A Brief Introduction to Rational Emotive Behavior Therapy

Apostol,C.G. (Oct 4, 2008).
Rational Emotive Behavioral Therapy.
DLSU-Manila, Philippines
Slides created by
Clarence G. Apostol
Guidance Counselor
Center for Guidance and Counseling
Mapua Institute of Technology
Intramuros, Manila

 This presentation will focus on :
◦ Historical development
◦ View of the Human Nature
◦ Nature of Difficulty
◦ Role of the Counselor
◦ Goals of the Counseling
◦ Techniques/Leads & Responses
◦ Steps of Counseling
◦ Role of History Taking & Testing
◦ Critiques & Limitations
◦ Applications of REBT

1913-2007

 Born: -Sep. 27,1913
 Birthplace: -Pittsburgh, PA
 Died: -July 24, 2007
 Location of death: -New York City
 Cause of death: -Kidney failure
 Religion: -Atheist
 Race or Ethnicity: -White
 Sexual orientation: -Straight
 Occupation: -Psychologist
 Nationality: -United States

 Born in Pittsburgh in 1913
 At age five he suffered tonsillitis
and latter diabetes
 Ellis had chronic renal problems
since 9 and diabetes by 40
 Exaggerated fear of public
speaking
 Shy around women

 Raised in New York City
 Difficult childhood
◦Parents divorced when he was 12
 His writings have focused on ways
to help people overcome
destructive, self-defeating
emotions and beliefs to ultimately
improve their lives

 Albert Ellis has authored more than
70 books and 700 articles
 Albert Ellis listed as the 2nd most
influential person in the history of
psychotherapy
 Died at the age of 93 on Tuesday, Jul
24, 2007 , of apparent kidney and
heart failure.

 Rational Emotive Behavior
Therapy (REBT)
◦Albert Ellis
 Cognitive Therapy (CT)
◦Aaron Beck

 Is based on the concept that emotions
and behaviors result from cognitive
processes;
 And that it is possible for human
being to modify such processes to
achieve different ways of feeling and
behaving
 Is one of the therapies that come
under the heading “cognitive-
behavioral”

“People are disturbed not
by things, but by the views
which they take of them.”
-Epictetus
Greek Stoic Philosopher
Ist century A.D.

 Started by Albert Ellis in 1955-
Grandfather of Cognitive Behavior
Therapy
 Originally called Rational Therapy
 Rational Emotive Therapy
 Early 1990’s changed to Rational
Emotive Behavior Therapy

 After two decades of practicing
psychoanalysis he became
increasingly disillusioned by the
limited progress
 Ellis, a Columbia trained clinical
psychologist, formulated this
treatment after deciding that
psychoanalysis was inefficient.

 Changed its name when its founder,
Albert Ellis, decided it needed to be
more reflective of focusing on behavior
as well as cognitions.
 Combination of Humanistic &
Behavioral Therapy to help deal with
issues from past

Albert Ellis Institute established in 1959
teaches principles of healthy living
Albert Ellis Foundation established in
2006 to promote REBT, a non-profit
institutions in New York ( Parrott, 2003).
Journal of Rational-Emotive and Cognitive
Behavior Therapy reports latest findings

 Thoughts and feelings are not two
disparate processes
 Beliefs are more important than events
Research supports several REBT
premises
 Changing thoughts, behaviors, or
emotions changes other modalities

 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

Situation/
Event
Cognitive Processing
Response:
Behavioral
Emotional
Cognitive

Lost job
Internal beliefs
(“I’m worthless.”
“It’s hopeless.”)
Depression
Lost job
Internal beliefs
“My boss is a jerk.
I deserve something
better.”
No depression

1) People have the potential to be
 Rational, self preserving, creative,
functional and to use metathought
 Irrational, self-destructive, short-range
hedonists, dysfunctional
2) Culture and family can perpetuate irrational
thinking
3) Humans perceive, think, emote and behave
simultaneously
4) All psychotherapies are not equally effective
5) A warm therapeutic relationship is not a
necessary or sufficient condition for change

6) REBT uses whatever techniques
work; focus is not symptom
removal but real cognitive change
7) Neurotic thinking is the result of
unrealistic, illogical thinking
8) The causes of an individual’s
problems are not the events that
have happened but how the
individual perceives them
9) There is an element between
stimulus and response; it is
thought and emotional response

Understanding the
Theory Behind
REBT

“Humans largely create their
own distress. ”
-Ellis

Should
Ought
Awful
Must
I Want
I Need

I did poorly on
my job today
Isn’t that
horrible
Anxiety, depression,
worthlessness
I feel anxious,
depressed and
worthless
Isn’t that
horrible
Intensified
feelings
of anxiety,
depression and
worthlessness

