In this article we will talk about one of the fundamental components of the well-known technique of Cognitive Restructuring: behavioral experiments.

Why do we say that these experiments are fundamental? Very simple: in the context of therapy it is relatively “easy” for the patient to test some beliefs on a verbal level, but the definitive challenge comes when the therapist proposes to carry out an activity outside, on his own, to test these distorted or dysfunctional beliefs or thoughts in a behavioural way.

Usually, it is at this point that the reticence that had not yet arisen in therapy appears. The fact is that moving from the abstract to action (from the verbal to the behavioural) is a challenge for anyone.

What is a behavioral experiment?

Don’t worry, it’s not about doing experiments with patients for unethical purposes, but rather “exercises” or activities that the patient carries out, voluntarily and consciously, in his or her daily life to overcome a problem or a difficult situation.

A behavioral experiment can consist of doing (in cases of social phobia, for example) or not doing something (especially in cases of obsessive-compulsive disorder), observing the behavior of others, daring to ask other people about what they think, feel or do (especially interesting in cases of social phobia), obtaining information from other sources such as books…

The aim of these experiments is to test the distorted beliefs/cognitions of the patients , which have to be specific (e.g. “I will be criticized”, “I will be left blank and I won’t know what to say”) rather than too general (“I am not worth it”, “I am no good”).

To ensure the usefulness of behavioural experiments it is very important that the patient does not focus on himself when carrying out the experiment, but on the task. In addition, it is essential that they stop using their defensive behaviors, as they contribute to the maintenance of the dysfunctional beliefs and thoughts that we want to modify.

Types and examples

There are 2 basic types of experiments:

Active experiments

They are the most frequent and the ones we have explained. They consist of the patient doing or not doing something.

  • Doing something : let’s imagine a person who has a lot of anxiety when speaking in public, and believes that the anxiety is perceived by the listeners. You are asked in therapy to record it on video, we ask you to watch the recording afterwards and check what the signs of anxiety are and the degree to which it is appreciated.
  • Stop doing something : person with Obsessive Compulsive Disorder who believes that if he has a sharp object nearby he will not be able to resist the urge to use it. Then, the experiment would consist of him/her staying in the office with a kitchen knife on the table and the tip directed towards the therapist for a while.

Observational experiments

In these cases the patient is only an observer who is dedicated to collecting data, not an active participant as in the previous type. They will be useful in cases where the patient is very afraid to conduct an active experiment, or when more information is needed to make an active one. Examples: direct observation (modeling), conducting surveys, or information from other sources.

When to use them?

We will prepare together with the patient and use the behavioural experiments when we are applying the technique of cognitive restructuring, in parallel. That is to say, when we want to make the person’s beliefs more flexible and modify them, behavioural experiments are a good ally.

Some authors recommend introducing behavioural experiments as soon as possible, as it is understood that therapeutic advances go hand in hand with behavioural changes. Psychologists are interested in the achievement by the patient of broad and prolonged changes in time (affective, cognitive and behavioral changes), which almost always require behavioral questioning.

In this sense, the verbal questioning that we carry out in the Cognitive Restructuring technique when looking for evidence for and against certain thoughts is very useful to “smooth out” the terrain and make it easier for the patient, but if small “pushes” are not introduced so that the person does or does not do things, the therapy can be prolonged indefinitely (e.g., always moving in the abstract and in the verbal, in our “comfort zone”). This implies a high economic cost for the patient, the non-achievement of the therapeutic objectives and a possible professional frustration for the psychotherapist.

How to prepare them?

The behavioural experiments are prepared in therapy together with the psychotherapist, who will be an important guide to achieve the expected changes . They will never be predetermined experiments, but will vary greatly depending on the patient and the problem.

A self-registration of the experiment should be prepared in session and should include a record of the experiment:

  • Date
  • Patient’s prediction (usually specific anticipated consequences, the severity or intensity of the consequences, and degree of belief in the prediction) For example: “when I go out to do the oral presentation I’m going to get red as a tomato, I’m going to sweat a lot, my voice is going to shake, I’m going to go blank and panic, I’m going to have to run away from the place and I’ll have made a fool of myself”.
  • Alternative perspective and degree of belief in it
  • Experiment (detail what will be done and what the patient is going to focus on -before carrying it out-, write down what has really been done, including all the defensive behaviours -after carrying it out-).
  • Results (consequences that have actually occurred, their severity, and the extent to which the patient’s prediction has been fulfilled).
  • Conclusion (what have you learned about your anxious prediction and the alternative, degree of belief in them).
  • What to do from now on and what to look out for in similar situations