RATIONAL EMOTIVE BEHAVIOR THERAPY – ALBERT ELLIS

 Originally called ‘Rational Therapy’, soon changed to ‘Rational-Emotive Therapy’

 In the early 1990’s named it what we now called ‘Rational Emotive Behavior Therapy’
 Ellis (1913-2007) derived REBT theory mainly from the ancient Asian philosophers; the
Greeks and the Romans, and others. Also, he derived REBT from several modern
constructivist philosophers, such as Kant, Russel, Dewey, Wittgenstein and Michael
Mahoney.
Rational Emotive Behavior Therapy
 REBT encourages a person to identify their general and irrational beliefs (e.g. I must
be perfect") and subsequently persuades the person challenge these false beliefs
through reality testing.
 It is based on the concept that emotions and behaviors result from cognitive
processes; and that it is possible for human beings to modify such processes to
achieve different ways of feeling and behaving.

 Some people’s assumptions are largely irrational, guiding them to act and react in ways
that are inappropriate and that prejudice their chances of happiness and success. Albert
Ellis calls these basic irrational assumptions.
ABC Model

o Example:

A1. Activating event – what happened:

A friend passed me in the street without acknowledging me.

A2. Inferences about what happened:

He’s ignoring me. He doesn’t like me.

B. Beliefs about A:
I’m unacceptable as a friend – so I must be worthless as a person (Evaluation).

C. Reaction:
Emotions: depressed
Behaviors: avoiding people generally.
  Note: ‘A’ alone does not cause ‘C’ – ‘A’ triggers off ‘B,’ and ‘B’ then causes ‘C’. Also,
ABC episodes do not stand alone: they run in chains, with a ‘C’ often becoming the ‘A’
of another episode – we observe our own emotions and behaviors and react to them. For
instance, the person in example above could observe their avoidance of other people,
interpret this as weak and engage in self-downing.

 Ellis believes that it is not the activating event (A) that causes negative emotional and
behavioral consequences (C), but rather that a person interprets these events
unrealistically and therefore has an irrational belief system (B) that helps cause the
consequences (C)

