Using Behavioral Experiments to Help Clients Improve Health Anxiety

 Understanding Behavioral Patterns in Health Anxiety

As clinicians, we talk a lot about the problematic behaviors our clients get tangled up in when struggling with health anxiety. We talk about this for good reason. These behaviors act like a vortex, pulling clients deeper into the vicious cycle that keeps health anxiety alive. There is an incredible sense of freedom that comes when clients learn to disengage from these behaviors. In this article, we’ll review some foundational ways to help clients begin that process, starting with understanding their unique behavioral tendencies.

Exploring Behavioral Tendencies

Clients with health anxiety often share similar behavioral patterns, though their specific fears, triggers, and assumptions vary widely. Before attempting to reduce or eliminate the behaviors that maintain anxiety, it’s essential to help clients identify and understand their own patterns. This awareness allows for interventions that are targeted and personalized to their unique “health anxiety profile,” so to speak.

We can start by helping clients reflect on their recent experiences:

• When did they last feel anxious about their health?

• What did they do in response to that anxiety?

• Which coping behaviors feel automatic or irresistible?

Here’s the basic cycle we often observe in session:

1. The client perceives a potential threat to their health.

2. Anxiety rises.

3. The client engages in behaviors aimed at reducing that anxiety.

It’s step three, those immediate “make it feel better” actions, that perpetuates the problem. As you work with clients, it can be helpful to walk through examples of these safety and avoidance behaviors, such as:

• Seeking reassurance from loved ones about symptoms

• Seeking reassurance from doctors about symptoms

• Avoiding the doctor or medical system altogether

• Avoiding reminders of disease and/or death

• Seeking reassurance from the internet about symptoms

• Looking up information after hearing someone’s scary health story or seeing a news update

• Repeatedly poking, prodding, or evaluating a new symptom

• Conducting regular body scans for signs of illness

• Taking excessive preventive measures, such as staying close to hospitals or constantly checking vitals

Once clients identify which of these apply to them, you can drill down further into the specifics.

For instance:

• If a client engages in frequent body scanning, what exactly do they check? (Lymph nodes? Skin? Heart rate? Oxygen levels?)

• If they seek reassurance from medical providers, what does that look like? (Multiple appointments? Portal messages? ER visits?)

• If they tend to research symptoms online, what patterns emerge? (Googling disease rates? Watching patient videos? Reading comment sections for “clues”?)

Most clients will recognize multiple patterns and that’s okay. The goal is not self-criticism but awareness, which sets the stage for meaningful behavioral experimentation.

The Function and Power of Behavioral Experiments

Behavioral experiments are a cornerstone of CBT for health anxiety. They allow clients to test their assumptions and gather new, corrective experiences that disconfirm feared predictions.

(1) Testing Beliefs

If a client believes, for example, that “the only way to stay safe is to see a doctor every time I notice a new symptom,” we can collaboratively design an experiment to test this belief. You might suggest waiting three days before seeking medical attention for a mild, unexplained sensation (e.g., a headache or body ache).

Conversely, for clients who cope through avoidance (e.g., “If I go to the doctor, I’ll definitely receive bad news”), experiments might involve scheduling a routine check-up or following through with recommended tests.

The key is experiential learning—clients discover through their own experience, not simply through reassurance, that feared outcomes are often less likely than anticipated.

(2) Building Tolerance for Uncertainty

Behavioral experiments also provide opportunities to strengthen tolerance for uncertainty. Clients with health anxiety often hold the assumption that uncertainty equals danger. The intolerance of uncertainty (IU) drives both excessive checking and avoidance.

By helping clients engage in experiments that involve not knowing, and staying with that discomfort, we facilitate emotional learning. Over time, clients become more comfortable with uncertainty, leading to significant reductions in health anxiety.

Ideas for Behavioral Experiments

Once clients have identified their behavioral patterns, you can tailor experiments to target both safety behaviors and avoidance. Here are examples you might adapt:

Behavioral Experiment Ideas for Safety Behaviors

• Wait 3 days (or 1–2 weeks) before scheduling a doctor visit for a mild, unexplained symptom

• Refrain from researching a new symptom online for a designated time period

• Avoid looking up disease information after hearing a scary story or health-related news

• Attend an event located far from a medical facility

• Exercise without carrying a phone or monitoring device

• Go several hours (or a full day) without wearing a smartwatch or fitness tracker

• Refrain from asking loved ones for reassurance about a symptom

• Avoid self-exams (e.g., lymph nodes, breast checks, skin scans) for a set period

• Avoid checking vitals (e.g., heart rate, blood pressure, oxygen) for several hours or days

Behavioral Experiment Ideas for Avoidance Behaviors

• Watch a short video or clip of a medical exam

• Schedule a check-up, screening, or recommended procedure (e.g., mammogram, colonoscopy)

• Read or watch content related to illness or healthcare

• Visit a hospital or medical building without attending an appointment

• Read obituaries or stories involving illness or death

• Engage with a book or film about someone facing illness

• Schedule any necessary follow-up appointments or lab work

• Perform routine self-exams at home as recommended by medical guidelines

Tips for Designing and Implementing Experiments

When guiding clients through behavioral experiments:

• Individualize the experiment. Tailor it to the client’s unique fear patterns and current readiness level.

• Ensure it’s challenging but manageable. Aim for an anxiety rating of 6–7 out of 10 to facilitate meaningful learning.

• Use graded exposure principles. For clients with significant avoidance, start small and gradually progress. For example:

  • Imagine going to the doctor (4/10)

  • Watch a video of a physical exam (6/10)

  • Sit in a medical waiting room (7/10)

  • Schedule the appointment (8/10)

  • Attend the appointment and receive results (9–10/10)

• Encourage social support. Involving a trusted loved one can help with accountability and motivation.

• Use thought records. Have clients track the process before, during, and after the experiment:

  • Before: Describe the planned experiment and predict outcomes.

  • During: Record anxiety levels (0–10) at several points.

  • After: Document results—what happened, how anxiety shifted, and whether predictions came true.

  • Reflect: Note coping strategies used and insights gained.

Integrating Behavioral Experiments into Ongoing Work

Behavioral experiments are not a one-time intervention. They’re part of an ongoing process of cognitive and behavioral change. Encourage clients to continue experimenting and build confidence incrementally. Over time, clients learn that the absence of safety behaviors does not equal danger and that they can tolerate uncertainty without constant reassurance or avoidance.

Clinical Reflection 
When introducing behavioral experiments, it can be helpful to frame them as collaborative curiosity rather than exposure “assignments.” Clients are often more willing to engage when they view the task as an opportunity to learn something new about their anxiety rather than a test of endurance.

By integrating these experiments into treatment, clinicians can help clients move from anxious vigilance toward greater cognitive flexibility and emotional resilience. The freedom that comes from disengaging from health anxiety’s behavioral vortex is not immediate but with repeated, well-structured experiments, it becomes deeply attainable.

Want to take the next step to help clients with health anxiety?

If you are a mental health professional and want to better understand health anxiety and how to treat it, take my comprehensive course- Treating Health Anxiety with Exposure-Based Cognitive Behavioral Therapy. If you are a licensed clinical social worker, this course is approved by ASWB for 13 clinical continuing education credits.