Rational Emotive Behavior Therapy

Introduction

Rational emotive behavior therapy (REBT) is a therapy approach that was developed by Albert Ellis in the 1950s. It is a therapy approach that involves the identification and replacement of negative behaviors with positive ones. It is founded on three core principles, namely activating agent, beliefs, and consequences. Individuals have certain beliefs that determine their thoughts and emotions. Any emotional state has a corresponding behavioral outcome, known as a consequence. Therapists work together with patients to identify irrational beliefs and destructive thought patterns that could have adverse emotional, psychological, or behavioral effects. The first step is the identification of negative patterns. The second step is their replacement with rational thought patterns that have a positive impact on behavior. Research has shown that REBT can be effectively used to improve the lives of individuals with several conditions, including depression, phobias, anxiety, addictive behaviors, aggression, procrastination, irregular sleep patterns, and eating disorders. REBT is an effective therapy form in the treatment of many mental illnesses.

Brief History

REBT was developed by Albert Ellis, an American psychologist, and psychotherapist. He created the therapy approach in the 1950s and based it on the precepts of CBT. REBT is widely used in several fields of study and practice because it is both a school of thought and a psychotherapeutic system of theory and practice. like most psychologists during his time, he was trained in psychoanalysis. He was frustrated because the recovery process of patients who underwent treatment through psychoanalysis was relatively slow. Therefore, he decided to develop a faster and more effective method. Ellis introduced it first during a conference of the American Psychological Association (APA) in 1956. In 1957, he introduced the term “rational therapy” in an article that he authored and published titled “Rational psychotherapy and individual psychology” (Geldard et al., 2017). Ellis was inspired by many philosophers, and aspects of ancient philosophy can e identified in his theory. For instance, Marcus Aurelius, Cicero, Seneca, and Epictetus were major influences. Ellis’ approach to therapy was named rational Emotive Therapy in 1959, but the name was later changed to REBT in 1992.

Major Contributors

Albert Ellis is the main person associated with REBT because he created and developed it. The theory he incorporated in his approach to therapy was borrowed from ancient Greek, Roman, and Asian philosophy. In that regard, the teachings from several philosophers can be identified in his theory. These include Marcus Aurelius, Seneca, Epictetus, Cicero, Zeno of Citium, and Chrysippus. Their indirect contributions played a significant role in the development of the widely-applied REBT. Since the creation of REBT, many psychologists have conducted studies to determine its effectiveness in various fields. For instance, several studies have been conducted to evaluate its effectiveness in the treatment of anxiety disorders and depression. Cognitive-behavioral therapy (CBT), developed by Aaron Beck, is the precursor of REBT. However, many researchers refer to Ellis as the “grandfather’ of the field because of his extensive and revolutionary contributions to clinical psychology.

Core Concepts

REBT is based on the basic concept that emotions and feelings originate from beliefs that people hold. This contradicts the myth that emotions are caused by the events that occur in people’s lives. In that regard, it is of utmost importance for people to develop rational and healthy beliefs that have positive outcomes. Researchers have found out that beliefs are directly related to one ‘s happiness and emotional growth (Geldard et al., 2017). Irrational and self-defeating beliefs lead to negative emotional outcomes such as anxiety, depression, and self-blame. REBT has three major guiding principles, namely activating events, beliefs, and consequences (Bernard & Dryden, 2019). First, the identification of the event that triggers certain emotional responses is critical. Second, the beliefs that are associated with the response should be identified and evaluated. Third, it is important to note that a combination of the activating agent and the core beliefs leads to consequences or outcomes that can be either positive or negative (Geldard et al., 2017). REBT is based primarily on the identification and the deconstruction of negative beliefs and their replacement with positive perceptions.

How It Works

REBT is founded on the belief that people are unaware that their perceptions of themselves are irrational and negatively affect their interactions with other people. in addition, these beliefs determine their responses under different situations and circumstances. He postulated that thoughts are the source of negative emotions that lead to self-destructive actions (Bernard & Dryden, 2019). He taught that people have the power to challenge and change their irrational beliefs and become happy. Research has shown that the majority of the psychological issues that people face are caused by their irrational beliefs and the misrepresentation of events that occur in their lives (Geldard et al., 2017). Self-acceptance is achieved by abandoning negative thoughts and replacing them with affirmative ones that elicit positive emotions (Bernard & Dryden, 2019). This is only achieved through embracing positive beliefs. The main role of a therapist in REBT is to help the patient identify, challenge, question, and dispute negative beliefs, emotions, and behaviors to replace them with positive ones. Clients are encouraged to practice every day because changing a longstanding belief or pattern of thought is a difficult undertaking.

