What are behavioral experiments in therapy?

In this article we are going to 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 ultimate challenge comes when the The therapist proposes that you carry out an activity outside, on your own, to behaviorally test those distorted beliefs or thoughts or dysfunctional.

Usually, it is at that moment when the reluctances that had not arisen up to now in therapy appear. And it is that going from the abstract to the action (from the verbal to the behavioral) is a challenge for anyone.

What is a behavioral experiment?

Don't worry, it's not about doing experiments with unethical purposes on patients, but they are "exercises" or activities that the patient puts into practice, voluntarily and consciously, in his day to day to overcome a problem or a situation difficult.

A behavioral experiment may 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, in daring to ask other people about what they think, feel or do (especially interesting in cases of social phobia), in obtaining information from other sources like books...

The objective of these experiments is to test the distorted beliefs/cognitions of the patients, which have to be specific (eg. eg, "they're going to criticize me", "I'll go blank and I won't know what to say") instead of too general ones ("I'm not worth it", "I'm useless").

To ensure the usefulness of behavioral experiments, it is very important that the patient's attention is not focused on himself when he carries them out, but on the task. In addition, it is essential that you stop using your defensive behaviors, since 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 those that we have explained. They consist of the patient doing or not doing something.

• Do 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. He is asked in therapy to record himself on video, we ask him to watch the recording after the fact 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 won't be able to resist the urge to use it. Then, the experiment would consist of him staying in the office with a kitchen knife on the table and with the point pointed towards the therapist for a while.

observational experiments

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

When to use them?

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

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

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 “level” the ground and make it easier for the patient, but if small "pushes" are not introduced to make the person do or stop doing things, the therapy can be prolonged indeterminately (eg. e.g., always moving in the abstract and in the verbal, in our “comfort zone”). This entails a high financial cost for the patient, failure to achieve therapeutic objectives and possible professional frustration for the psychotherapist.

How to prepare them?

Behavioral experiments are prepared in therapy together with the psychotherapist, which 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.

It is convenient that a self-registration of the experiment be prepared in session, which must include:

• Date
• Prediction of the patient (they are usually specific anticipated consequences, their severity or intensity, and degree of belief in said prediction). For example: "When I go out to do the oral presentation, I'm going to turn red like a tomato, I'm going to sweat a lot, it's going to shake my voice, I will go blank and panic, I will have to run out of the place and I will have done the ridiculous".
• Alternative perspective and degree of belief in it.
• Experiment (detail what will be done and what the patient is going to pay attention to -before carrying it out-, write what has actually been done, including all the defensive behaviors - after it has been carried out cape-).
• Outcomes (consequences that have actually occurred, their severity, and the extent to which the patient's prediction has come true).
• Conclusion (what you have learned in relation to your anxious prediction and the alternative, degree of belief in them).
• What to do from now on and what to look for from now on in similar situations.