Introduction
REBT is a type of CBT approach in psychotherapy that enables a client to learn challenging inappropriate and false thoughts that cause unwelcomed behavior and develop new appropriate patterns of running their lives. This therapy assumes that individuals contribute to their psychological problems and symptoms because of their unchanging and intense beliefs about incidences and conditions (Corey, 2017). It is a holistic and integrative approach because it emphasizes the individuals’ emotions, cognitions, behaviors, and interactions (Corey, 2017). Some therapists employ this approach to help clients identify their illogical credence, dispute them, and substitute them with productive and sensible cognition. This therapeutic process has similarities with an educational process (Corey, 2017). This is because the therapist teaches the client how to change their behavior, react to situations, and put these new beneficial behaviors into action. Therefore, it is considered the preferred CBT in treating various patients.
Origin of the Theory
Albert Ellis developed rational emotive behavior therapy during his early days as a psychologist. He created it as he was practicing psychoanalytically oriented psychotherapy when he realized his clients improved faster after developing new ways of thinking about themselves (Corey, 2017). Additionally, Ellis created it to find solutions to his problems. He had intense fears of speaking in public and talking to young women. Therefore, Ellis forced himself to talk to 100 different young men in one month (Corey, 2017). He used rational and behavioral techniques, which desensitized him from fear of rejection from women.
Beliefs about Human Nature and the Counseling Process
REBT hypothesizes that human beings are the causes of their problems and symptoms due to inappropriate, intense, and rigid beliefs they hold against incidences and circumstances. It explains that people learn irrational beliefs from their loved ones in early childhood and recreate these beliefs in their entire life (Corey, 2017). It states that through auto-suggestion and self-repetition, people actively reinforce their self-defeating thoughts. Additionally, REBT emphasizes that the impaired functioning attitudes common among most individuals are due to blame. Moreover, Ellis hypothesized that REBT is based on individuals’ aptness to convert their desires into irrational commands and demands (Corey, 2017). These cause blame resulting in emotional disturbances, abnormal behaviors, and disorderly feelings.
REBT requires the effort of the counselor and clients to ensure its success. The counselor must demonstrate to the clients how they: incorporated irrational absolute expectations and demands into their thoughts; and are keeping their emotional instability by continuing with the irrational thoughts; can change their beliefs and minimize irrationality. Additionally, they should encourage them to incorporate rational philosophy into their life to avoid such future incidences (Corey, 2017). On the other hand, the client has to change their thought patterns and emotional reactions that they generated and complete their therapy homework assignments to minimize irrational thinking, emotional instability, and unwelcomed reactions and behaviors (Corey, 2017). Moreover, to ensure success in this technique, the client should recognize their irrational thoughts and belief system, be willing to be helped to change their irrational thoughts and reactions, and incorporate a rational belief system in their daily lives.
The client and the therapist create a collaborative, supportive relationship to choose logical and life-enhancing therapeutic goals. These goals include differentiating between logical and illogical goals and between futile and life-enhancing goals. These allow the therapist to educate the client to change their unwelcomed thoughts and behaviors to healthier actions and belief systems. Additionally, REBT has a goal of helping clients accept themselves with no limits enabling them to take up others and live unconditionally. This enhances the clients’ ability to enjoy their life and develop positive life-changing reactions.
Research
Research has demonstrated that the REBT approach has certain contributions and limitations in the therapeutic process. A systematic review and meta-analysis identified that REBT is an effective approach to helping clients with obsessive-compulsive disorder, social anxiety, depression, and disruptive behavior (David et al., 2017). Additionally, REBT interventions are suitable when employed in therapeutic processes on individuals regardless of their presenting thematic differences. These interventions effectively analyze their effects on the alleged mechanism of change (David et al., 2017). Moreover, research has demonstrated that REBT-based binge-eating behavior management program effectively enhances self-esteem and body positivity, reducing covert narcissism and mental illness, and managing binge-eating behavior among female college students (Yang & Han, 2020). This resulted in improvements in the students’ quality of life and general health status. These studies employed the ABCDE model of REBT to convert the test group’s irrational thoughts to rational beliefs. Therefore, these studies proved that the three techniques of REBT— integrative cognitive, emotional and behavioral— were effective in the psychological management of mental illness and its associated symptoms.
