Rational Emotive Behavior Therapy (REBT)
Albert Ellis
Goal
"Changes in beliefs and reduction of symptoms (Seligman & Reichenberg, 2014, p. 278)...helping people to learn cognitive skills that promote rational thinking and lead to greater happiness and self acceptance" (Ellis & Ellis, 2011, pp. 278-279).
"Changes in beliefs and reduction of symptoms (Seligman & Reichenberg, 2014, p. 278)...helping people to learn cognitive skills that promote rational thinking and lead to greater happiness and self acceptance" (Ellis & Ellis, 2011, pp. 278-279).
Theoretical Concepts
Human Development and Emotional Health
- Awareness, acceptance, and appreciation of oneself and others
- Social interest; recognition that contributing to the world enhances our own happiness
- Self-direction and personally meaningful goals
- Involvement in long-range, absorbing creative pursuits; commitment to something outside oneself
- Long-range hedonism; the ability to enjoy the present as well as the discipline to defer immediate gratification and seek pleasure in
the future
- Acceptance of uncertainty and ambiguity
- Flexibility, ability to adapt to change
- High frustration tolerance so we are not devastated by disappointments
- Ability to think in a clear, logical, scientific, and rational way
- Willingness to take sensible risks, experiment, and be reasonably adventurous
- Recognition that we cannot always be totally happy and that life will not always go exactly as we hope
- Acceptance of responsibility for our own emotional difficulties
(Ellis & Dryden, 2007, p. 274)
Self-Acceptance
People who only value themselves because of their successes and not based on their worth as a person will often times have emotional difficulties. Therefore, if a person suffers a failure, for example, he/she will severely judge themselves. Instead, people should be proud of their achievements and have the ability to recognize and appreciate their strengths as well as their weaknesses. In addition, happiness will more easily attained if people continue to believe in themselves even when they are disappointed.
Example : A person who values himself/herself because getting a 4.0, getting a doctorate, and getting a residence at the top hospital in the
country.
Origins of Emotional Disturbance
Because of irrational beliefs, people often have dysfunctional thoughts and believe that life should go the way they plan for it to go. REBT is optimistic and "it emphasizes will and choice and perceives people as having inborn dries toward actualization and happiness (Ellis & MacLaren, 2005). People have the ability to make choices, understand that their thoughts interrupt those choices, and are always working towards being fulfilled and making the necessary positive changes.
Secular Humanism
The belief is that people are unique and decide to live in a social group where they feel as though they belong. Humans are not judged as good or bad but rather the actions of those humans can be deemed good or bad. Rather than believing that there is one absolute truth, secular humanists believe that there are many different possibilities and they strive for peace and fairness.
Thoughts as the Route to Change
In this theory, people are responsible for their emotional problems and change will occur once the person recognizes this. Emotional problems stem from people's irrational thoughts; however, those irrational thoughts can be changed by working hard in order to reduce emotional problems.
Focus on Present Thoughts
Even though people's pasts are important, this theory focuses on present thoughts. By focusing on present thoughts, not only can the counselor and client build a relationship but also makes the counseling more meaningful. To change irrational beliefs, people must first become aware of them. From there, counselors can use different strategies that promote change. In addition, the clients are their own therapists "to enable them to use methods of REBT throughout their lives to identify and change their self-destructive thoughts" (Seligman & Reichenberg, 2014, p. 276).
REBT's View of Insight
Having insight into one's problems is not a concern of REBT. This is due to the fact that insight is seen as possibly harmful because it leads to self-blame.
Three Levels of Insight
1. The insight to see that we choose to upset ourselves
2. The insight to see that we acquired our irrational beliefs and to see how we continue to maintain them
3. The insight to see that we need to work hard to change
(Ellis, 1998)
REBT's View of Emotions
Like insight, time in not spent on understanding or changing emotions; however, "clinicians recognize that if people can become aware of their emotions and their impact, this can facilitate their efforts to identify and change their irrational beliefs" (Seligman & Reichenberg, 2014, p. 276).
Self-destructive emotions : "enduring, immobilizing, and nonproductive; reflect overreactions to stimuli; and lead to negative self-images
and actions" (Ellis, 1986)
Eight emotional problems : "guilt, shame, jealous, hurt, anxiety, depression, envy, and unhealthy anger" (Dryden, 2011)
Appropriate emotions : "transient, manageable, in proportion to the stimulus, and enhancing of self-acceptance" (Ellis, 1986)
Appropriate emotions contain both positive and negative emotions. It's alright to feel negative emotions when
dealing with loss or sadness.
REBT's View of Behavior
Behaviors are not a main focus of treatment but rather are used for showing progress as well as the focus of at home tasks. "REBT views behaviors, emotions, and thoughts as having a reciprocal relationship, thoughts are the primary route to change" (Seligman & Reichenberg, 2014, p. 276). If someone is able to change his/her thoughts as well as actions, then change can be made in emotions and behaviors.