ABCDE Model
The ABC format is extended to include ‘D’ (Disputing irrational beliefs) and ‘E’ (the new
Effect the client wishes to achieve, i.e. new ways of feeling and behaving).
EXAMPLE:
A. Activating event - You fail a big exam.
B. Belief about the event - You believe, 'I'm not smart enough.
C. Emotional or behavioral response - You feel depressed and rip up all of your study material.
D. Disputation - You realize that you are not required to always pass every exam.
E. New effect/emotions and behaviors - You feel disappointed but start studying to do better next
time.
What is irrational thinking?
To describe a belief as irrational is to say that:
1. It blocks a person from achieving their goals
2. It distorts reality
3. It contains illogical ways of evaluating oneself, others and the world: demandingness,
awfulising, discomfort-intolerance and people-rating.
TWO TYPES OF DISTURBANCE
 Ego disturbance
o Represents an upset to the self-image
 o It results from holding demands about one’s ‘self’ (e.g. ‘I must…do well/not
fail/get approval of others’; followed by negative self-evaluations such as: ‘When
I fail/get this approval/etc. this proves I am no good’ and so on. This belief
create…
o Ego anxiety – emotional tension resulting from the perception that one’s ‘self’ or
personal worth is threatened.
 Discomfort disturbance
o Results from demands about others (e.g. ‘People must treat me right’) and about
the world (e.g. ‘The circumstances under which I live must be the way I want’).
o Two types:
 Low frustration-tolerance (LFT)
 Results from demands that frustration not happened, followed by
catastrophizing when it does.
 It is based on beliefs like: “The world owes me contentment and
happiness;’ or: ‘Things should be as I want them to be, and I can’t
stand it when they are not.’
 Low discomfort-tolerance (LDT)
 Arises from demands that one not experience emotional or
physical discomfort, with catastrophizing when discomfort does
occur.
 It is based on beliefs like: ‘I should be able to feel happy all the
time;’ ‘I must be able to feel comfortable all of the time,’
‘Discomfort and pain are awful and intolerable, and I must avoid
them at all costs;’ ‘I must not feel bad;’ and so on.
o Discomfort disturbance leads to problem like:
 Secondary disturbance (upsetting oneself about having a problem, e.g.
becoming anxious about being anxious, depressed about being depressed,
and so on.)
 Guilt is a common secondary disturbance: for instance, people with
anger problems may down themselves because they have trouble
controlling their rage.
FOUR TYPES OF EVALUATIVE BELIEF
1) Demandingness
 Also known as ‘musturbation’
 The way people hold unconditional should and absolutistic musts – believing that
certain things must or must not happen, and that certain conditions (for example
success, love, or approval) are absolute necessities.
 REBT suggest three basic musts:
1. Demands about the self;
2. Demands about others;
3. Demands about the world
2. Awfulizing
 Occurs when we exaggerate the consequences of past, present or future events;
seeing them as the worst that could happen.
 Characterized by words like ‘awful’, ‘terrible’, ‘horrible’.
 3. Discomfort intolerance
 Often referred to as ‘can’t-stand-it-it is’, is based on the idea that one cannot bear
some circumstance or events; seeing them as the worst that could happen.
 It often follows awfulizing and can fuel demands that certain things not happen.
4. People-rating
 It represents and overgeneralization whereby a person evaluates a specific trait,
behavior or action according to some standard of desirability or worth. They then
apply the evaluation to their total person – e.g. ‘I did a bad thing; therefore, I am a
bad person.’
3 LEVELS OF THINKING
1. Inferences
 Statements or ‘fact’ (or at least what we think are the facts – they can be true or
false).
 In REBT, little time is spent on a client’s inferences – they are regarded as
significant only in the sense that they provide a window to the evaluative
thinking.
2. Evaluations
 More significantly from the REBT perspective, as well as making inferences
about things happen, we go beyond the ‘facts’ to evaluate them in terms of what
they mean to us.
 Irrational evaluations consist of one or more of the four types of beliefs listed
earlier.
3. Core beliefs
 Guiding a person’s inferences and evaluations are their underlying, general core
beliefs.
 An example of general core belief that would apply to the inference and
evaluation are using as our example could be: ‘For me to be worthwhile as a
person I must have someone who loves me unreservedly.’

Psychotherapy
 REBT has been successfully used to help people with a range of clinical and non-clinical
problems, using a variety of modalities.
 It aims not at ‘positive thinking’ but rather at realistic thoughts, emotions and behaviors
that are in proportion to the events and circumstances an individual experience.
 It is educative and collaborative. Clients learn the therapy and how to use it on
themselves (rather than have it ‘done to them’).
 REBT is a method of psychotherapy, so the emphasis is on helping people change how
they feel and behave in reaction to life events.
 It tends to be humanistic, anti-moralistic, and scientific. Human beings are the arbiters of
what is right or wrong for them.
 Its emphasis is on profound and lasting change in the underlying belief system of the
client, rather than simply eliminating the presenting symptoms.
Critical Evaluation
  Rational emotive behavior therapists have cited many studies in support of this
approach. Most early studies were conducted on people with experimentally induced
anxieties or non-clinical problems such as mild fear of snakes (Kendall & Kriss, 1983).
However, a number of recent studies have been done on actual clinical subjects and have
also found that rational emotive behavior therapy (REBT) is often helpful (Lyons &
Woods 1991).
COGNITIVE BEHAVIORAL THERAPY – AARON BECK

 He is known as the father of Cognitive Therapy.

 He has been named one of the "Americans in history which shaped the face of
American Psychiatry" as well as one of the "five most influential psychotherapists of
all time.”
 Beck is the proponent of cognitive-behavior therapy (CBT), whose guiding principle is
that the driving forces of mental dysfunction are habitual, unrealistic, self-defeating
ideas— “automatic thoughts,” in the clinical parlance—that, like tinted lenses, color
one’s perceptions of, and therefore one’s reactions to, the external world.
 His theory opened the door for many new ideas in the world of psychology. From his
original theory, many other theories have been created by other professionals in the field.