The limitations of REBT are debatable due to various methodological reasons. Like any other therapy type, REBT has varying preferences between different people (Corey, 2017). However, there are limited studies that have demonstrated the limitations of REBT. Therefore, generalization about its effectiveness and limitations in different therapeutic processes to the general population would be inappropriate (Yang & Han, 2020; David et al., 2017). Increased follow-up studies are needed to determine its effectiveness in managing various disorders in the long term and compare this technique with other psychotherapeutic methods.
Compatibility with Diverse Cultures
REBT has various strengths and limitations when addressing diversity, multicultural and social justice issues in individual counseling. The strengths include REBT’s tendency to be sensitive to individuals’ cultures and emphasize cognition, action, and collaboration (Corey, 2017). REBT is a client-based approach and emphasizes learning, using evidence-based methods, concerned with present character and brevity (Corey, 2017). Additionally, it recognizes and uses the clients’ beliefs, emotional reactions, and behavioral preferences throughout the therapy (Corey, 2017). This enables the client to feel respected, and their viewpoints are taken seriously during the therapeutic sessions. REBT’s limitations are based on its unique approach to the therapeutic process. REBT has a negative perception of dependency resulting in an unfavorable response to this technique. It has a harsh approach to clients compared to other techniques. Moreover, its assertive, independent, verbal ability, rational, cognitive, and behavior change approaches can be inappropriate to some cultures that discourage such perspectives (Corey, 2017). Another limitation is its individualistic orientation which might be challenging to cultures to emphasize the intervention of the environment.
I would modify the REBT technique to ensure it is appropriate for diverse cultures to avoid any limitations in different ways. Firstly, I would study the cultures and religions of my clients (Pantalone et al., 2019). Secondly, I would identify and acknowledge the thematic issues such as health beliefs, individual identity, communication styles, family structure, individualism and collectivism, and therapeutic goals that cause a difference in the client’s behavior (Pantalone et al., 2019). I would ensure that every aspect of the client’s socio-cultural belief system is considered during the therapy sessions. Thirdly, I would incorporate a competent and theoretically consistent REBT technique (Pantalone et al., 2019). I would ensure I enhance caution in the client’s language and expressions during therapy sessions (Corey, 2017). These approaches allow the provision of culturally competent treatment. It enables both the counselor and the patient to create a positive relationship that acknowledges the cultural, religious, and ethnic differences to enhance an effective culturally competent REBT technique.
Appropriateness for Crisis
Different scientific journals and books have demonstrated that REBT intervention can be used in crisis intervention. Various research studies have shown its significant effort to reducing psychological, emotional, physical, and sexual abuses among different groups (Corey, 2017; David et al., 2017; Yang & Han, 2020). Therefore, the REBT techniques can train professional therapists in developing a refined holistic approach that emphasizes clients’ multicultural cultures, diversities, and social justice issues.
Christian Worldview Compatibility
The varying ways in which REBT is compatible with Christianity ideologies are evident in the scripture. The first compatibility with Christianity is that the REBT approach emphasizes individuals changing their negative thoughts into positive beliefs and actions, resulting in a positive life and healthy behavior similar to the Bible’s text of Romans (Rom. 12: 2, New King James Version). The second compatibility is in 2 Corinthians 10: 5, which emphasizes destroying thoughts against God’s knowledge and gaining control of thoughts to believe in Christ is similar in ideology to REBT theory about owning one’s thoughts to guide them in developing rational thoughts that are meaningful to their lives. The third compatibility is in James 2: 14, where the Bible educates on an individual’s beliefs affecting their character and actions. Therefore, this is similar to REBT theory, which hypothesizes that an individual’s emotions and actions result from their beliefs that are actively reinforced in their daily lives, causing them to behave according to that system.
