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Treating Sensorimotor OCD : The Clinician's Guide to Assessment, Formulation, and Evidence-Based Protocols for Hyperawareness and Body-Focused Obsessions - Jane Lillian Rafter

Treating Sensorimotor OCD

The Clinician's Guide to Assessment, Formulation, and Evidence-Based Protocols for Hyperawareness and Body-Focused Obsessions

By: Jane Lillian Rafter

eBook | 25 February 2026

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Sensorimotor OCD is one of the most misdiagnosed and undertreated subtypes in clinical practice. Clients present with persistent, distressing hyperawareness of normal bodily functions, including breathing, swallowing, blinking, heartbeat, and tongue position, and they cycle through providers who mistake the presentation for health anxiety, panic disorder, somatic symptom disorder, or generalized anxiety. Standard exposure and response prevention protocols often fail because they target the sensation rather than the monitoring behavior that maintains the cycle. Until now, clinicians have had no single resource dedicated to the assessment, formulation, and treatment of this specific OCD subtype.

A Complete Clinical Framework for an Underserved Subtype

This professional guide provides mental health clinicians with everything needed to recognize, accurately diagnose, and effectively treat sensorimotor and hyperawareness obsessions. Beginning with a comprehensive overview of how body-focused OCD presentations differ from other anxiety-related conditions, the book walks through a systematic differential diagnosis protocol, collaborative case formulation models, and realistic treatment planning that sets appropriate expectations from session one.

Four Evidence-Based Treatment Protocols in One Volume

The core of the guide delivers detailed, session-by-session treatment protocols across four modalities: modified exposure and response prevention redesigned for unavoidable triggers, inference-based cognitive behavioral therapy targeting obsessional doubt and inferential confusion, metacognitive therapy with attention training technique integration, and acceptance and commitment therapy for clients who need a values-based approach. Each protocol includes case examples with clinical dialogue, specific adaptation guidance for sensorimotor presentations, and clear decision frameworks for matching clients to the right modality.

Advanced Clinical Guidance for Real-World Complexity

Treatment rarely unfolds in a vacuum. Dedicated chapters address comorbidity management when sensorimotor OCD co-occurs with generalized anxiety, depression, ADHD, autism spectrum conditions, and additional OCD subtypes. A pharmacological considerations chapter provides structured guidance on medication options, augmentation strategies, prescriber collaboration, and intensive treatment referral pathways. The final chapter delivers reproducible client handouts, session worksheets, daily monitoring forms, exposure planning tools, and family psychoeducation materials ready for immediate clinical use.

Built for the Practicing Clinician

Every chapter opens with a narrative clinical vignette, includes research spotlights with verifiable citations, and closes with a Monday Morning Application section containing five actionable steps that can be implemented in the next clinical session. This is not a theoretical overview. It is a practice-ready manual grounded in current evidence and written for therapists, psychologists, counselors, psychiatric nurse practitioners, and clinical social workers who want to deliver effective treatment for a population that has been underserved for too long.

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