Uploaded by Helga Mokdad

Cognitive Therapy and Rational Emotive Behavior Therapy

Cognitive Therapy and Rational Emotive Behavior Therapy: Similarities and Differences
Helga El Mokdad
CBT/REBT Diploma
Cognitive Therapy and Rational Emotive Behavior Therapy: Similarities and Differences
Cognitive Behavioral Therapy (CBT) is a broad term that encompasses several types of
psychotherapies including Cognitive Therapy and Rational Emotive Behavior Therapy. Although
both of these psychotherapies are considered talking therapies and are under the same school of
thought, cognitive behavioral therapy, there are many similarities and differences between them.
Cognitive Therapy was developed by Aaron Beck whereas Rational Emotive Behavior Therapy
was developed by another prominent pioneer of CBT, Albert Ellis. The following paper will
compare these two types of psychotherapies in an attempt to better understand the similarities
and differences theoretically and practically.
Rational Emotive Behavior Therapy (REBT) is considered to be one of the first cognitive
behavioral approaches that was developed by Albert Ellis in 1955. The basic principle of REBT
is that of emotional responsibility. This principle of emotional responsibility states that
individuals are held responsible for their emotions because it is the way they interpret events and
situations that creates their psychological problems. Moreover, according to REBT, cognitions,
behaviors and emotions interact in a complex manner and have a reciprocal cause-and-effect
relationship. Thus, while one would think that interpretations of events may lead to thoughts
which eventually lead to emotions and behaviors, the interaction is not as simple as that. REBT
is based on a simple model which is called the ABC model. In this model, A is the activating
event, B is the belief about the event, and C is the consequence. Basically, the model states that it
is not the activating event that causes the emotions, thoughts, behaviors, action tendencies, and
physical symptoms at C, but rather it is the belief about the event that results in the consequence.
Therefore, REBT emphasizes the concept of beliefs, which are the interpretations and
evaluations we give to certain life situations. These beliefs can be either rational or irrational.
Rational beliefs are those that are flexible, realistic, logical and practical in that they help
individuals move towards their goals. On the other hand, irrational beliefs are considered to be
rigid, illogical and unrealistic and they impair individuals and impede them from moving
towards their goals. REBT therefore teaches clients about the differences between rational and
irrational beliefs and helps them identify and dispute the irrational beliefs that have been selfindoctrinated and acquired over time in order to replace them with the more rational beliefs.
However, these rational and irrational beliefs do not exist by themselves, as there are derivatives
from these beliefs as well. For instance, the irrational belief, which is usually based on a rigid
“must”, “should” or “ought to”, has three derivatives including awfulizing, low-frustration
tolerance, and self, other or world-damning. Rational beliefs on the other hand are represented by
preferences and have three derivative as well which include anti-awfulizing, high-frustration
tolerance, and self or other acceptance. Thus, by helping clients identify and dispute the
irrational beliefs and replace them with the more flexible rational ones, clients can change their
emotional reactions to situations and therefore develop healthy negative emotions, rather than
unhealthy negative emotions from irrational beliefs. The difference between healthy negative
emotions and unhealthy negative emotions is also emphasized in REBT, as an irrational belief
leads to an unhealthy negative emotion whereas a rational belief leads to a healthy negative
emotion. The goal therefore is to replace the irrational belief with the rational one in order to
replace the unhealthy negative emotion with a healthy negative emotion. Thus, therapy in REBT
is seen as an educational process in which the therapist teaches the client how to identify and
dispute irrational beliefs, and the focus in therapy is on thinking and acting rather than
expressing emotions. The therapist also collaborates with the client on assigning homework in
between the therapy sessions and teaches the client certain strategies for rational thinking which
the client can learn to use and practice in everyday life.
While Albert Ellis was developing Rational Emotive Behavior Therapy, Aaron Beck was
also developing his approach known as Cognitive Therapy at about the same time, but both were
developing their approaches separately and independently. Cognitive therapy holds the premise
that psychological problems stem from several common processes which include a faulty way of
thinking, making incorrect inferences, and failing to differentiate between what is real and what
is not. In cognitive therapy, Beck uses the term cognitive distortions to refer to the faulty
thinking patterns individuals engage in. Thus, the feelings and behaviors of individuals are
determined by how they perceive and structure their experiences. In other words, cognitive
therapy emphasizes the importance of focusing on the cognitive content during an individual’s
reaction to a certain negative life event or to a certain line of thoughts that the individual is
experiencing. By focusing on the thoughts and behaviors and changing them, an individual can
change his or her emotions. Cognitive Therapy is based on a cognitive model which includes
three levels: the core belief, the intermediate thought and the automatic thoughts. Core beliefs are
the ultimate underlying beliefs that individuals hold and that have been indoctrinated and deeply
held. These core beliefs lead to intermediate thoughts, which in turn when an individual
experiences a certain life event, they generate what we call automatic thoughts. Automatic
thoughts are thoughts or personalized notions that an individual has immediately when
experiencing a certain situation or event and which lead to an emotional reaction. Cognitive
therapists use Socratic questioning to get to the intermediate thoughts and ultimately to the core
beliefs of the individual. When reached, cognitive restructuring or schema restructuring is used
by encouraging clients to find evidence for and against their core beliefs, and this is done in an
effort to help individuals restructure and change their core schemas to develop a way of thinking
that is more functional. In brief, the theoretical assumptions on which cognitive therapy is based
on include the following: the therapist is able to access the internal communication and cognitive
content of an individual’s experience, a client’s belief has highly personal meanings, and these
personalized notions and meanings can be identifies and discovered by the client rather than
taught or interpreted by the therapist. And finally, according to Aaron Beck, when people
experience difficulties, they tend to commit logical errors which are the cognitive distortions that
have been previously described, that do not represent the objective reality. These cognitive
distortions are disputed in therapy as well by finding evidence for and against them, in order for
the client to understand that his or her way of thinking is distorted and does not represent the
objective reality of his or her surroundings.