Despite having some similarities to Christian ideologies, there are instances where REBT is incompatible with Christianity. The first incompatibility is that REBT is a type of CBT based on naturalism and hedonism (Johnson, 2019). It allows people to make decisions based on their happiness and human nature. This is contrary to the Bible because it relates hedonism to sin and emphasizes that humans need God to help them make spiritual and physical decisions. The second incompatibility is that REBT explains that human beings choose to suffer by choosing irrational thoughts, and incorporating rational beliefs in daily life can avoid that suffering (Johnson, 2019). However, Christianity believes that they understand and come spiritually closer to God in suffering and that their suffering has a meaning. The third incompatibility is that in REBT, the therapist is the source of knowledge, and he helps make better judgment and decisions (Johnson, 2019). In Christianity, God and the Holy Spirit are seen as the source of knowledge and guide human beings’ actions and decisions.
Case Conceptualization Using REBT
Luana presented with memory loss symptoms, low self-esteem, inferiority complex, and anxiety. Luana is seeking to find her identity due to the recent flashback she’s been having about her past that she does not understand and clearly remember. This memory loss and flashbacks are traced back to a road accident she had with her family. Using the clinical targets approach, the thematic groups identified are a related fear of conflict presented by Luana’s shyness and psychogenic perception of the world as threatening presented by her inferiority complex. Additionally, Luana has maladaptive thinking because she sees herself as inferior to her husband and other wealthy family members. She exhibited inappropriate thoughts of being inferior to a much wealthier family, and she thinks she does not fit in.
The therapist can use the REBT theory to help her identify this irrational thought of inferiority and replace it with a positive belief that she is enough. This is then reinforced by engaging in therapeutic homework of helping her practice having a positive attitude about herself. Therefore, REBT therapy sessions will be beneficial to dispute Luana’s core self-defeating beliefs of inferiority and low self-esteem and replace them with self-belief actions and feelings of worthiness.
Evidence-Based Considerations
REBT theory is beneficial to Luana in disputing feelings of inferiority, anxiety disorder, and low self-esteem. Research has shown that REBT is the most appropriate method of dealing with maladaptive behavior and symptoms of mental illness such as anxiety, low self-esteem, and inferiority complex (Stephenson et al., 2017). Therefore, using the ABCDE model of REBT, Luana can achieve its therapeutic goals of unconditional self-acceptance, other-acceptance, and life acceptance.
Ethical Considerations
Ethical considerations must arise with any therapeutic approach used in treating patients. Some of the codes of ethics that might arise while using the REBT approach are the ACA Codes of Ethics A.1. The ACA Code of Ethics A.1 requires the therapist to respect the patient’s dignity and promote her welfare (A.1.a) and protect the patient’s records from falling into unauthorized personnel (A.1.b). Additionally, it requires them to collaborate to devise appropriate counseling plans for the patient and recognize their supportive network (A.1.d).
Cultural Considerations
There are significant multicultural issues that may arise while using REBT therapeutic theory with Luana. Some of these are REBT’s rigidity and negative attitude on dependence and the social-cultural Luana’s belief that she will be considered a failure when she goes through a divorce. REBT believes that an individual’s reaction to unpleasant circumstances is the reason for their mental disturbances. Therefore, this might result in a misunderstanding between the therapist and Luana.
Theoretical Interventions
Cognitive Techniques
This technique involves using a persuasive cognitive method that helps clients identify the self-deprecating remarks about themselves and their inabilities. The therapist then educates the patient on challenging these thoughts to help them stop believing in them. Additionally, the therapist encourages the client to incorporate factual philosophical ideas in their daily lives (Corey, 2017). Using this technique, I would help Luana determine her irrational thoughts of feeling inferior and having low self-esteem and anxiety. I will help her counter these thoughts with productive factual philosophies and encourage her that she is worth everything around her and her family’s attention, experience, and friendship.
