What Is… a CBT Behavioural Experiment

In this series, I dig a little deeper into the meaning of psychology-related terms. This week’s term is behavioural experiments.

Behavioural experiments are a cognitive behavioural therapy (CBT) technique to test out beliefs in real-world conditions. It’s like being your own social scientist. Behavioural experiments are commonly used in the treatment of anxiety disorders to test unrealistic predictions and provide exposure.

We often make predictions about the world based on our own internal models about how the world works. Yet the way we think the world works doesn’t necessarily match up all that well with reality. In science, that kind of thing is tested by selecting an appropriate setting and running an experiment to deliberately gather evidence that can either support or go against a hypothesis. A behavioural experiment is the same kind of thing.

The process begins by selecting a belief to test and rating the strength of the belief. If it’s helpful, you can break this rating down into how strongly you believe cognitively and emotionally; it’s not uncommon for emotional attachment to persist even when there’s some cognitive recognition that it might not be reality-based. The next step is deciding on a setting/context and a way to test it. You’ll want a setting that allows you to actually test the belief without a lot of noise getting in the way.

Examples of behavioural experiments

Potential experiments include:

• seeing what happens when safety behaviours are dropped (safety behaviours are things we do to try to feel safer, but they don’t actually increase physical safety and end up just perpetuating anxiety)
• deliberately doing a behaviour you’re worried about exhibiting (e.g. being shaky or dropping something) to see if the consequences match your predictions
• deliberately exposing yourself to an anxiety-provoking situation to see if the feared outcome will occur
• test out a feared situation through role-playing or replicating some elements of the context but in a controlled situation
• if you’re working on adopting new beliefs, testing those out in real-life settings
• surveying other people to see if they think what you assume they do
• discovery experiments can involve searching for information that may confirm or deny a belief
• testing out two different predictions to see which turns out to be closer to the actual outcome
• having someone else conduct an experiment and directly observing how it turns out

It’s important that the experiment be set up so that nothing happening, or people doing nothing, wouldn’t act as evidence to support your prediction. Doing nothing is always easier than doing something; for that reason alone, people doing nothing is a likely outcome.

Evaluating the outcome

Once the experiment is completed, the next step is to compare the expected and actual outcomes, and determine if the strength of the belief has changed. If the outcome was different from what was expected, that becomes part of the evidence base that the belief is unrealistic. We have a natural cognitive bias to pay more attention to the negative, and evaluating the results of a behavioural experiment can be a way of rationally working through experiences that aren’t negative.

If the outcome is in fact what was expected, that could indicate that the belief itself isn’t the issue. At that point, a better place to focus might be on developing coping strategies. For example, if I’m anxious about people noticing my tremor, and people do sometimes notice it (which is true in my case), the focus could shift from “what if they notice” to “how am I going to cope most effectively when they do notice?”

Usefulness of this tool

For beliefs that have built up over years, doing a behavioural experiment or two obviously isn’t going to make them change overnight. It’s a tool in the toolbox that may be useful for some people, and may not be for others.

While I’m a logical-minded person, and this appeals to me on that level, with my own particular brand of crazy, I don’t tend to make a lot of predictions. When I do, it tends to relate continuation of already established patterns of outcomes. While I occasionally get some physical anxiety symptoms with my depression, I don’t avoid doing things because of anxiety. I avoid situations that repeatedly produce dysphoria, but I don’t need a behavioural experiment to confirm it; it’s already been confirmed; the issue is what to do about it, not whether it’s true.

Have you ever done behavioural experiments? How did that turn out?

Worksheets from PsychologyTools or TherapistAid can help with the process.

References

• CBT4panic.org: Behavioural experiments
• Oxford Guide to Behavioural Experiments in Cognitive Therapy
• PsychologyTools: How to use behavioural experiments to test what you believe

The post Psychotherapy Alphabet Soup: CBT, DBT, ACT, and More provides an overview of a variety of different therapeutic approaches.