Irrational Beliefs
Themes
- Awfulizing
- Self-deprecation, including global evaluations of human worth and self-criticism
- Frustration intolerance
(Ellis, 2001)
Rational beliefs can be classified as those that makes sense, are based on reality, and are versatile. They are not judgmental and instead offer possibilities.
Irrational beliefs, on the other hand, are things that we believe we ought to do or should do. Irrational beliefs also encompass present demands and absolutes. These beliefs are very judgmental and do not coincide with reality.
Example : "I must act perfectly and be achieving and lovable at all times. If I do not, I am incompetent and worthless" (Ellis, 1984)
Format of Sessions
The ten step pattern:
1. Review old business from the previous session.
2. Check up on mood, behavior, thoughts, symptoms, and medication.
3. Elicit new business, especially any major life changes.
4. Follow up on homework.
5. Establish the agenda for the sessions.
6. Do the work according to the ABC format.
7. Summarize the work that has been done.
8. Assign new homework.
9. Obtain feedback on the session.
10. Close the session.
(Walen, DiGiusepe, & Dryden, 1992)
Before starting the ten-step pattern, the client and counselor will meet in order to discuss what REBT is, its goals, and expectations. After, for the first few sessions, assessments will be done to understand different aspects of the client (i.e. history & emotions). With this type of counseling, homework is essential; even if the client forgets to complete it because it's a good review of the previous session. By the end of treatment, "clients should have learned to evaluate and dispute their own beliefs using a variety of strategies, and be prepared to continue that process throughout their lives" (Seligman & Reichenberg, 2014, p. 278). Lastly, there is no set number of treatments because counseling lasts as long as there is a need and until counseling goals are achieved.
Treatment
Therapeutic Alliance
In the REBT approach, the relationship between the counselor and the client is collaborative. Clients take control of their treatment while the counselor serves as the teacher. The counselor helps the client to see the differences between rational and irrational thinking as well as coming to terms with a more rational reality. The counselors are influential, encouraging, communicators, and are highly involved in the counseling session.
Clinicians practicing REBT should be :
- Structured but flexible
- Intellectually, cognitively, and philosophically inclined
- Active and directive in their style
- Comfortable using behavioral instruction and teaching
- Untroubled by fear of failure and willing to take thoughtful risks
- Emotionally healthy, accepting of themselves and others as fallible
- Practical and scientific rather than mystical and magical
- Comfortable with a variety of interventions
(Ellis & Dryden, 2007, p. 279)
Identifying, Assessing, Disputing, and Modifying Irrational Beliefs
REBT uses the ABCDE method for "identifying, assessing, disputing, and modifying beliefs" (Ellis & Ellis, 2011). In order to help people identify their beliefs, the REBT Self-Help Form or Attitudes and Beliefs Inventory are used.
A - The first step is "identification and description of the activating event" (Seligman & Reichenberg, 2014, p. 280). This is from where
discomfort is coming as well as the starting point for irrational thoughts.
Example : "My supervisor gave me an average rating on my evaluation" (Seligman & Reichenberg, 2014, p. 280).
B - The second step is the belief about the activating event in step A. These beliefs can be rational or irrational and people have a choice
about their belief and whether to identify the stimulus as positive, negative, or neutral.
Example : "My supervisor should praise me more and is a jerk for not seeing how hard I work. It is awful that I work so hard and am not
valued as I ought to be" (Seligman & Reichenberg, 2014, p. 280).
C - The third step is the consequences that come from the belief. By evaluating the consequences, it can be determined whether a belief is
rational or irrational. If the belief is irrational, there is potential harm to the client; on the other hand, if the belief is rational, this will
lead to more constructive consequences.
Example : "Martin experienced anger, shame, and anxiety about the possibility of losing his job. His behaviors included berating his
supervisor" (Seligman & Reichenberg, 2014, p. 280).
D - The fourth step is dispute or debate. Beliefs are evaluated and deemed rational or irrational. From there, the counselor will focus on
present irrational beliefs and then move the client towards more conceptual irrational beliefs.
Example : "Strategies to dispute irrational beliefs include cognitive, behavioral, and emotional approaches to change. For Martin, all
three are relevant. Cognitive approaches might involve examining the logic of his belief, including the adequacy of the
supervisor's information on Martin's performance and whether receiving an average evaluation was truly awful or simply
undesirable. Ellis would probably have used emotional methods, pointing out Martin's awfulizing, his tendency to
catastrophize, and his perfectionistic need to have his life be exactly as he wishes. Ellis might have encouraged Martin to
feel appropriate and nondestructive emotions such as annoyance and disappointment, which contribute to rational thinking,
rather than shame and anger, which are self-destructive and inappropriate emotions. Martin might also benefit from
behavioral strategies, such as meeting with his supervisor, providing her additional information about his work, and planning
an outing or creative project to help him focus on rewarding aspects of his life" (Seligman & Reichenberg, 2014, p. 281).
E - The last step is new rational effect or belief which explains the desired outcome. The desired outcome will entail rational beliefs and
new feelings and actions in order to achieve happiness.
