Behavioral Experiments

Jennifer Wiseman, BA, Piper Meyer-Kalos, PhD, LP, Julie Rohovit, PhD and Tanya Line, BS, LADC
Beliefs, feelings and behaviors are interconnected. However, our beliefs are the driving force behind subsequent feelings and behaviors. Sometimes negative beliefs can generate distressing feelings which can lead to unhealthy behaviors. Many individuals with mental illness and/or substance use disorders struggle with negative beliefs and in turn, develop unhelpful coping strategies. Examples of these coping strategies include avoiding, isolating, and substance use. Originating from cognitive behavioral therapy, a behavioral experiment is a helpful tool designed to test the consequences of a current belief and help people develop more realistic beliefs. Through the process of a behavioral experiment, individuals evaluate current coping strategies and beliefs about their illness and/or substance use. This helps them recognize inconsistencies, discrepancies and collect evidence to develop a more realistic perspective. Additionally, individuals can often broaden their perspective and learn they have more control over their behavior than previously thought.

What are behavioral experiments?

They are:

  • Experiential activities individuals complete during or between sessions
  • Opportunities to explore a different perspective of a problem or difficult situation
  • Learning experiences that actively engages the participant(s)
  • Tools to test the validity of an individual’s belief
  • Designed to help individuals develop a more evidence- based belief system
  • Creative and tailored to each individual
  • Adaptable to a variety of settings

How are behavioral experiments developed?

  • Collaboratively between the person and the practitioner
  • Through identification of key thoughts/beliefs
  • By carefully planning the experiment from start to finish
  • With the assumption that the activity is a “no-fail” adventure – it is a learning process

Joe’s Behavioral Experiment

Joe struggles with co-occurring anxiety and alcohol use disorder. He has been working with a therapist and wants to reach out to meet new friends, but has been avoiding social situations because he gets extremely anxious. In the past, Joe used alcohol to help manage his anxiety. Recently, Joe was invited to a co-worker’s house for a BBQ. He predicts that if he goes to the BBQ without drinking beforehand, he will be extremely anxious and make a fool of himself.

Phase 1 – Prediction

Joe: I know I should go to the BBQ. It will give me a chance to meet new people, but I’m nervous I’ll get too stressed out and make a fool of myself. I always used to drink before social stuff to calm down.
Practitioner: The thought of going to a social event without drinking is something you’re not used to- maybe we can test this out. Perhaps you could schedule a meeting for coffee with some of your group members. This would be a way for you to see if your prediction of getting nervous and making a fool of yourself at a social event really occurs.
Joe: I guess I could reach out to them to see if they would meet for coffee.
Practitioner: That’s great! It will be like collecting data and testing your belief. What do you think will happen?
Joe: I always worry I will get all shaky and sweaty and say some really stupid stuff. People will think there is something wrong with me and they will laugh at me.
Practitioner: So, you feel like every time you’re nervous you always get shaky and sweaty and people stare at you. How would you feel if this prediction came true?
Joe: Mortified, like I can never show my face again. I would feel hopeless too because I won’t ever meet new people.
Practitioner: Okay, if you were to rate this using a percentage, how strongly do you believe this would happen?
Joe: I don’t know, maybe 80 or 90% sure.
Practitioner: Which one, 80% or 90%?
Joe: Let’s go with 85%.

Phase 2 – Experiment

Practitioner: How might we design an experiment that could test this prediction?
Joe: Well, I could ask Brad and David if they want to meet out this Thursday after group for coffee.
Practitioner: That’s a fantastic idea. Sometimes we use coping skills that can be unhelpful when we are stressed out, like avoiding a situation altogether or using substances. What other things have you done in the past to cope?
Joe: Sometimes I would cancel last minute or I just wouldn’t show up. If I did go, I would drink beforehand or avoid talking to people and leave early.
Practitioner: How would you know if your prediction had come true?
Joe: I guess I could ask the guys if I looked really nervous or worried.
Practitioner: Great idea! If you want to take it to the next level, you could see if you had any other physical signs that you were nervous. You can try wiping your hands on your napkin to see if sweat is on the napkin.
Joe: Yes, I think my hands get really sweaty when I am nervous so I guess I could wipe my hands on my napkin to see if that really happens.

Phase 3 – Outcome

Practitioner: So, how did you do at coffee?
Joe: I asked Brad and David to coffee after group Thursday and they both showed up. I didn’t know what to talk about at first and felt pretty nervous, but they started talking about David graduating from group, so we talked about that for a while. I did okay. I asked Brad afterward if I looked stressed out and he said he didn’t notice at all. I also wiped my hands on the napkin and there was no sweat on it.
Practitioner: That’s great news Joe, I am so glad to hear it went well!

Phase 4 – Learning

Practitioner: What was helpful about this experiment?
Joe: Even though I was really nervous and thought I was sweaty, I got through coffee and didn’t drink beforehand. I’m not sure if we will get together again, but it was good practice!
Practitioner: So, the experiment was a win-win situation. In the future, do you think people will laugh at you if you say something stupid? How likely is it that this will happen, in a percentage?
Joe: I’ll go with 40%.
Practitioner: So, it went down, that’s great! How about we try it again, if you go to the BBQ?
Joe: I suppose I could. I feel like it might be easier after having coffee with the guys.
Practitioner: The BBQ seems a little more stressful; at the same time, you feel more comfortable in social settings after coffee with Brad and David. If you go to the BBQ, how might you design the experiment?

The Center for Practice Transformation is sponsored by funds from the Minnesota Department of Human Services Adult Mental Health Division and Alcohol and Drug Abuse Division.