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The Y-BOCS is the dominant clinician-administered OCD severity measure. It’s the standard outcome in OCD treatment trials, ERP outcome research, and pharmacotherapy decisions for treatment-resistant cases. You fill it about the client after a structured interview. The client never sees the form.

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What it measures

Ten items, scored separately for obsessions and compulsions:
  • Obsessions (items 1-5): time spent, interference, distress, resistance, control
  • Compulsions (items 6-10): time spent, interference, distress, resistance, control
Each item scores 0-4. Total range is 0-40.

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When to use it

  • OCD severity tracking — the primary outcome in CBT-ERP and SSRI treatment trials
  • ERP (Exposure-Response Prevention) treatment-response measurement
  • Tic-related OCD differential — often paired with the YGTSS in pediatric and young-adult patients (roughly half of Tourette’s cases carry comorbid OCD)
  • Treatment-resistant OCD decision-making — clomipramine, augmentation, deep TMS, gamma knife capsulotomy

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How you fill it

Solo fill. Open Y-BOCS from the templates picker and tap New response. The renderer presents the 10 items in two groups (Obsessions / Compulsions) with a header between them for visual chunking. Typical administration is 20-30 minutes with the rater manual. The form never goes to the client — Y-BOCS is psychometrically a structured interview, not a self-report. The picker has no “Send to client” option for this measure.

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Scoring and severity cutoffs

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Total + subscales

  • Total: sum of all 10 items, 0-40
  • Obsessions subscale: sum of items 1-5, 0-20
  • Compulsions subscale: sum of items 6-10, 0-20

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Severity bands (Goodman et al. 1989)

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Clinical change thresholds

  • Response: ≥35% reduction in total from baseline (Pallanti 2002 international consensus)
  • Remission: total ≤12 sustained

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Rater training

The Y-BOCS Rater Manual (Goodman et al., distributed by UPMC Western Psychiatric Institute and Clinic) provides scoring anchors and probe questions. Reliability with trained raters typically reaches ICC 0.85+.

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What we render vs. the source

Verbatim Goodman 1989 items with the published severity anchors in the choice display text. The 10 items are presented in two groups (Obsessions / Compulsions) with a section header in the Rivet renderer. The Y-BOCS Symptom Checklist — the separate ~65-item lifetime symptom inventory that distinguishes obsession content (contamination, aggressive, sexual, hoarding, religious, somatic, ordering, miscellaneous) from compulsion form (cleaning, checking, repeating, counting, ordering, hoarding, miscellaneous) — is a separate template and is not part of the 10-item severity scale.

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Y-BOCS vs OCI-R

The Y-BOCS is the severity standard and it costs your time — ten items rated by you across an interview, covering how much time the symptoms take, how much they interfere, how distressing they are, how hard the client resists and how much control they have. It’s the measure OCD treatment trials report, which is why a Y-BOCS number travels: a 35% drop is the conventional definition of treatment response. The OCI-R is self-report, takes the client a few minutes, and is better at a different job — showing which of the six symptom dimensions are active, which is what you need when planning exposure work. Most practices use both: OCI-R to see the shape of the problem and to track between sessions, Y-BOCS at assessment and at intervals to measure severity properly. Note that the Y-BOCS symptom checklist — the long lifetime inventory of specific obsessions and compulsions — is a separate instrument from the ten severity items, and Rivet includes the severity items only.

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Is it free to use?

Yes. Free clinical use, per UPMC Western Psychiatric.

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Citations

  • Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Heninger, G. R., & Charney, D. S. (1989). “The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability.” Archives of General Psychiatry, 46(11): 1006-1011. Free clinical use per UPMC Western Psychiatric Institute and Clinic.
  • Pallanti, S., Hollander, E., Bienstock, C., et al. (2002). “Treatment non-response in OCD: methodological issues and operational definitions.” International Journal of Neuropsychopharmacology, 5(2): 181-191.

YGTSS

Yale Global Tic Severity Scale. Frequently paired with Y-BOCS in Tourette’s and tic-related OCD presentations.

Clinician-administered overview

Why these six measures don’t ship to clients, and how solo fill works.