Example : "After disputing his beliefs, Martin developed more rational beliefs such as: 'Although I am disappointed that my evaluation
was average, it is not the end of the world. I will take steps to familiarize my supervisor with my work and obtain a more
positive evaluation next time" (Seligman & Reichenberg, 2014, p. 281).
Approaches to Disputing Irrational Beliefs
Since irrational beliefs are mainly caused by our thoughts, counselors in REBT work with their clients to identifying these beliefs and work on replacing them with more rational beliefs and actions.
Four Strategies of Disputation
1. Logical disputes : identify magical thinking and leaps in logic
Example : Just because your sister seemed quiet and distracted when she visited you on her birthday, it doesn't
logically follow that she is rejecting a close relationship with you
2. Empirical disputes : focus on an accumulation of evidence
Example : You told me that after her visit, your sister called to tell you what a good time she had and suggested
that you visit her soon. You also told me that your sister is a quiet person. When we examine this
evidence, there is little reason to believe that your sister is withdrawing from you. In fact, the
evidence suggest just the opposite.
3. Functional disputing strategies : focus on the practical consequences of people's beliefs, looking at whether their beliefs get them
what they want
Example : Believing that your sister is withdrawing leads you to withdraw from her and brings up
memories of past wrongs you believe she has done to you. This belief isn't helping you
build your relationship with your sister, as you want to do.
4. Rational alternative beliefs : offer a viable alternative belief
Example : I know your sister is going through a difficult divorce. I wonder if another possible
explanation for her quietness could be that she felt sad because she wasn't with her husband
on her birthday.
(Beal, Kopec & DiGiuseppe, 1996)
Four Disputing Styles
1. Didactic style : explanatory, educational, and efficient but involves getting information rather than using a single dialogue.
Example : Marnie, I think you may be jumping to unwarranted conclusions about the significance of your sister's
behavior. Keep in mind that she is still recovering from her divorce and that may be affecting her mood.
2. Socratic style : using questions to promote client reasoning. This is the most common REBT technique.
Example : What do you make of your sister's call and invitation to visit? Do those behaviors suggest she is with-
drawing from your relationship?
3. Metaphorical style : analogies, especially from the client's own experience, to dispute beliefs
Example : Your reaction to your sister's visit reminds me of the time you believed your supervisor was dis-
satisfied with your work because she did not offer you a ride to a conference. Then later you learned
that she had to leave the meeting early because of a medical appointment and so could not give you
a ride. I think that was the same month you received a top evaluation from your supervisor.
4. Humorous style : disputes the belief in a lighthearted way. Clinicians should be sure to never make fun of people, only of their
thoughts and behaviors.
Example : So let's see...It sounds like you are equating the number of words a person speaks to you with how much
they like you. How about for the next day you count how many words each person you encounter says
to you. Then we can determine which one likes you best.
(Beal, et al. 1996)
Other Intervention Strategies
In order to encourage positive change, one must first identify his/her irrational beliefs and then use rational emotive imagery (REI).
Cognitive strategies
- Detecting, evaluating, disputing, and modifying irrational cognitions
- Writing to express and explore thoughts and feelings
- Teaching the difference between rational and irrational beliefs
- Confronting irrational beliefs
- Identifying disadvantages or particular thoughts, actions, and feelings
- Socratic questioning
- Reducing thinking to absurdity
- Identifying and changing self-talk
- Reframing a situation by changing labels and language
- Listing ways to cope with the worst that might happen
- Rating experiences on a continuum to counteract awfulizing
- Generating alternatives
- Distracting oneself
- Using visualization and imagery
- Rating degree of conviction in beliefs and then rerating after change
- Formulating, writing down, and repeating rational coping statements
- Promoting a focus on happiness
- Exercising high frustration tolerance
(Seligman & Reichenberg, 2014, p. 283)
Behavioral strategies
- Using relaxation strategies
- Engaging in shame-attacking exercises (potentially embarrassing experiences such as singing loudly on the bus to insulate oneself
against feelings of shame)
- Creating challenging situations and then coping with them
- Role-playing
- Taping sessions for later review
- Reversing roles; clinician takes on client's irrational beliefs, and client talks clinician out of those beliefs
- using two chairs to represent a rational and an irrational belief, person enacts a dialogue between the two beliefs, moving from one
chair to the other
- Acting as if a person is someone else; stepping out of character
- Reading self-help books and listening to tapes intended to effect change
- Training in skills such as assertiveness and effective communication
- Planning pleasurable activities and involvement in an absorbing interest or long-range pursuit
(Seligman & Reichenberg, 2014, p. 283)
Affective strategies
- Imagining the worst that might happen
- Providing emotionally powerful stories, metaphors, and parables
- Using emotionally charged language
- Persuading
- Eliciting inappropriate emotions via imagery and then practicing changing them
- Using humor
- Encouraging willpower and determination to change
- Promoting unconditional clinician-and-self acceptance
(Seligman & Reichenberg, 2014, p. 283)