The History of Cognitive Behavioral Therapy

 Cognitive behavioral therapy was invented by a psychiatrist, Aaron Beck, in the 1960s.
 Beck realized that the link between thoughts and feelings was very important. He
invented the term automatic thoughts to describe emotion-filled thoughts that might pop
up in the mind.
 Beck called it cognitive therapy because of the importance it places on thinking. It’s now
known as cognitive-behavioral therapy (CBT) because the therapy employs behavioral
techniques as well.
 Beck saw that the way to break this cycle was by changing the thoughts before focusing
on changing the behavior.
 Beck’s (1967) system of therapy is similar to Ellis’s, but has been most widely used in
cases of depression.

General CBT Assumptions:

• The cognitive approach believes that abnormality stems from faulty cognitions about others,
our world and us. This faulty thinking may be through cognitive deficiencies (lack of planning)
or cognitive distortions (processing information inaccurately).
• These cognitions cause distortions in the way we see things; Ellis suggested it is through
irrational thinking, while Beck proposed the cognitive triad.
• We interact with the world through our mental representation of it. If our mental
representations are inaccurate or our ways of reasoning are inadequate then our emotions and
behavior may become disordered.
 The cognitive triad are three forms of negative (i.e
helpless and critical) thinking that are typical of
individuals with depression: namely negative
thoughts about the self, the world and the future.
These thoughts tended to be automatic in depressed
people as they occurred spontaneously.
CBT is based on a straightforward, common sense
model of the relationships among cognition, emotion, and behavior.
Three aspects of cognition are emphasized:
1. Automatic thoughts
2. Cognitive distortions
3. Underlying beliefs or schemas
Automatic Thoughts
An individual’s immediate, unpremeditated interpretations of events are referred to as automatic
thoughts. Automatic thoughts shape both the individual’s emotions and their actions in response
to events.
Cognitive Distortions
Errors in logic are quite prevalent in patients with psychological disorders. They lead individuals
to erroneous conclusions. Below are some cognitive distortions that are commonly seen in
individuals with psychopathology:
 Dichotomous thinking: Things are seen regarding two mutually exclusive categories
with no shades of gray in between
 Overgeneralization: Taking isolated cases and using them to make wide generalizations
 Selective abstraction: Focusing exclusively on certain, usually negative or upsetting,
aspects of something while ignoring the rest
 Disqualifying the positive: Positive experiences that conflict with the individual’s
negative views are discounted
 Mind reading: Assuming the thoughts and intentions of others
 Fortune telling: Predicting how things will turn out before they happen
 Minimization: Positive characteristics or experiences are treated as real but insignificant
 Catastrophizing: Focusing on the worst possible outcome, however unlikely, or thinking
that a situation is unbearable or impossible when it is really just uncomfortable
 Emotional reasoning: Making decisions and arguments based on how you feel rather
than objective reality
  “Should” statements: Concentrating on what you think "should" or “ought to be” rather
than the actual situation you are faced with or having rigid rules which you always apply
no matter the circumstances
 Personalization, blame, or attribution: Assuming you are completely or directly
responsible for a negative outcome. When applied to others consistently, blame is the
distortion.
Underlying Beliefs
Underlying beliefs shape the perception and interpretation of events. Belief systems or schemas
take shape as we go through life experiences.
Core Beliefs
 The central ideas about self and the world
 The most fundamental level of belief
 They are global, rigid, and overgeneralized
Examples of dysfunctional core beliefs:
 “I am unlovable.”
 “I am inadequate.”
 “The world is a hostile and dangerous place.”
Intermediate Beliefs
 Consist of assumptions, attitudes, and rules
 Influenced in their development by the core beliefs
Examples of dysfunctional intermediate beliefs:
 “To be accepted, I should always please others.”
 “I should be excellent at everything I do to be considered adequate.”
 “It is best to have as little as possible to do with people.”

