Directions: Make a list of all the things you avoid. Rate the degree to which you avoid each item: (0 = not at all, 10 = completely).
Include items that are somewhat uncomfortable (4–7) along with ones you must completely avoid (9–10).
Situations or Objects Avoided Degree Avoided (0–10)
Using the laundry in my apartment complex
Touching a doorknob in a high-class restaurant
Touching a doorknob in a fast-food restaurant
Buying items that I saw someone else touch
Checking out a book from the public library
Picking up litter
What I avoid: