FOCI: Florida Obsessive Compulsive Inventory
A brief self-report measure for adults comprising a symptom checklist and a 5-item severity scale. Quick to administer and sensitive to treatment change. A severity score ≥8 suggests clinically significant OCD.
FOCI Score Interpreter
Clinically significant threshold met; further evaluation warranted.
5 items, each rated 0–4. Higher scores indicate greater OCD severity. A score ≥8 with ≥1 checklist symptom endorsed indicates clinically significant OCD.
| Total severity score | Interpretation |
|---|---|
| 20+ | ExtremeMaximum severity; intensive clinical attention indicated. |
| 16–19 | SevereSubstantial impairment; treatment is strongly indicated. |
| 12–15 | ModerateClinically significant OCD; treatment recommended. |
| 8–11 | MildClinically significant threshold met; further evaluation warranted. |
| 0–7 | SubclinicalScores below 8 suggest OCD symptoms are not at a clinically significant level. |
Storch EA et al. J Clin Psychol. 2007;63(9):851–859 (≥8 clinical-significance threshold). Finer severity tier labels (mild/moderate/severe/extreme) reflect common clinical convention. Educational reference only — not a diagnostic tool.
About the FOCI
The Florida Obsessive Compulsive Inventory (FOCI) was developed by Eric Storch and colleagues at the University of Florida as a brief, practical alternative to lengthier OCD measures such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). It was designed for adults and is intended for both initial screening and ongoing monitoring of OCD severity in clinical and research settings.
The FOCI is structured similarly to the Children's Florida Obsessive Compulsive Inventory (C-FOCI), adapting the format for adult presentations of OCD across the full range of common symptom themes.
What the Assessment Measures
The FOCI consists of two parts:
Part 1, Symptom Checklist A checklist of 20 common OCD symptoms. Clients indicate which symptoms (obsessions and compulsions) they currently experience. Items span:
- Contamination concerns and cleaning
- Harm obsessions and checking
- Unwanted intrusive thoughts (aggressive, sexual, religious)
- Symmetry and ordering
- Repeating, counting, and arranging rituals
- Hoarding
Part 2, Severity Scale (5 items) Rated on a 0–4 scale, assessing:
- Time spent on obsessions and compulsions
- Distress caused by symptoms
- Interference with daily functioning
- Resistance to symptoms
- Control over symptoms
Scoring
Severity Scale total score: 0–20
| Score Range | Severity |
|---|---|
| 0–7 | Subclinical |
| 8–11 | Mild |
| 12–15 | Moderate |
| 16–19 | Severe |
| 20 | Extreme |
A severity score of ≥8, combined with the presence of at least one checklist symptom, indicates clinically significant OCD warranting further evaluation or treatment.
Psychometric Properties
The FOCI demonstrates adequate to good psychometric properties:
- Internal consistency: Cronbach's α = 0.82–0.89
- Test-retest reliability: r = 0.74–0.89
- Significant convergent validity with Y-BOCS total score
- Sensitive to treatment response in ERP and CBT trials
- Comparable performance to the Y-BOCS in detecting OCD severity
(Storch et al., 2007)
Advantages Over Longer Measures
The FOCI takes approximately 5 minutes to complete compared to 20–30 minutes for a clinician-administered Y-BOCS. This makes it suitable for:
- High-volume clinical settings
- Repeated measurement throughout treatment
- Intake screening alongside other measures
Clinical Considerations
- The FOCI severity scale captures global OCD severity rather than dimension-specific severity; if treatment planning requires identification of dominant symptom themes, consider supplementing with the DOCS
- Self-report measures may underestimate OCD severity in patients with limited insight
- The checklist is useful for identifying treatment targets and monitoring symptom shifts over time
References
- Storch EA, Kaufman DA, Bagner D, et al. (2007). Florida Obsessive-Compulsive Inventory: development, reliability, and validity. Journal of Clinical Psychology, 63(9), 851–859. PMID: 17674398
- Storch EA, Khanna M, Merlo LJ, et al. (2009). Children's Florida Obsessive Compulsive Inventory: psychometric properties and feasibility of a self-report measure of obsessive-compulsive symptoms in youth. Child Psychiatry and Human Development, 40(3), 467–483. PMID: 19326209
Frequently Asked Questions
How is the FOCI scored?
The FOCI severity scale contains five items, each rated 0–4, yielding a total score of 0–20. A higher score indicates greater OCD severity. To screen positive, a person needs a severity score of ≥8 and at least one symptom endorsed on the 20-item checklist.
Is the FOCI self-report or clinician-administered?
The FOCI is a self-report measure completed by the individual being assessed, typically in about five minutes. It does not require a trained clinician to administer, making it practical for routine clinical monitoring and high-volume settings.
Can the FOCI diagnose OCD?
No. The FOCI is a screening and severity-monitoring tool, not a diagnostic instrument. A score of ≥8 on the severity scale warrants further clinical evaluation, but a diagnosis of OCD requires a comprehensive assessment by a qualified clinician.
What does a FOCI severity score of 8 or above mean?
A score of ≥8, combined with at least one endorsed checklist symptom, indicates clinically significant OCD symptoms that are likely to interfere with functioning and warrant further evaluation or treatment consideration. Scores below 8 suggest subclinical severity.
Bill this assessment
The FOCI: Florida Obsessive Compulsive Inventory qualifies for reimbursement under these CPT codes (US).
Last reviewed: Jun 3, 2026
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