Freud that…. The pleasure principle runs people’s
lives
Horney & Fromm
that…..
Cultural and family influences impact
people’s irrational thinking
Adler that….. Fictitious goals order people’s lives
Allport that…. Individuals think and act in a certain
manner and have difficulty changing
Pavlov that…… Cognitive conditioning occurs

Frank that….. People are prone to the influence of
suggestion
Piaget that…. Active learning is more effective than
passive
Anna Freud that…. People refuse to acknowledge mistakes
and resort to defenses
Maslow & Rogers
that …….
Humans have great untapped resources

CT REBT
Therapist’s
Approach
more collaborative more confrontational
View of the
Problem
multiple cognitive
distortions
pathology arises from
shoulds, musts, & oughts
Emphasis psychoeducation an
early and critical
component of
treatment
higher reliance on
psychoeducation
Focus “hot cognitions”
critical, but obtained
in a less aggressive
manner
more focus on emotional-
evocative methods and
core set of irrational
beliefs
View of the
Problem
functional philosophical

Source: Morris, Charles.(2004). Psychology: An Introduction,
11/E.cvhart.net/psych_files/powerpoints/PowerPoints_14/Therapy.ppt

Nature of
Human Being

 Assumes that people
are both rational and
irrational, sensible
and crazy.
 This duality is
biological and is
perpetuated unless a
new way of thinking
is learned.
13th Floor

 We have the biological and cultural tendency to
think crookedly and to needlessly disturb
ourselves
 Humans are self-talking, self-evaluating &
self-sustaining
 We develop emotional & behavioral problems
when we mistake simple preferences (love,
approval, success) for dire needs
 We have the capacity to change our cognitive,
emotive, and behavioral processes

Sources of
Difficulty

Ellis places irrational beliefs into three
categories correlated with emotional
disturbance.
 “I absolutely must perform important tasks
well and be approved by significant others or
else I am an inadequate, pretty worthless
person”
◦ RESULT: Severe feelings of anxiety,
depression, and demoralization often leading
to severe inhibition.

 Irrational ideas lead to self-
defeating behavior
 Some examples:
◦ “I must have love or approval from all
the significant people in my life.”
◦ “I must perform important tasks
competently and perfectly.”
◦ “If I don’t get what I want, it’s
terrible, and I can’t stand it.”

 “Other people, especially my friends
and relatives, truly must treat me
kindly and fairly, or else they are
rotten, damnable people”
◦ RESULT: Severe feelings of anger, rage,
fury, often leading to fights, child abuse,
assault, rape, murder and genocide.

 Through autosuggestion & self-repetition
we install & maintain self-defeating beliefs-
irrational dogmas & superstitions self-
created plus irrational beliefs from
significant others
 Blame is core of emotional disturbance-so
to recover stop blaming self & others
 We escalate desires & preferences into
dogmatic & absolutist “shoulds, musts,
oughts, demands, commands-which are
irrational beliefs which need to be changed

“The condition under which I live
absolutely must be comfortable ,
unhassled, and enjoyable, or else
it’s awful, I can’t stand it, and my
life is hardly worth living!”
RESULT: Severe feelings of low
frustration tolerance, often leading to
compulsion, addiction, avoidance,
inhibition, and public reaction.

 Consciousness raising (aware of
irrational thinking patterns)
 Counterconditioning (replace
irrational thinking with rational
thinking)
 Contingency management (rearrange
reinforcements to support behavior
changes)

A = existence of fact, event, behavior,
attitude of individual
B = person’s belief
C = emotional & behavioral
consequence or reaction of individual
D = disputing intervention-challenge
beliefs
E = effective philosophy after disputing
F = new set of feelings

 Human beings are largely
responsible for creating their own
emotional reactions &
disturbances
 Goal: show people how to change
irrational beliefs that directly
“cause” disturbed emotional
consequences

 Challenges irrational beliefs
 Use principles of logic-destroy unrealistic,
unverifiable hypotheses
 Detect~detect the “shoulds”, “I musts”
“awfulizing” “self-downing”
 Debate~learn to logically & empirically
question beliefs-to argue self out of them
 Discriminate~irrational-self-defeating
from rational-self-helping beliefs

Role of the
Counselor

 Active and direct interaction.
 Instructors who teach and
correct client cognitions.
 Main assessment instrument is
evaluation of a client’s thinking.
 Do not rely heavily on DSM-IV-
TR diagnostic categories.

