Ellis’ REBT – Transdiagnostic Humanistic and Existential CBT Model


Albert Ellis and REBT

Psychologist Albert Ellis, Ph.D. first articulated the principles of Rational Emotive Behaviour Therapy (REBT) in 1955. Albert Ellis was born in 1913 in Pittsburgh, Pennsylvania, but moved to New York at age 4. He was hospitalised numerous times during childhood, and suffered renal glycosuria at age 19 and diabetes at age 40. Because Ellis suffered from these ailments for most of his life, his problems inspired him over the years to find effective means of coping. Ellis originally studied psychoanalysis and believed it to be the deepest form of psychotherapy. Later, he came to the conclusion that analytical and dynamic psychotherapies are unscientific. He became dissatisfied with them as effective and efficient forms of treatment. In 1955 he combined cognitive, humanistic, existential philosophies, and behaviour therapy to form what is now known as Rational Emotive Behaviour Therapy (REBT). He was one of the world’s most influential psychologists and a prolific author. REBT has the longest history of any of the cognitive behaviour therapies.

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REBT or Rational Therapy (RT) as it was known up to 1961, or Rational Emotive Therapy (RET) as it was known up to 1993 is an action-oriented humanistic approach to emotional growth that stresses individuals’ capacity for creating, altering, and controlling their emotional states. REBT places much emphasis on the present – on currently held beliefs and attitudes, painful emotions, and maladaptive/dysfunctional behaviours that can sabotage a fuller experience of life. That is, REBT teaches people how to overcome problems and how to implement healthy and realistic alternatives to current psychological patterns.

Trans-diagnostic

REBT is a is trans-diagnostic CBT Model. Unlike some forms of CBT, which require practitioners to have a wide knowledge of specialist protocols, REBT looks at the person as a whole rather than as a symptom and teaches a model that can be successfully applied to a wide range of different emotional issues. It offers a therapeutic structure which helps the client to achieve long lasting emotional and behavioural change, a universal model they can continue to apply to all areas of their lives which they may find challenging.

Humanistic

REBT is humanistic. It is a philosophy asserting human dignity and a person’s capacity for fulfilment through reason and scientific method. It focuses on each person’s potential and stresses the importance of personal growth and exercise of free will. It looks at the person as a whole and the uniqueness of each individual.

Existential

REBT is existential because it looks at the person not merely as the thinking subject but the acting, feeling living human being. It does not moralise but rather helps the client to pursue their enlightened interests and goals. It acknowledges human suffering and choice for each individual. So it helps clients to face up to their situations, accept fallibility and be honest about their experiences.

Acceptance based Model

In essence, REBT is an acceptance based CBT model. Acceptance means acknowledgement of the client’s experience. The experience can be past, present, future, internal or external and/or real or imaginary. This means clients are helped to accept the past, present and future possibilities. Whatever the experience, REBT helps the client to acknowledge and not to avoid or re-frame their experience. This helps the client to get better in the long term.

Evidence based

REBT is an evidence based CBT model. Not only do clients learn empirical or evidence based thinking, they also learn logical or philosophical and pragmatic thinking. There is also considerable evidence to demonstrate REBT’s efficacy and/or effectiveness in dealing with a range of psychological problems. REBT has been subjected to research, showing good results with many diagnostic and outcome measures (Leichsenring, Hiller, Weissberg, & Leibing 2006). Initial REBT studies were criticised for using mainly trans-diagnostic categories rather than DSM categories. Subsequent REBT studies used the DSM categories and rigorous controlled designs in testing outcomes (David et al., 2008), mechanisms of change (Szentagotai et al., 2008), cost-effectiveness for various mental disorders (Sava et al., 2009). Large scale meta-analysis summarising REBT’s clinical trials have shown that REBT is effective for a spectrum of disorders both in adults (Engels et al., 1993); Lyons and Woods, 1991) and children (Gonzales et al., 2004).

David, Szentagotai, Eva & Macavei (2005), reporting on the results of two meta studies i.e. Engels et al., 1993 and Lyons and Woods, 1991, specifically on clinical application of REBT state “REBT is not only a clinical theory useful for clinical populations, but also an educational system with implications for nonclinical and subclinical populations (e.g., depressed mood, lack of assertiveness, test or speaking anxiety) who have an interest in self-help materials and personal development.” Over 300 studies were involved.

Finally,Ellis (1994) characterises REBT’s approach and goals by saying that REBT is not, “…primarily interested in helping people ventilate emotion and feel better, but in showing them how they can truly get better, and lead to happier, non-self-defeating, self-actualized lives.”

References

David, D., Lynne, S.J., Ellis, A. 2010. Rational and Irrational Beliefs, Research, Theory, and Clinical Practice. Oxford Press.

David, D., Szentagotai, A., Lupu., Cosman, D., (2008), Rational Emotive Behaviour Therapy, Cognitive Therapy, and Meditation in the Treatment of Major Depressive Disorder: a Randomised Clinical Trial, post treatment Outcomes, and Six month Follow Up. Journal of Clinical Psychology 64(6): 28-46.

David, D., Szentagotai, A., Kallay, E., & Macavei, B. (2005). A synopsis of rational-emotive behaviour therapy (REBT): Fundamental and applied research. Journal of Rational-Emotive and Cognitive Behaviour Therapy, 23, 175-221.

Davies, F.M., (2006). Irrational Beliefs And Unconditional Self-Acceptance. Correlational Evidence Linking Two Key features of REBT. Journal of Rational Emotive & Cognitive Behaviour Therapy, Vol. 24, No 2. Summer 2006.

Ellis, A. (1994). Reason and Emotion in Psychotherapy. Revised and updated edition. New York: Birch Lane Press.

Engels, G.I., Garnefski, N., Diekstra, R., (1993), Efficacy of Rational Emotive Therapy: A Quantitative Analysis. Journal of Consulting and Clinical Psychology 61(1): 1083-1090.

Gonzalez, Jorge E., J. Ron Nelson, Terry B. Gutkin, Anita Saunders, Ann Galloway, and Craig S. Shwery. 2004. “Rational Emotive Therapy with Children and Adolescents: A Meta-Analysis.” Journal of Emotional and Behavioral Disorders 12 (4): 222-235.

Leichsenring F, Hiller W, Weissberg M, Leibing E. (2006) Cognitive-behavioral therapy and psychodynamic psychotherapy: techniques, efficacy, and indications. Am Journal of Psychotherapy. 60(3):233-59.

Lyons, Larry C., and Paul J. Woods (1991). The Efficacy of Rational Emotive Therapy: A Quantitative review of the outcome research. Clinical Psychology Review 11(4): 357-369.

Sava, Florin, A., Brian T. Yates, Ciorel Lupu, Aurora Szentagotai, and Daniel David (2009), cost effectivenss and cost utility of Cognitive Therapy, Rational Emotive Behavioural Therapy, and Flupxetine (Prozac) in treating depression: a randomised clinical trial. Journal of Clinical Pychology 65(1):36-52.

Szentagotai, Aurora, Daniel David, Viorel Lupu, and Doina Cosman (2008), Rational Emotive Behavioural Therapy versus Cognitive Therapy versus Pharmacothrapy in the treatment of major depressive disorder: Mechanisms of Change analysis: Psychotherapy: Theory, Research, Practice, Training 45(4): 523-538

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