⁎ Rational Emotive ⁎ Behavior Therapy
Developer
✶ Developed REBT due to dissatisfaction with approaches being used during this time like Psychoanalysis & Person-Centered Therapy
✶ Difficult childhood influenced his approach
✶ Often sick & overworked himself into miserable state
✶ Learned that positive thinking improves self-worth
✶ Irrational beliefs are the cause of struggle & viewed as the reason for mental health issues
✶ Thoughts & cognitive distortions influence behavior & emotions
Irrational beliefs often include words like should, ought, & must
R - Rational
✶ Most people realize that when they think more rationally & reasonably, their life goes better
E - Emotive
✶ Most people understand that their emotions are affected by what happens to them & how they think about those events
B - Behavior
✶ Most people accept that what they do (behavior) affects how they think & feel
T - Therapy
✶ Can also mean teaching or training
✶ Focused on the here & now
✶ Emphasis is on profound & lasting change
✶ Working to address client’s underlying belief systems
✶ Individuals should be accepted for themselves
✶ Mistakes are inevitable & do not take away our inherent worth (USA)
Albert Ellis
Basic Principles
✶ Results from demands about others
e.g. “people must treat me right”
✶ Results from demands about the world
e.g. “the circumstances under which I live must be the way I want”
Discomfort Disturbance
Frustration and/or Discomfort Tolerance:
✶ Important to identify client’s level of frustration tolerance as this is often a contributing factor to irrational beliefs & maladaptive behaviors
✶ Emotional tension resulting from the perception that one’s ‘self’ or personal worth is threatened
✶ Leads to other problems such as avoidance of situations where failure, disapproval, etc. might occur
✶ Looking to others for acceptance which can lead to unassertive behavior due to fear of what others may think
Ego Disturbance
A-B-C-D-E-F Model
This model helps to understand problems & modify patterns, & is used for psychoeducational & intervention purposes.
* Most REBT trainings do not include the ‘F’ stage
This model assumes that as individuals, we disturb ourselves about experiences by the beliefs that we hold
Working to teach clients that it’s our beliefs about the activating event that leads to the consequences
✶ A - Activating Event
✶ B - Belief
✶ C - Consequences
✶ D - Dispute / Debate
✶ E - New rational effects or beliefs
✶ F - Feeling & behaving in new ways
Key Concept
Goals of Counseling
Role of Counselor
✶ Collaborative, empathetic & genuine
✶ Active, directive, teaching, & practical
✶ Structured, but open to being flexible
✶ Teach clients strategies & about their own beliefs & thought process
✶ Identify, challenge, & change client’s irrational beliefs
✶ Motivator, role model, & cheerleader
✶ Utilize various techniques
✶ To learn new cognitive skills that promote rational thinking and lead to greater happiness & unconditional self-acceptance
✶ To decrease emotional disturbance & self-defeating behaviors
✶ To improve the rationality of clients
✶ Create a philosophical change of beliefs
Potential Format for REBT Session
✶ Review previous session
✶ Check-in on mood, behavior, thoughts, symptoms, & medication
✶ Elicit new business
✶ Follow-up on homework
✶ Establish the agenda
✶ Do the work using the A-B-C-D-E-F model
✶ Summarize the work that has been done
✶ Assign new homework
✶ Obtain feedback about the session
✶ Close
Therapeutic Process
✶ Establish a therapeutic alliance
✶ Teach & use the A-B-C-D-E-F Model
✶ Apply a wide range of strategies
Therapeutic Techniques
✶ Disputing Irrational Beliefs:
✶ Didactic, Socratic, Metaphorical, Humorous, ABC Model
✶ Cognitive:
✶ Socratic questioning (awfulizing, low frustration tolerance, demanding beliefs)
✶ Cost-Benefit Analysis, Journaling
✶ Behavioral:
✶ Shame Attacking, Role-Playing
✶ Emotive:
✶ Rational Emotive Imagery, Forceful Self-Dialogue, Replacing Shoulds
Application of REBT
Multicultural Groups
✶ Experiences of discrimination, racism, & oppression can significantly impact clients’ mental health & contribute to irrational beliefs about self-worth, safety, & control
✶ Crucial to leverage cultural strengths & resources to support the therapeutic process
✶ Must consider client’s developmental level & cognitive ability to effectively engage with REBT
LIMITATIONS
✶ The confrontational nature of REBT may not be appropriate for all populations
✶ What may be considered an irrational belief in one culture may be rational in another
✶ Language comprehension may be a barrier for some clients