Behavioural Experiments: Practitioner Guide

Behavioural experiments (BEs) are planned experiential activities used to test the validity of a target cognition or prediction which is often maladaptive in some way. BEs help clients gather real-word evidence through experience to foster positive cognitive change.

CLINICAL EVIDENCE BASE

The effectiveness of behavioural experiments is supported by multiple lines of evidence:

  • Action-orientated strategies such as BEs can facilitate engagement and alter maladaptive cognitions in people diagnosed with depression (Westbrook et al., 2011).
  • BEs as a replacement, or in addition to exposure, yield positive treatment effects (Clark et al., 2006; Mortberg et al., 2007; Ougrin, 2011).
  • BEs can be a useful tool in prompting positive change in delusional beliefs (Morrison, 2002; Tarrier & Wykes, 2004).
  • BEs can be used successfully in treatment of insomnia via modification of sleep misperceptions (Tang & Harvey, 2006).

WORKSHEET USES

When to Use

  • Testing maladaptive cognitions or predictions.
  • Clarifying ambiguous beliefs to help clients understand the nuance of their cognition.
  • To encourage perspective shifts and show that alternative viewpoints or behaviours can be helpful.
  • Develop or strengthen skills.
  • Gather real world information.
  • Reinforce or consolidate therapeutic gains and/or insights.

EMOTIPAL WORKSHEET STRUCTURE

Task (Planning) - 6 columns

Belief to test

Belief rating

Alternative perspective

Alternative belief rating

Experimental design

Predicted outcome

Record the thought or belief to be evaluated by the experiment

Rate strength of belief in the belief to test (0-100%)

Record a more balanced alterative to your ‘belief to test’

Rate strength of belief in the alternative perspective

Describe the steps you will take to evaluate the ‘belief to test’: Record the action you will take; where and when the action will occur; the duration of the activity

Record what you believe will happen during this experiment

Task (Conducting the experiment) - 2 columns

Actual outcome

Emotional response

Record what actually occurred during the experiment. Focus on thoughts, behaviours, and the behaviours/responses of any other people involved.

Record specific emotions you experienced, their intensity levels, and any changes (e.g., felt anxious 80% at the start, this reduced to 30% after 30 mins).

Task (Reflecting) - 4 columns

Evidence for original belief

Evidence against original belief

Revised belief

Revised belief rating

Identify any aspects of the experience that supported your initial ‘belief to test’

Record information that went against your ‘belief to test’

Re-write an updated or more accurate version of your ‘belief to test’ based on your experiences with the experiment.

Rate how strongly you believe the revised belief

TROUBLESHOOTING

Common Challenges and Solutions

High anxiety or discomfort

  • Break the experiment into smaller steps
  • Utilise self-soothing and/or anxiety management strategies
  • Normalise anxiety provided it is not at overwhelming levels.

Lack of belief or confidence in BE rationale

  • Provide thorough psychoeducation.
  • Utilise success stories with other people/clients (provided you have obtained necessary consent and ensured anonymity).
  • Try small ‘mini-experiments’ in session to demonstrate principles and build confidence.

Use of safety behaviours

  • Provide psychoeducation on safety behaviours.
  • Identify safety behaviours and provide alternatives, starting with behaviours that cause least anxiety to inhibit.

Difficulty generating clear predictions

  • Encourage the client to define the feared outcome
  • Detail prediction from the perspective of ‘anxious’ or ‘depressed’ brain, etc

Non completion of BE

  • Conduct a review to identify barriers to completion
  • Use problem-solving, BE modification, and/or skills development to address barriers

References

Note: While this guide references various studies, practitioners should verify current research as the field continues to evolve. The core principles remain well-established in the literature and clinical practice.

Clark, D. M., Ehlers, A., McManus, F., Hackmann, A., Fennell, M. J. V., Campbell, H., … Louis, B. (2006). Cognitive therapy vs. exposure and applied relaxation in social phobia: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(3), 568–578. https://doi.org/10.1037/0022-006X.74.3.568

Morrison, A. P. (2002). A manualised treatment protocol to guide delivery of cognitive therapy for people with distressing psychosis: Learning from clinical trials. Psychotherapy and Psychosomatics, 71(4), 246–256. https://doi.org/10.1159/000064810

Mörtberg, E., Clark, D. M., Sundin, Ö., & Åberg Wistedt, A. (2007). Intensive group cognitive treatment and individual cognitive therapy for social phobia: Sustained improvement at 5-year follow-up. Journal of Anxiety Disorders, 21(4), 387–397. https://doi.org/10.1016/j.janxdis.2006.06.003

Ougrin, D. (2011). Efficacy of exposure versus cognitive therapy in anxiety disorders: Systematic review and meta-analysis. BMC Psychiatry, 11, 200. https://doi.org/10.1186/1471-244X-11-200

Tang, N. K. Y., & Harvey, A. G. (2006). Altering misperception of sleep in insomnia: Behavioral experiment versus verbal feedback. Journal of Consulting and Clinical Psychology, 74(5), 767–776. https://doi.org/10.1037/0022-006X.74.5.767

Tarrier, N., & Wykes, T. (2004). Is there evidence that cognitive behaviour therapy is an effective treatment for schizophrenia? A cautious or cautionary tale? Behaviour Research and Therapy, 42(12), 1377–1401. https://doi.org/10.1016/j.brat.2004.06.020

Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications (2nd ed.). SAGE Publications.

Template Information Block

Behavioural experiments are structured activities designed to test the accuracy of your thoughts, beliefs, or predictions through real-world experience. This worksheet guides you through testing a specific belief that may be contributing to your distress by gathering concrete evidence rather than relying on assumptions. You'll record your initial belief, consider an alternative perspective, and design a simple experiment to test these ideas.

After completing the experiment, you'll document what actually happened, how you felt, and revise your belief based on this new evidence. This process helps you develop more balanced and accurate thinking by replacing assumptions with real experiences. Your practitioner will help you design appropriate experiments that challenge unhelpful beliefs while ensuring you feel safe and supported throughout the process.

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