216 ASSESSMENT AND INTERVENTION STRATEGIES
behaviors or other self- protective measures were utilized; (4) observations about how
other people reacted to the client; (5) significant features of the environment; and (6) the
outcome in terms of noticeable changes in the client’s thoughts and feelings.
When discussing the experiment it is particularly important to evaluate the outcome
in light of the previously stated hypothesis, or predicted outcome. Did the client experi-
ence as much anxiety as expected? Was her own response or the responses of others con-
sistent with her prediction? Was the outcome more or less positive than expected? How
similar was the actual outcome to the predicted outcome? If there was a discrepancy,
what does this indicate about the relation between threat appraisals and anxiety? When
reviewing the outcome of a behavioral experiment, the therapist is drawing the client’s
attention to the anxiety- provoking properties of heightened threat and vulnerability
interpretations, and the anxiety- reducing effects of the alternative perspective. The goal
is to reinforce the cognitive conceptualization of anxiety and to promote the idea that
cognitive change is a critical component of anxiety reduction.
The overall purpose of the consolidation phase, then, is to arrive at the significance
or personal meaning of the exercise for clients. Did the behavioral experiment pro-
vide a powerful demonstration of the cognitive conceptualization of anxiety? Did they
learn something new about their thinking or way of coping with anxiety that might
be responsible for its reduction? Did the exercise highlight how exaggerated threat and
vulnerability appraisals can intensify subjective anxiety? What can the client take away
from the experiment? This form of questioning will ensure that the behavioral experi-
ment fits within the cognitive case conceptualization developed for the client. It will also
help consolidate any therapy gains that have been made during the sessions. In fact the
main purpose of behavioral experiments that are assigned as homework is to reinforce
or consolidate what has been introduced in the cognitive therapy session by provid-
ing the client with personally relevant experiential evidence. It is this critical review of
the experiment’s outcome and its implications that enables empirical hypothesis- testing
exercises to play a significant role in the therapeutic process.
Jodie reported at the following therapy session that she did the behavioral experi-
ment and recorded a description of the experiment and its outcome on the Empirical
Hypothesis- Testing Form. She noted that she arrived to the class at 8:55 and sat in the
middle row. Ten minutes later she made a detailed observation of her peers and then 15
minutes into the lecture she took three to four deep breaths and observed possible reac-
tions. However, she was unable to even slightly shake her body at the 20-minute mark
because of fear someone would notice her odd behavior. In the outcome section of the
form she wrote that only one or two students even glanced at her when she sat down in
class or took the deep breaths. When the therapist reviewed this further, Jodie indicated
she was actually quite surprised that her fellow students paid so little attention to her.
She was also surprised that she actually experienced less anxiety than usual during the
class. The therapist highlighted the discrepancy between the actual outcome (“Students
pay little attention even when Jodie acted in a way that might draw some momentary
attention”) and Jodie’s prediction (“If I do anything like breath differently it will draw
attention to me and I’ll get very anxious”). This experiment was a powerful demonstra-
tion for Jodie that thinking others are looking at her makes her more anxious than other
people’s actual momentary glances, and that testing out her anxious thoughts (“people
are looking at me”) with actual evidence (“people take much less notice of me than I
think”) will lead to a reduction in anxious feelings.