The ABC Model

The ABC model is a component of REBT that was created by Ellis to show how the misrepresentation of events leads to unhappiness. An important precept of Ellis’ theory is that the feelings that events elicit are determined by people’s interpretation regarding their meanings. The model illustrates how thoughts, emotions, and behavior are connected (Bernard & Dryden, 2019). Activating agent or a trigger refers to any event or situation that a person encounters that arouses their emotions. For instance, a friend’s failure to reply to a text message or the denial of a promotion at work. Belief refers to the perspective that a person holds about the events that take place in their lives(Bernard & Dryden, 2019). These can be either interpreted correctly and arouse positive emotions or misinterpreted to elicit negative feelings. The emotions that an event arouses in a person are based on their interpretation of its meaning or place in their lives. Consequences refer to an outcome that arises from allowing a belief to direct one’s behavior (Geldard et al., 2017). Research has shown that the major cause of people’s psychological problems is the erroneous interpretation of situations or the embracement of irrational beliefs.

The ABCDE model was also developed by Ellis, and it is an extended version of the ABC model. The acronyms stand for different concepts. A stands for the activating agent. B stands for the belief system while c stands for emotional consequences (Bernard & Dryden, 2019). D stands for the process of disputing thoughts and beliefs, and E stands for the effects of new beliefs (Bernard & Dryden, 2019). When an individual disputes a longstanding self-defeating belief, different outcomes are observed. The consequences are mainly positive and include constructive behaviors and positive emotions. Individuals need to replace their irrational thoughts with rational ones. The disputation process results in rational beliefs that have positive influences on how the individual thinks and behaves (Bernard & Dryden, 2019). Empowering beliefs lead to positive emotions, and consequently positive behaviors.

The ABCDE Model.
Fig 1: The ABCDE Model (Bernard & Dryden, 2019).

Benefits of REBT

RENT has numerous benefits that explain why therapists use it to treat many conditions. Clients learn to take responsibility for their thoughts, feelings, and actions without being judgmental (Geldard et al., 2017). They also learn how to identify irrational beliefs and thoughts that have a direct influence on their behaviors. The skills that are acquired in therapy sessions can be used to improve all areas of life. For example, they learn how to disrupt self-defeating thoughts and replace them with positive self-affirming thoughts when facing difficult situations. REBT teaches clients how to abandon unrealistic expectations of themselves and others, and instead, embrace healthier and more realistic prospects that reflect reality (Geldard et al., 2017). Patients also learn how to accept themselves and become self-aware. Self-awareness increases understanding and empowers individuals to take their time before jumping to conclusions. In that regard, they become more compassionate and non-judgmental. This leads to stronger relationships that are based on trust and honesty. Finally, clients learn how to handle difficult situations with grace because the risk-taking exercises that they do strengthen their will and change their attitudes and perspectives (Geldard et al., 2017). REBT imparts coping skills (decision-making, problem-solving, and conflict-resolution skills) that can be applied in any situation in life that involves interactions with other people.

Techniques

The practice of REBT involves the application of three types of techniques. They include problem-solving, cognitive restructuring, and coping techniques. The type of technique applied during therapy mainly depends on the patient’s symptoms and the therapist’s past clinical experience with different approaches. Problem-solving techniques are usually used to address the activating event. They include problem-solving skills, assertiveness, social skills, decision-making skills, and conflict-resolution skills (Geldard et al., 2017). Cognitive restructuring techniques aid in the deconstruction of irrational beliefs. They include humor and irony, reframing, visualization, guided imagery, disputing irrational thoughts, and rationalizing techniques. Coping techniques are applied in the management of the emotional consequences that originate from irrational beliefs. They include relaxation, meditation, and hypnosis.

Cognitive Techniques

One of the methods used is disputing irrational beliefs. For instance, some people believe that life should always be fair. Therefore, they are unable to cope when they fail or when they encounter tough times. Patients need to find evidence that disproves their irrational beliefs and biased assumptions. Therapists can help patients who believe that they are failures relieve a moment of success in their past. Reframing refers to the process of looking at an event from a positive perspective to understand it and deal with the outcomes more favorably. It gives new meaning to events, and as a result, helps people to cope better. Thought stopping involves learning how to interrupt negative thought patterns and stopping them before they translate into actions. This is an important skill to acquire because thoughts are directly linked to behavior.

Emotive Techniques

These techniques help clients understand the relationship between their negative emotions and beliefs and their behavior. Humor is an effective method that allows people to laugh at their faulty beliefs and the reactions that they cause. Role-playing is an effective way of gaining core skills through practice while dealing with the negative beliefs and emotions that give rise to certain outcomes. Many therapists use shame-attacking exercises to get rid of shame and guilt in the lives of their patients. The main goal of such exercises is to help clients become more accepting of who they are by getting rid of the shame that they feel regarding their beliefs, thoughts, or actions. Rational emotional imagery involves the correction of an individual’s reaction to a certain event that is either real or imagined. Clients imagine a certain event and then practice experiencing an appropriate reaction that is better than the usual destructive emotion that leads to self-defeating behaviors. Encounter exercises are aimed at helping clients deal with dreadful events in a more positive way.

