REBT – A Therapist’s Guide (Notes)
Ellis credits Epictetus: “People are disturbed not by things but by the views they take of
them.” 10
When people are confronted with Adversity (A), it is largely their Beliefs (B),
specifically irrational beliefs, that lead to disturbed Consequences (C). 10
“Rational” means “that which helps people to achieve their basic goals and purposes.”
Irrational beliefs are those that interfere with goals. 19
“[R]ational also means helping the group to survive and to achieve its basic goals . . ..”
19 (REBT recognizes the importance of belonging to a social group.)
Cognition, emotion, and behavior are intrinsically integrated and holistic, (3) and when
people disturb themselves, their cognitions, emotions, and behaviors interactionally make
them upset. 26
“When people are disturbed, they think-feel-act in a dysfunctional, self-defeating manner,
and when they undisturb themselves they almost invariably change some of their
cognitions, change their emotional reactions, and change their activities.” 3
The research supporting the effectiveness of REBT is strong. 6 & 7
REBT is rooted in the following postmodern ideas:
We don’t have any absolute certainty about reality.
Our views about good and bad, right and wrong, are constructions.
Human personality has large relational and social influences.
People are influenced by their cultures, and there is no evidence that some
cultures are better than others.
5. We have no absolute way of knowing which goals and purposes are better or
worse. 14 & 15
1.
2.
3.
4.
People have a natural ability to change themselves, but REBT “actively-directively tries
to help them do so in collaboration with an involved therapist.” 16
REBT is about helping people make profound philosophical changes. 16
“REBT integrates some aspects of many therapeutic theories, and eclectically uses
specific techniques from many sources . . ..” 6
REBT emphasizes working flexibly and adaptively.
Almost all feelings are natural, (20) but some are healthier than others. “Healthy
negative feelings tend to produce self-helping and community-helping actions.” 21
REBT encourages striving toward success but not converting the striving to “absolutistic
demands.” 21
“[P]eople innately and by social teaching develop into rational and irrational thinkers.”
22
REBT emphasizes cognitions because:
1.
2.
3.
4.
Irrational beliefs are often easily accessible.
Core irrational beliefs often affect several dysfunctions.
Changing a core irrational belief can often change several dysfunctions.
Making a profound philosophical change can make a person less susceptible
to future disturbances.
5. Cognitive changes can sometimes be understood quickly. 26
People choose their beliefs based on the strength of their desires. 28
Common core irrational beliefs include:
1.
2.
3.
4.
absolutistic musts and shoulds
awfulizing
I-can’t-stand-it-it is
Damning oneself and others
Core beliefs are also related to overgeneralizations, especially related to “is.” 29
Core beliefs influence each other. 29
Cognitions maintain dysfunctions, sometimes because people have irrational beliefs
about their symptoms. 31
Three main irrational beliefs are:
1. “I absolutely must under all conditions do important tasks well and be
approved by significant others or else I am an inadequate and unlovable
person.”
2. “Other people absolutely must under all conditions treat me fairly and justly
or else they are rotten and damnable persons.
3. “Conditions under which I live absolutely must always be the way I want
them to be, give me almost immediate gratification, and not require me to
work too hard to change or improve them; or else it is awful, I can’t stand
them, and it is impossible for me to be happy at all!”
Believing that Adversities directly cause Consequences is a common irrational belief. 36
Three main insights are likely to help clients:
1. Adversities often contribute to consequences, but so do beliefs.
2. Although disturbed consequences often originated in childhood and
adolescence, it is the continued irrational beliefs that maintain the disturbance.
3. Changing dysfunctional consequences takes work and practice. 38
REBT is about helping people get better, not just to feel better. 38
REBT promotes active-directive therapy. Active-directive therapy often helps people
change because:
1.
2.
3.
4.
5.
6.
they may be biologically prone to be disturbed
they may have low frustration tolerance
they may view change as dangerous because it takes away their excuses
they may prefer to interact with a caring therapist than to get better
they may be hostiles to others who are pushing them to change
they may not agree with a therapeutic approach
There are cautions for being too directive:
1.
2.
3.
4.
Be aware of the limitations of the techniques you use.
Monitor clients’ reactions and be prepared to change techniques.
Have many methods available.
Give unconditional acceptance and show clients how to give it to themselves.
46
Assessment starts with identifying consequences, then identifying adversities, and then
identifying irrational beliefs.
Before beginning interventions, make sure clients understand the ABC model and they
understand that they are primarily responsible for their own reactions to life events. 58
Disputing irrational beliefs is the primary method of REBT. There are different kinds of
disputations:
1. Functional disputes – questioning whether the belief helps accomplish desired
goals.
2. Empirical disputes – questioning whether the “facts” are accurate.
3. Logical disputes – questioning the logic of thinking processes.
4. Philosophical disputes – (Which is not philosophical I the technical sense)
questioning whether despite dissatisfactions if some pleasure can be derived
from life anyway.
Making rational coping statements is the next step after disputing the irrational beliefs.
The deeper and more profound the statements, the more helpful they are likely to be. 67
Other techniques include:
1. Modeling - asking a client to emulate someone who demonstrates the desired
behavior.
2. Referenting – cost benefit analysis of the behavior
3. Cognitive homework – e.g. identifying and disputing irrational beliefs
4. Bibliotherapy and psychoeducational assignments – books, lectures, groups
5. Proselytizing – sharing the approach with others
6. Recording sessions – allows clients to review ideas they may have missed and
to reinforce other ideas.
7. Reframing – viewing a problem from a different perspective, which gives it a
different meaning.
8. Stop and monitor – establish cues to stop and notice thought processes
throughout the day.
REBT also includes emotional techniques:
1. Rational emotive imagery
2. Forceful coping statements
3. Forceful taped disputing
4. Role playing
5. Reverse role playing
6. Humor (includes Ellis’s songs)
7. Unconditional acceptance by the therapist
8. Teaching unconditional self-acceptance and unconditional other acceptance
9. Encouragement
10. Encounter exercises
REBT includes behavioral techniques:
1.
2.
3.
4.
5.
6.
7.
8.
9.
reinforcements
penalties
shame-attacking exercises
skill training
paradoxical homework
relapse prevention
in vivo desensitization
staying in difficult situations
acting on rational beliefs