What PANDAS and PANS are, how to spot them, and why they require medical treatment first
- How a thorough assessment sets you up seamlessly for ERP
Also featuring: a baby learning to roll over in the background.
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