 Challenge the clients to validate his/her ideas
 Use logical analysis to minimize the clients
irrational beliefs
 Show how this ideas can be replaced with
more irrational ideas
 Teach the client how to apply the scientific
approach to thinking so that he/she can
observed and minimize the irrational ideas
and illogical deductions which foster self-
destructive ways of feeling and behaving

You are today where your
thoughts have brought
you; you will be
tomorrow where your
thoughts take you.
-James Allen

Goals of the
Counseling

 Primary goal is to help people realize
they can live more rational and
productive lives.
 Avoid having more of an emotional
response to an event than is
warranted.
 Help people change self-defeating
habits of thoughts or behavior.

LEADS and
RESPONSES

1. Open and closed questions
2. Interpretation
3. Encouragement/Persuasion/
4. Opinion-giving
5. Confrontation
6. Direct examination of incongruities and
discrepancies
7. Humor/Sarcasm
8. Exploration/lecture
9. Suggestion/Advice-giving/Prescription of
behavior Source: Villar, 2008

Counseling
Techniques

 Before changes can be made,
clients must learn the basic ideas
of REBT and understand how
thoughts are linked with emotions
and behaviors.
 Highly didactive and very directive.

 Counselors teach their clients the
anatomy of an emotion – feelings
are a result of thoughts, not
events, and self-talk influences
emotion.
 Critical for clients to be able to
dispute irrational thoughts.

1. Cognitive Disputation - the
use of direct questions, logical
reasoning, and persuasion.
◦ May challenge clients to prove
their responses are logical.
◦ May incorporate the use of
“Why?” questions.

2. Imaginal Disputation - relies
on the client’s ability to
imagine.
◦ Employs a technique called
rational emotive imagery (REI).
◦ Client imagines a situation
likely to be upsetting and
examines his/her self-talk.

3. Behavioral Disputation - involves
behaving in a way that is the
opposite of the client’s usual way of
thinking.
◦ If successful, a new Effective Philosophy
will emerge.
This process is most effective when all
three methods of disputation are
used in conjunction.

 Making the clients imagine the worst that
could happen in the situation
Self-Reinforcing Schedule
 Giving oneself a desired reward after having
performed the behavior assignment

Probably the most important REBT
strategy is homework. This can
include such activities as:
 Reading, Self-help exercises
 Experiential activities & Journaling
 Thought Stopping and Intentional
Reframing
Therapy sessions are really ‘training
sessions’, between which the client
tries out and uses what they have
learned.

A B C D/Rational
Response
E
Situation Belief Emotion Disputation Effects
Studying
counseling
theories
I feel so
stupid.
I’ll never
be a
good
counselor
since I
already
feel lost
Confusion,
frustration
, anxiety
Just because I
don’t
understand
everything
about these
theories
doesn't make
me stupid.
Relief,
mild
tension2/19
8pm

Involves arguing in an assertive
fashion and convincing oneself
to falsify of a belief.
e.g. I am failure if my wife leaves me.
Counter: My wife’s behavior is
independent of my own success and
accomplishments.

 An inner source to deal peacefully with
confrontations
1. Learn to say no
2. Learn to use I statements
e.g. I perceive what you said is to me is
incorrect
3. Use eye contacts
4. Use assertive body language-an assertive
tone of voice with wimpy posture
5. Practice manipulation-roadblocks to
manipulation like intimidation, avoidance
and personal attacks

 Substituting negative, self-defeating
thoughts with positive, affirming
thoughts that change perceptions of
stressors from threatening to
nonthreatening.

 The use of Neurolinguistic
Programming (NLP)-a program
designed to look at how thoughts
control our language and how our
language influences our behavior
 NLP helps one to unlearn old thoughts
and learn new approach toward
optimal excellence

 A coping technique ; expression
of thoughts, feelings, memories
and ideas in written form, either
prose or poetry, to increase self-
awareness

Thoughts
I gotta
get that
paper
finished
by Friday.
I should
Give
Shiela
a call.
Feed
the
Fish.
relieved
quite
kinda
depressed
veryexhausted
glad
it’s
over
I feel

1. Confrontation
2. Encouragement
3. Using humor
4. Role playing
5. Shame-attacking exercises
6. Use of force & vigor
7. Desensitization

Steps of
Counseling

1. Show client incorporated irrational
beliefs-teach how to separate
irrational from the rational beliefs-
engage in activities which are not
self-defeating
2. Demonstrate to client keeping
emotional disturbance active by
illogical thinking

3. Help client to modify thinking-
recognize vicious cycle of self-
blaming
4. Challenge clients to develop
rational philosophy of life-
dispute core irrational thinking-
teach how to replace with
rational beliefs

Role of History
Taking

 History-taking is not given
much emphasis. However, it
figures the counselor traces the
development of irrational ideas
to some past circumstances or
situation, or to his/her parents
and his/her culture ( Villar,
2008).