Common Mental Health Conditions Addressed by Cognitive Behavioral Therapy

Cognitive behavioral therapy works best when an individual wants to focus on a particular
problem. Some of the major mental health concerns that CBT can be used to address include:

 Anger management
 Social anxiety
 Depression
 Panic or anxiety attacks
 Obsessive-compulsive disorder
 Sleep problems
 Mood swings
 Eating disorders
 Drug abuse and alcohol dependency
 Relationship and sex issues

Cognitive Therapy Case Formulation

Cognitive therapy case formulation offers a hypothesis about the causes and nature of the
presenting problem. It consists of five components:
 Problem List consists of a list of the client's difficulty including interpersonal, financial
and occupational.
 Diagnosis is helpful in developing the problem List and for treatment planning.
 Working Hypothesis describes the relationship among the problems on the Problem List
and consists of four sections including schemata and summary of the hypothesis.
 Strengths and Assets help the therapist to draw from the client's strength to design the
necessary interventions.
 Treatment Plan includes goals that are ways to solve the problems on the Problem List.
Each goal has specific interventions to help to accomplish the goal.
Cognitive Techniques
Cognitive techniques are to change cognition, and this, in turn, will change affect and behavior.
Specific cognitive techniques include:
 Decatastrophizing: This technique is also known as the "what if" technique, and assist the
clients to identify problem-solving strategies to prepare them for the things they fear.
 Reattribution: This helps clients to consider the alternative causes of events in order to
assign responsibility where it is due.
 Redefining: This enables clients to move from believing that a problem is beyond their
personal control.
 Decentering: This helps anxious clients who feel that they are the center of attention to
examine the logic behind these thoughts.
Behavioral Techniques
Cognitive therapy often uses behavioral methods to achieve its goals of cognitive change.
Behavioral techniques are used to challenge maladaptive beliefs and encourage new learning. It
is also used to teach clients skills such as relaxation techniques, behavior rehearsal, and
scheduling activity.
Since these behavioral techniques are geared towards promoting cognitive changes, the clients’
perceptions, thoughts, and conclusions are explored after each behavioral activity. Below are
some behavioral approaches that are used in cognitive therapy.
 Homework: This gives clients the opportunity to apply the cognitive principles they learn
in therapy sessions in the time between sessions.
  Hypothesis testing: What is the evidence that the automatic thoughts are true, or not true?
 Behavior rehearsal and role-playing: Useful skills are practiced, that the client use in life
situations
 Activity scheduling: This provides the structure and encouragement the clients need for
them to carry out activities.
 Graded task assignment: Clients are given assignments that move from non-threatening to
more difficult tasks.
Psychotherapy
The therapist creates a warm, safe environment for the clients for them to have the opportunity to
express themselves without judgment. Beck’s cognitive behavioral therapy aims to help
empower clients to take control of their lives and to ultimately improve their overall quality of
life.
Critique of CBT
Like all great theories, the initial version was no doubt the most accurate, but Beck’s theory does
lend itself to research, and a large portion of depression related research in one way or another
relies on the theory. The research conducted for CBT has been a topic of sustained controversy.
While some researchers write that CBT is more effective than other treatments, many other
researchers and practitioners have questioned the validity of such claims. For example, one study
determined CBT to be superior to other treatments in treating anxiety and depression. However,
researchers responding directly to that study conducted a re-analysis and found no evidence of
CBT being superior to other bona fide treatments and conducted an analysis of thirteen other
CBT clinical trials and determined that they failed to provide evidence of CBT superiority.

VIEW OF HUMAN NATURE

 Genetic and evolutionary predisposition toward certain types of emotional responses.

 Rational, pragmatic and constructivist perspective.

 Cognitive behavioral therapy is seen as an anti-deterministic, active, educative and

empirical approach to counseling.

 Beck suggests that most individuals are not aware of their core beliefs.

 Focusing minimally on the past, CBT initially shows clients how their current
thinking affects attitudes, feelings and behaviors.