In this article, we will talk about one of the fundamental components of the well-known technique of cognitive restructuring: behavioral experiences.
Why do we say these experiences are fundamental? Very simple: in therapy it is relatively “easy” for the patient to verbally test certain beliefs, but the ultimate challenge comes when the therapist offers to do an outdoor activity, alone, to put behavioral tests on. those distorted or dysfunctional beliefs or thoughts.
Usually, it is at this stage that reluctance appears which had not been manifested 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?
Rest assured, these are not unethical experiments with patients, but “exercises” or activities that the patient voluntarily and consciously performs on a daily basis to overcome a problem or difficult situation.
A behavioral experience may consist of doing (in the case of social phobia, for example) or in stopping doing something (especially in the case of obsessive-compulsive disorder), of observing the behavior of others, of daring to ask another person what think, feel or do (particularly interesting in case of social phobia), by obtaining information from other sources such as books …
The aim of these experiments is to test the distorted beliefs / cognitions of the patients, Which should be specific (eg, “They will criticize me”, “I will stay blank and not know what to say”) rather than too general (“I am not worth it”, “I am not serving”) .
To ensure the usefulness of behavioral experiments, it is very important that the patient does not focus on himself when performing them, but on the task. Additionally, it is essential that you stop using your defensive behaviors as they help maintain dysfunctional beliefs and thoughts that we want to change.
Types and examples
There are 2 basic types of experiences:
These are the most common and the ones we have explained. They consist of what the patient does or does not do.
- do something: Imagine a person who has a lot of anxiety when speaking in public and who believes that anxiety is perceived by listeners. The therapy is requested to be videotaped, we ask that you watch the recording afterwards and check for signs of anxiety and to what extent it is appreciated.
- Stop doing something: Person with obsessive-compulsive disorder who believes that if they have a sharp object nearby, they won’t be able to resist the urge to use it. Then the experience would be to have it left in the consultation with a kitchen knife on the table and with the tip pointed at the therapist for a while.
In these cases, the patient is only an observer who is dedicated to data collection, 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 conduct an active experiment, or when more information is needed to make it active. Examples: direct observation (modeling), surveys or information from other sources.
When to use them?
We will prepare with the patient and use behavioral experiences when we apply the technique of cognitive restructuring, in parallel. In other words, when you want to make a person’s beliefs more flexible and changed, behavioral experiences are a good ally.
Some authors recommend introducing behavioral experiments as early as possible, as it is understood that therapeutic advances go hand in hand with changes in behavior. Psychologists are interested in the patient making large and prolonged changes over time (affective, cognitive and behavioral changes), which almost always require behavioral questioning.
In this way, the verbal questioning we have done in the cognitive restructuring technique when looking for evidence for and against certain thoughts is very helpful in “flattening” the ground and make it easier for the patient, but if small ‘pushes’ are not introduced to get the person to do or stop doing things, therapy can be prolonged indefinitely (eg, always on the move – us in the abstract and verbally, in our “comfort zone”). This leads to a high economic cost for the patient, the non-achievement of therapeutic goals and possible professional frustration for the psychotherapist.
How to prepare them?
Behavioral experiences are prepared in therapy with the psychotherapist, which will be an important guide to achieve the expected changes.. They will never be predetermined experiences, but will vary widely depending on the patient and the problem.
It is advisable to prepare a self-registration of the in-session experience, which should include:
- The data
- Patient prediction (usually specific anticipated consequences, the severity or intensity of the same and the degree of belief in that prediction). For example: “when I go out to do the oral presentation I will turn red like a tomato, I will sweat a lot, my voice will shake, I will be empty and I will panic, I will have to run out of space and I will have made a fool of myself.”
- Alternative point of view and degree of belief in it.
- Experience (detail what will be done and what the patient will focus on -before performing it-, note what was actually done, including any defensive behaviors -after performing it-).
- Results (consequences that actually occurred, their severity, and the extent to which the patient’s prediction came true).
- Conclusion (what did you learn about your anxious prediction and the alternative, degree of belief in them).
- What to do from now on and what will be fixed from now on in similar situations.