Psychological
Testing

 REBT does not generally
depend on tests.
 The ideal is to focus on what
the clients brings with him/her
to counseling in terms of
irrational ideas and beliefs
(Villar, 2008).

Strengths and
Contributions

 Clear, easily learned and effective.
 Can be easily combined with other
behavioral techniques to help clients
more fully experience what they are
learning.
 Relatively short-term.
 Has generated a great deal of research
and literature.
 Has continued to evolve over the years
as its processes and techniques have
been refined.

Limitations
and
Criticisms

 Not effective for individuals with
mental problems or limitations
such as schizophrenics and
those with severe thought
disorders.
 Limited usefulness if not
combined with behavioral or
emotive techniques.

 REBT’s direct and confrontive
way of working with clients is a
limitation for some.
 May not be the simplest way of
helping clients change
behaviors or emotions.

 REBT does not focus on free
association, complex history
taking, dream analysis or
sexual conflicts
 Transference is seen in REBT as
often resulting from irrational
beliefs
 REBT employs persuasive and
directive techniques

 Considerable similarities between the two
approaches as Adler often wrote about
individuals developing fictional beliefs which
is a concept similar to Ellis' idea of irrational
beliefs
 Departs from Adler regarding emphasis on
Past memories
Social interest
 REBT is more future oriented and behavioral

 There are lots of commonalities
between the two approaches
especially regarding holistic
view of individuals
 REBT views the Jungian focus on
dreams, fantasies, symbols or
archetypes as a “waste of time”

 Both emphasize importance of
unconditional positive regard
which REBT labels as full
acceptance or tolerance

Differences Similarities
REBT values the therapy
relationship but does not
view it as the vehicle for
change
Great optimism in the ability
of people to change
REBT focuses on teaching
the 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 has a strong focus on
cognition
 More similar to CT and
Multimodal Therapy than BT

CT REBT
Thoughts Labeled dysfunctional irrational
Type of Reasoning
Used
inductive deductive
Beliefs Associated
with
Psychopathology
cognitive specificity
for each disorder
core set of
irrational beliefs
View of the
Problem
functional philosophical
Therapist’s
Approach
more collaborative more
confrontational

“There’s nothing either
good or bad but thinking
makes it so”.
-Shakespeare

Applications
of REBT

●Depression
●Anxiety disorders, including obsessive-
compulsive disorder, agoraphobia,
specific phobias, generalised anxiety,
posttraumatic stress disorder, etc.
● Eating disorders, addictions, impulse
control disorders
●Anger management, antisocial behaviour,
personality disorders
●Sexual abuse recovery

 Adjustment to chronic health problem,
physical disability
 Pain management
 General stress management
 Child or adolescent behaviour disorders
 Relationship and family problems
 Personal growth
 Workplace effectiveness

 Easier to identify disorders which
are not treated by the approach
which include individuals which are
◦ Psychotic, Manic, Autistic, Brain Injured
◦ Mentally Deficient

 Corey, Gerald.(2005). Theory and Practice of
Counseling and Psychotherapy. Singapore:
Wadsworth, a division of Thomson Learning.
 Ivey, A. E., D’Andrea, M., Ivey, M. B. and Morgan, L.
S. (2002). Theories of counseling and
psychotherapy: A multicultural perspective, 5th ed.
Boston, MA.: Allyn & Bacon.
 James, R. K. & Gilliland, B. E. (2003). Theories and
strategies in counseling and psychotherapy, 5th ed.
Boston, MA: Allyn & Bacon.
 Kottler, J. A. (2002). Theories in counseling and
therapy: An experiential approach. Boston, MA:
Allyn & Bacon.

 Parrott, Les III. (2003). Counseling and
Psychotherapy.2nd Ed. USA:Brook/Cole, a division of
Thomson Learning.
 Rosales, Lily Rosqueta.(1989). Counseling in
Perspective: Theory, Process and Skills. Quezon
City: University of the Philippines Printery.
 Seaward, Brian Luke. (2006). Managing Stress:
Principles and Strategies for Health and Well Being.
London: Jones and Barlett Publishers.
 Villar, I. V. G. (1997). Western approaches to
counseling in the Philippines. Manila, Philippines:
De La Salle University Press.
 Villar, I. V. G. (2008). Multicultural Counseling and
Western approaches to counseling in the
Philippines. Makati: Alligned Transformations.

“THE WHOLE WORLD IS
A COMEDY TO THOSE
WHO THINK, A
TRAGEDY TO THOSE
WHO FEEL.”
-Horace Walpole

A Brief Introduction to Rational Emotive Behavior Therapy

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