Emotive Techniques
These are clear and evoking techniques that assist the patient in disputing their irrational beliefs. They involve the use of various procedures such as unconditional acceptance, rational emotive role-playing, modeling, rational-emotive imagery, and shame-attacking exercises (Corey, 2017). For example, I would use this technique to help Luana develop new healthy emotional patterns to replace the inappropriate ones and use shame-attacking techniques to help her overcome her anxiety.
Behavioral Techniques
These techniques involve assigning the client behavioral homework assignments to carry out outside therapy sessions. Behavioral techniques involve using operant conditioning, self-management principles, systematic desensitization, relaxation techniques, and modeling (Corey, 2017). An example of how I would use this technique is by assigning Luana homework to maintain eye contact with her closest friend during conversations to enhance his ability to keep her chin up during conversations. Therefore, it will help in eliminating her shyness and improve her relationship with people.
Spiritual Application
Various spiritual challenges might arise during a therapeutic session with Luana. These challenges are based on the religious aspects of Christianity. For example, the REBT approach relies on the therapist as the source of knowledge in healing and overcoming her irrational thoughts and differences in the beliefs of suffering according to REBT and Christianity. Luana being a Christian, might believe that suffering is part of being closer and increasing her knowledge about God and salvation. However, the therapist using the REBT-based approach believes that Luana’s suffering from inferiority complex is due to her irrational beliefs. Additionally, Luana states that she believes God will help her overcome her situation, which is contrary to the theory of REBT that emphasizes the role of an individual in changing the thoughts and beliefs in their life. If Luana were interested in having Christian counseling be part of the treatment plan, I would adjust to using a religiously specific REBT approach to acknowledge similarities and differences and enhance the therapeutic process.
Prognosis/ Outcome
The expectation of the outcomes of this therapy is Luana’s development of a positive attitude towards herself, thus enhancing her self-esteem and minimizing her anxiety. Additionally, continuous therapy sessions using this CBT will allow her to start gaining her memory. However, her spiritual views on Christianity might pose challenges in ensuring a successful shorter therapy session. This is because of the little disparities this approach has with Christianity. Her anxiety might not end in just one therapy session. Therefore, I would recommend her for bibliotherapy and purchase and read the REBT self-help book (Corey, 2017). This is because they are effective in helping to reduce the client’s anxiety.
Theoretical Orientation
I believe that human beings are innate to good character. When any deviations are detected in a client during a therapy session, the counselor should help them in addressing this deviation. The theoretical orientation that I would integrate into my perspective focuses on the client’s strengths instead of weaknesses to help her overcome anxiety, self-esteem, and memory. I am highly likely to include this theory in my theoretical orientation because REBT is a tested theory in ensuring individuals pursue a fulfilling and less miserable life. Therefore, it enables individuals’ to incorporate positive psychology when facing different life situations and enhance their well-being.
References
Corey, G. (2017). Theory and practice of counseling and psychotherapy (10th ed.). Cengage Learning.
David, D., Cotet, C., Matu, S., Mogoase, C., & Stefan, S. (2017). Fifty years of rational-emotive and cognitive-behavioral therapy: A systematic review and meta-analysis. Journal of Clinical Psychology, 74(3), 304–318. Web.
Holy Bible: New King James Version. (2021). Cambridge University Press.
Johnson S. E., (Ed.). (2019). REBT with Religious People. In W. Dryden, & M., E. Bernard, REBT with diverse client problems and populations (pp. 323 – 338). Springer.
Pantalone D. W., Iwamasa G. Y., Martell C. R. (2019). Cognitive-behavioral therapy with diverse populations. In Donson K. S., & Dozois D. J. A., Handbook of cognitive-behavioral therapies (pp. 445 – 462). The Guilford Press.
Stephenson, E., Watson, P. J., Chen, Z. J., & Morris, R. J. (2017). Self-compassion, self-esteem, and irrational beliefs. Current Psychology, 37(4), 809–815. Web.
Yang, J., & Han, K. S. (2020). A rational emotive behavior therapy-based intervention for binge eating behavior management among female students: A quasi-experimental study. Journal of Eating Disorders, 8(1). Web.