Multitreatment of obsessive-compulsive checking in a geriatric patient.

A team worked with an young learners woman who checked her door lock up to 40 times a night.

They used a mix of tools: verbal exposure, response delay, and praise for fewer checks.

Sessions happened in her home, twice a week, for six weeks.

Lock checks dropped from 40 to 2 per night after the first week.

The gains held at three-month follow-up.

Verbal exposure—talking through the fear of “someone breaking in”—cut the urge when real locks were too risky to practice with.

Wilmut et al. (2013) also used a “talk-only” window: one 30-minute daily worry slot lowered anxiety and insomnia.

Both studies show you can shrink repetitive thoughts without touching real objects.

Fisher et al. (2003) and Jaffe et al. (2002) looked at vocal tics, not checking, but they echo the same rule—target the behavior first, then hunt for idiosyncratic triggers if progress stalls.

If a client’s compulsion is unsafe to rehearse—fall risk, sharp objects, or hospital gear—use verbal exposure. Ask them to describe the feared scene in detail, then wait 30 seconds before any action. Track the delay; praise every extra second. You can start this Monday with no extra materials.