> ## Documentation Index
> Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt
> Use this file to discover all available pages before exploring further.

# Y-BOCS — Yale-Brown Obsessive Compulsive Scale

> The 10-item clinician-administered OCD severity scale — the standard outcome measure in ERP and SSRI trials.

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.

## 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.

## 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

## 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.

## Scoring and severity cutoffs

### 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

### Severity bands (Goodman et al. 1989)

| Total | Band         |
| ----- | ------------ |
| 0-7   | Subclinical  |
| 8-15  | Mild OCD     |
| 16-23 | Moderate OCD |
| 24-31 | Severe OCD   |
| 32-40 | Extreme OCD  |

### Clinical change thresholds

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

## 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+.

## 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.

## 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](/clinical-templates/screening/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.

## Is it free to use?

**Yes.** Free clinical use, per UPMC Western Psychiatric.

## 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.

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