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 at the verbal level, but the definitive challenge comes when the therapist proposes to perform an activity abroad, on his own, to test behaviorally those beliefs or distorted or dysfunctional thoughts.
Usually, it is at that moment when there appear the reluctance that had not arisen until now in therapy. 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?
Quiet, it is not about doing experiments with unethical purposes with patients, but they are "exercises" or activities that the patient carries out, voluntarily and consciously, in their day to day to overcome a problem or a situation hard.
A behavioral experiment can consist in doing (in cases of social phobia, for example) or in stopping doing something (especially in cases of obsessive-compulsive disorder), in 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 such as books ...
The aim of these experiments is to test the distorted beliefs / cognitions of patients , which have to be specific (eg, "I will be criticized", "I will remain blank and I will not know what to say") instead of being too general ("I'm not worth", "I'm not good").
To ensure the usefulness of behavioral experiments it is very important that the patient does not focus his attention on himself when he performs them, but on the task. In addition, it is essential that you stop using your defensive behaviors, as they contribute to the maintenance of beliefs and dysfunctional thoughts that we want to modify.
Types and examples
There are 2 basic types of experiments:
They are the most frequent and those that we have explained. They consist of the patient doing or not doing something.
- Do something : imagine a person who has a lot of anxiety when speaking in public, and believes that anxiety is perceived by the listeners. You are asked in therapy to record on video, we ask you to watch the recording afterwards and check what are the signs of anxiety 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 in that it remains in the consultation with a kitchen knife on the table and with the point directed towards the therapist during a time.
In these cases the patient is only an observer who is dedicated to collecting data, does not have an active role as in the previous type. They will be useful in cases in which the patient is very afraid of carrying out 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 we will use behavioral experiments when we are applying the technique of cognitive restructuring, in parallel. That is, when they want to flex and modify beliefs of the person, behavioral experiments are a good ally.
Some authors recommend introducing behavioral experiments as soon as possible, since it is understood that therapeutic advances are taken together with behavioral changes. Psychologists are interested in the patient's achievement 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 perform in the technique of Cognitive Restructuring when looking for evidence for and against certain thoughts is very useful for "leveling" the ground and make it easier for the patient, but if small "pushes" are not introduced for the person to do or stop doing things, the therapy can be prolonged indefinitely (eg, always moving in the abstract and in the the verbal, in our "comfort zone"). This supposes 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?
Behavioral experiments are prepared in therapy with the psychotherapist, who will be an important guide to achieve the changes that are expected . They will never be predetermined experiments, but will vary greatly depending on the patient and the problem.
It is convenient that in the session a self-registration of the experiment is prepared, in which they must include:
- Prediction of the patient (usually anticipated specific consequences, the severity or intensity of them, and degree of belief in such prediction). For example: "when I go out to do the oral presentation I'm going to go red like a tomato, I'm going to sweat a lot, my voice will shake, I'll go blank and I'll panic, I'll have to run out of the place and I'll have done ridicule".
- Alternative perspective and degree of belief in it.
- Experiment (detail what will be done and what the patient will be fixed with - before doing it - write what has actually been done, including all the defensive behaviors - after having carried it out -).
- Results (consequences that have actually occurred, their severity, and the extent to which the patient's prediction has been met).
- 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 will be set from now on in similar situations.