After describing the basic premises of both Rational Emotive Behavior Therapy and
Cognitive Therapy, it is important to distinguish between these two forms of psychotherapies by
delineating the similarities and differences that exist between them. First, a discussion of the
similarities will show how these two therapies are alike and how they both share certain
assumptions. Both of these therapies share an important view that entails that psychological
difficulties and disturbances are the result of faulty thinking, and changing this faulty thinking
and adopting corrective actions is the remedy for such psychological difficulties. Moreover, both
Rational Emotive Behavior Therapy and Cognitive therapy focus on the present moment. In
other words, therapists focus on the client’s problems and thinking that are part of the present,
and no attention is given to the past as in earlier forms of Freudian therapies. These therapies are
also active and directive, which means that the therapist and the client have active roles to play
during the therapy, and the therapist directs the client and guides him or her on what to do during
the therapy sessions. Being time-limited is also a very essential component of these therapies, as
both usually required a limited number of sessions. In addition, both are structured and
empirical, as they are based on evidence from research, and both implement the use of
homework assignments as a way of helping clients practice in between the therapy sessions what
they have learned during the therapy sessions. Since both therapies also focus on faulty thinking,
they also require an explicit identification of the situations in which problems occur and the
associated interpretations and perceptions of those situations that lead to the psychological
disturbances and difficulties. This brings us to the importance of the behavioral principle in both
of these therapies, as it is emphasized that altering an individual’s behavior will help alter his or
her emotions and thoughts.
After discussing both Cognitive Therapy and Rational Emotive Behavior Therapy
separately, and after pointing out the similarities between these two types of therapy, it is
important to follow the aforementioned discussions with a discussion of the differences between
both therapies. First, REBT is based on the ABC model whereby it is the beliefs about an event
that result in the thoughts, emotions, and behaviors experienced by an individual. Cognitive
Therapy is based on the cognitive model which focuses on the three levels of cognition:
automatic thoughts, intermediate thoughts, and core beliefs. Second, REBT is highly persuasive
and confrontational, whereby the therapist acts as a teacher and models a rational way of
thinking by helping clients identify and dispute their irrational beliefs. Cognitive Therapy uses
Socratic questioning by asking open-ended questions in an effort to help clients reflect on their
thoughts and get to conclusions. Thus, in Cognitive therapy, more emphasis is placed on helping
clients themselves reach conclusions about their misconceptions, instead of teaching them as in
REBT. Collaborative empiricism is used in Cognitive therapy, as the therapist works
collaboratively with clients in an attempt to find evidence for and against their cognitions. Third,
there is a difference in the way both therapies attempt to explain faulty thinking. REBT views
beliefs as being irrational and nonfunctional. Cognitive therapy, on the other hand, does not
explain beliefs as being irrational, but instead views dysfunctional beliefs as being problematic
because of their impeding of normal cognitive processing. Thus, instead of viewing beliefs as
irrational, they are viewed as distorted, by being either too extreme, absolute or broad. Fourth,
REBT deals with both symptom treatment and advocating for a philosophy of healthy living.
Cognitive therapy simply focuses on symptom treatment. Fifth, REBT implements the use of
worse case scenarios to help clients face and confront the worse that can happen, whereas
Cognitive Therapy does not advocate for a discussion of worse case scenarios between the
therapist and the client. Sixth, the techniques used in REBT are cognitive, behavioral and
emotive in nature. While Cognitive Therapy does use cognitive and behavioral techniques,
emotive techniques are not used in Cognitive Therapy. Examples of emotive techniques used in
REBT are rational emotive imagery whereby worse case scenarios are imagined, using humor,
role playing, shame-attacking exercises, and use of force and vigor. And finally, an important
difference between REBT and cognitive therapy lies in the research efforts that have been put
into testing both therapies. Because of the therapeutic flexibility and the fact that most research
can only examine and test how people feel better, but not how they have made a philosophical
behavioral change, controlled research is difficult to attain for REBT. Thus, more research
efforts were put into Cognitive therapy.
To sum up, REBT and Cognitive Therapy have their differences in the terminologies
used, the techniques employed, their views of faulty thinking, the models they are based on, and
in the roles the therapist acquires in each, but this does not make them very different in their
ultimate goals. Both therapies advocate for clients to be relieved from psychological disturbances
and to attain a healthier living experience, but REBT adds to that the goal of having a healthy
philosophy of living rather than just finding a remedy to psychological disturbances.