Behavioral Techniques

Meditation is used by patients to acquire the skill of emotional control. In addition, it helps them to dispute their rational beliefs that are associated with self-defeating behaviors. Relaxation techniques are used to calm down clients when they feel anxious or stressed. Examples of common techniques include deep breathing exercises, guided imagery, progressive muscle relaxation, and meditation. Journaling is a way of processing thoughts b writing them down. It facilitates the evaluation of thoughts, feelings, and behaviors, and how the three are associated. Systematic desensitization is a stepwise process of subjecting clients to situations that elicit feelings f anxiety and helping them to keep calm using relaxation methods. Risk-taking exercises are conducted as a way of applying the knowledge gained during therapy to real-life situations. Moreover, clients work on homework assignments that include activities that involve practicing new skills on how to cope emotionally.

Therapy’s Atmosphere

Therapists work with clients to identify the beliefs and thought patterns that are responsible for their conditions. In many cases, there is an atmosphere of disbelief and denial as clients come to terms with reality. Many people usually have reasons to explain they’re deplorable mental and physical conditions. Therefore, a lot of effort is needed to change how they think about themselves and their situations. People have different personalities and use varied techniques to address their problems. Sessions with some clients could be confrontational while others could be non-confrontational and quiet. Therapists approach their clients’ situations with a lot of understanding and compassion. Therefore, they listen attentively and provide feedback empathically. On the other hand, clients respond differently. some might feel attacked or judged when a therapist makes a comment about their actions or thought patterns. Individuals who are driven by their egos could become confrontational and irritable in case they feel judged unfairly. Open-minded people are non-confrontational as they seek to understand their situations by evaluating the therapists’ perspectives, ideas, and insights.

Client Issues Addressed

Clients who seek REBT fall into different groups, depending on their conditions or emotional issues. REBT-associated clients include people suffering from anxiety, depression, and anger. Patients with post-traumatic stress disorder (PTSD), compulsive disorders, obsessive-compulsive disorder, autism spectrum disorders, and personality disorders are usually treated by practitioners of REBT (Raypole, 2018). Another group comprises individuals with complex presentations and difficulties with impasses and includes people with addictions, psychosis, and suicidality. Common clients include people with pornography and gambling addictions, substance abuse and dependence, and compulsive behaviors. (Raypole, 2018) The therapy approach is also used to treat people dealing with eating disorders, grief and loss, family conflict, marital issues, social skills deficits, relationship challenges, somatic complaints, excess guilt, self-sabotage, and procrastination. Therapists use combinations of different techniques to deal with the aforementioned issues.

Success Rates

Several studies have revealed that REBT is an effective form of therapy for treating various illnesses. A 2017 review that comprised an evaluation of 84 articles showed that the successful treatment of social anxiety, depression, obsessive-compulsive disorder, and disruptive behavior using REBT (Raypole, 2018). However, it recommended the need for more randomized trials to determine the range of conditions that it can be used to treat. The results of a 2016 study revealed that REBT can be successfully used to treat long-term depression. The study’s participants visited their primary physician less often after undergoing therapy for 12 months (Raypole, 2018). Moreover, the use of medications declined significantly. A similar study conducted in 2014 validated the findings that REBT can be used to treat depression. The effectiveness of REBT as a treatment modality is evident from these and other studies. However, recommendations for further research have been given to determine whether it is effective in addictive behaviors such as gambling.

Conclusion

Rational emotive behavior therapy (REBT) is a form of CBT therapy that was developed by Ellis in the 1950s. It describes the connection between thoughts, emotions, and behavior. The ACE and the ABCDE models are used to show these connections. The approach is used in the treatment of many conditions, including depression, anxiety, addictive behaviors, phobias, aggression, and procrastination. Its guiding [principles are the activating agent, beliefs, and consequences. An activating agent is an event or situation that arouses certain emotions in an individual. Belief refers to an individual’s perspective regarding that event. Consequences refer to the emotional reaction that originates from certain feelings. Research has shown that thoughts are precursors to actions. Therefore, individuals need to have rational beliefs and positive thought patterns for them to have constrictive behaviors. Irrational beliefs and negative thought patterns are the main cause of psychological problems and unhappiness in people. studies have shown that REBT is a highly successful and effective form of therapy in the treatment of many disorders and conditions. The atmosphere during a therapy session depends on the patient’s personality. If they are ego-driven, the atmosphere is usually confrontational. On the contrary, if they are open-minded, the atmosphere is usually quiet and non-confrontational.

References

Bernard, M. E., & Dryden, W. (Eds.). (2019). Advances in REBT: Theory, practice, research, measurement, prevention, and promotion. Springer.

Geldard, D., Geldard, K., & Foo, R. Y. (2017). Basic personal counselling: A training manual for counselors (8th ed.). Cengage Learning.

Raypole, C. (2018). Rational emotive behavior therapy. Healthline. Web.

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PsychologyWriting. (2023, September 18). Rational Emotive Behavior Therapy. https://psychologywriting.com/rational-emotive-behavior-therapy/

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PsychologyWriting. 2023. "Rational Emotive Behavior Therapy." September 18, 2023. https://psychologywriting.com/rational-emotive-behavior-therapy/.

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