Chapter 5: REBT
Overview
• Practical and symptom-focused
• Philosophically based, but techniques have empirical support
• Requires patient collaboration
• Patients change through identification of irrational thought processes
• Patient’s behaviors and thought processes are evaluated and criticized when necessary
• A → Activating Events
• B → Belief System
• C → Consequences
• D → Dispute
• REBT provides clients with several powerful insights
• A-B-C
• People are distressed reinforcing irrational thoughts.
• hard work and practice correct irrational thinking
• Cognition
• Feelings
• Desires
• Action
• REBT considers the importance of mind and body, or of thinking/feeling/wanting
(contents of the mind) and of behavior (operations of the body).
• Basic Concepts
• People have the potential to be both--
• Rational, self-preserving, creative, functional, and to use metathought
• Irrational, self-destructive, short-range hedonists, intolerant, and
grandiose
• Culture and family can perpetuate irrational thinking.
• Humans perceive, think, emote, and behave simultaneously.
• All psychotherapies are not equally effective
• REBT emphasizes unconditional acceptance of self, others, and life.
• A warm therapeutic relationship is not a necessary or sufficient condition for change.
• REBT not symptom removal real cognitive change.
• Neurotic thinking result of unrealistic, illogical, self-defeating thinking, and that
disturbance-creating ideas can be disputed.
• causes of an individual’s emotional distress what the individual believes about
the events.
• There is an element between stimulus and response; it is thought and emotional
response
• Analogy to Demonstrate REBT
• Ellis (billiards shot)
• hit a ball from the same spot, at the same angle, you will get the same results.
• person inside the ball who could control the outcome, outcome could be
different each time.
, Other Systems
REBT Compared to Psychoanalysis
• REBT does not focus on free association, complex history taking, dream analysis,
or sexual conflicts.
• Transference is seen in REBT resulting from irrational beliefs.
• REBT employs persuasive and directive techniques
REBT Compared to Client-Centered Therapy
• There are lots of commonalities
• emphasize importance of:
• unconditional positive regard, which REBT labels as full acceptance or tolerance.
• Differences • Similarities
• REBT values therapy relationship, but is not viewed • Great optimism in the ability of people to change
as vehicle for change.
• REBT focuses on teaching client more. • Perception that individuals are often overly self-critical
• REBT actively challenges patient’s perceptions. • Willingness to put forth great effort to help people
• REBT therapists are more action-oriented. • Willingness to demonstrate their methods publicly
• REBT therapists are more emotive-evocative. • Respect for science and research
• REBT Compared to Behavior Therapy
• lots of commonalities
• REBT strong focus on cognition.
• REBT is more similar to Cognitive Therapy (CT) and multimodal therapy than
Behavior Therapy (BT).
• • Cognitive Therapy • REBT
• Thoughts labeled • Dysfunctional • Irrational
• Type of reasoning used • Inductive • Deductive
• Beliefs associated with • Cognitive specificity for each • Core set of irrational beliefs
psychopathology disorder
• View of the problem • Functional • Philosophical
• Therapist’s approach • More collaborative • More confrontational
Precursors to REBT
• Ancient philosophers
, • Albert Ellis: He posited that people create many of their emotional difficulties by
misleadingly defining preferences (for love, approval, success, and pleasure) as needs.
• He termed this musturbatory thinking.
• “weak” therapeutic methods were unlikely to dislodge irrational assumptions
Personality
• Physiological
• Social
• Psychological
• Personality strong biological and environmental influences
• Humans are born with a tendency to want and a “need” to condemn themselves, others,
and the world when they do not immediately get what they supposedly “need.”
• Making the choice to change from “demanding” to “desiring” is difficult and work of
therapy.
• Should
• Ought
• Awful
• Must
• I Want
• I Need
• A1 I did poorly on my job today.
• A2 I feel anxious, depressed, and worthless.
• B1 Isn’t that horrible?
• B2 Isn’t that horrible?
• C1 Anxiety, depression, worthlessness
• C2 Intensified feelings of anxiety, depression, and worthlessness
• Most major psychotherapies focus on A (the adversities/traumas) or on C (the emotional
consequences).
• REBT focuses on B (belief system).
• The best way to interrupt the cycle of emotional disturbance is identifying and disputing
irrational or self-defeating beliefs.
• Humans largely create their own distress
Variety of Concepts
• CT
• REBT
• Therapist’s approach
• CT: More collaborative
• REBT: More confrontational
• View of the problem
• CT: Multiple cognitive distortions
• REBT: Pathology arises from shoulds, musts, and oughts
• Emphasis
• CT: Psychoeducation an early and critical component of treatment
• REBT: Higher reliance on psychoeducation
• Focus-
, • CT: “Hot cognitions” critical, but obtained in a less aggressive manner
• REBT: More focus on emotional-evocative methods and core set of irrational
beliefs
• View of the problem
• CT: Functional
• REBT: Philosophical
• Ways Individuals Alleviate Pain
Distraction
• Leads to less demands of others
• Individual becomes less anxious
• Palliative
Satisfying Demands
• If demands are catered to, the individual feels better but does not get better.
• Therapist can
• provide pleasurable sensations.
• teach methods to have demands met.
• give reassurance.
• Ultimate impact is demandingness reinforced.
Magic and Mysticism
• Magical solutions are often offered to children and even to adolescents and adults.
• Generally, magical solutions only temporarily placate the individual.
Giving Up Demandingness
• Most elegant of the solutions listed.
• REBT’s goal is to achieve minimal demandingness/maximal tolerance.
• Temporary, palliative techniques may be used in REBT with clients who refuse more
permanent resolution.
• Goal is minimization of musturbation, perfectionism, grandiosity, and low frustration
tolerance.
• REBT assists patients in seeing how giving up perfectionism improves their lives.
• REBT teaches patients to differentiate between desires and “musts.”
• Behavioral techniques are used in REBT to change habits as well as cognition.
• REBT helps clients acquire a more realistic, tolerant philosophy of life.
• REBT practitioners often employ a rapid-fire, active-directive-persuasive-philosophical
methodology.
Mechanisms of Psychotherapy
• No matter what feelings (which, by the way, do not distract the therapist) the patient
discusses, the focus is on the patient’s irrational beliefs.
• REBT therapists do not hesitate to contradict a patient’s beliefs and are often one step
ahead while showing acceptance.
• REBT therapists may do more talking than their patients.
• Strongest philosophical approach possible is used.