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.


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.


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.


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.


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.”


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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“Tis the season to be merry” – and polish up your REBT skills!!

The festive season is fast approaching and with it comes the inevitable negotiations with family and friends on who should spend the big day with whom. This is a time when practising your REBT skills will help you to get through those challenging situations the prospect of which may appear currently unbearable or too difficult to tolerate. In REBT terms, situations to which you have Low Frustration Tolerance (LFT).

LFT is a term coined by Albert Ellis the founding father of REBT. Ellis maintained that many of us go through life holding irrational absolutist beliefs that people SHOULD, MUST, and OUGHT to behave as we demand they SHOULD, and that if these demands are not fulfilled, we also irrationally conclude that we would simply find it unbearable, or believe that we wouldn’t be able to tolerate it. We therefore become emotionally disturbed at the prospect – hence the term Low Frustration Tolerance. Yet in reality in the face of such adversity we still survive and do not spontaneously combust.


Ellis further maintained that if instead of holding absolutist irrational demands we hold flexible preferences or desires about such situations, we are then able to accept that in the event of our preferences or desires not being met, we are able to develop High Frustration Tolerance. We can rationally accept that we are able to bear such situations but with difficulty, and in accepting this fact we become much less emotionally disturbed and able to take constructive action.

So, returning to the upcoming festivities: Let’s suppose your very overbearing highly critical mother or father-in-law is coming to Christmas lunch and you irrationally tell yourself “She/He absolutely MUST not criticise my cooking and “I can’t bear it when she/he criticises my cooking, I can’t stand it, its intolerable”, your unhealthy emotional reaction to this belief is likely to be one of anxiety and dread. Considering the thinking patterns associated with anxiety – that of having more task irrelevant thoughts and therefore inability to concentrate, together with the behavioural tendency of tranquilising your feelings – you are in fact very likely to mess up the recipe, burn the turkey and end up taking to the sherry in the kitchen. Giving ample ammunition to your mother or father in-law!

Whereas if you approach this event holding your healthy preference and High Frustration Tolerance belief of “I would prefer that she/he doesn’t criticise my cooking, but I accept that she/he might, and if she/he does It will be difficult but not unbearable”. You will feel healthily concerned about this event and experience the healthy thinking patterns and behavioural tendencies of concern. You will be able to prepare the meal, concentrate on the recipe, not hit the sherry bottle and may just get through Christmas lunch still speaking!

PS: Please feel free to replace, mother/father in law any other critical adult and have high frustration tolerance for all, including our sense of humour.

To all the uncritical mothers/fathers in-law and to all our readers

‘Merry Christmas and a very Happy New Year’

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Envy is not the same as jealousy: REBT conceptualisation

Both envy and jealousy can be healthy or unhealthy emotional states, but we have no words to make that distinction. We often confuse the two emotions but they are really quite separate and distinct, although often experienced at the same time.

Jealousy can be better thought of as ‘anxiety about a threat to an important relationship’, while envy is the emotion we experience when we strongly desire something that someone else possesses, a thing, a talent, a quality, an experience etc.


We confuse the two emotions frequently when we say things like ‘you’re on holiday and I’m jealous’, or ‘I’m jealous of your job’. What we mean is ‘I’m envious of your job, or your holiday’. So why is it important that we make this distinction? Surely, it’s just a straightforward mistake and most people know what we mean anyway. One of the reasons why we would do better to make the distinction is that both of these emotions lead to different types of behaviour. When we’re jealous, or anxious about a threat to our relationship, we tend to exaggerate the threat and this can involve lots of checking behaviours, and a neediness that can damage the relationship we want to protect.

Envy is a secret and often hidden emotion, and because it can be both healthy and unhealthy we often ignore its presence. If we are unhealthily envious of something someone else has, we have an extremely negative tendency to try and destroy, or devalue that thing. Healthy envy leads to constructive measures designed to help us to attain that thing. Unhealthy envy leads to destructive measures designed to acquire it from others through devious means and to deprive them of it, and if those measure don’t work, to attempt to destroy it, or devalue it.

Envy is an important emotion and is even listed as one of the ‘seven deadly sins’, and it is often hidden and covert. It is very common for people to seek psychotherapeutic help with emotions like depression and anxiety, but it is extremely rare for someone to seek therapeutic help for envy. Even so, “envy, to qualify as (unhealthy) envy, has to have a strong touch – sometimes more than a touch – of malice behind it. Malice that cannot speak its name, cold blooded but secret hostility, impotent desire, hidden rancour, and spite all cluster at the centre of envy.” ₁
In the modern world advertising is designed to trigger envy in all of us. Advertising seeks to make us desire strongly something that others, often featured visually, already have and enjoy. Envy leads to avarice and greed, and if unchecked, can lead to extreme unhappiness, even misery. “Envy is usually less about what one lacks than about what other people have.” ₂ Envy always results from the comparison of the self with others, and its destructive force lies in what that comparison then leads to behaviourally.

In REBT we make a distinction between healthy and unhealthy envy, and we only concern ourselves with its unhealthy expression. Even so, it is always helpful to help clients develop an improved awareness of envy and the role it plays in all of our lives. Once recognised it can be modified and ameliorated to make it less of a destructive force in our lives. Françoise de La Rochefoucauld once wrote, “In the misfortune of our best friends, we always find something that is not displeasing to us.” ₃

If we want envy to have less of a negative impact in our lives, and on our relationships with others, we would do well to create a better awareness of envy and its behavioural tendencies.

Ian Martin, CCBT Lecturer

1. Envy – Joseph Epstein, Oxford University Press, 2003
2. Envy – Joseph Epstein, Oxford University Press, 2003
3. Reflections on Various Subjects – Françoise de la Rochefoucauld, 1665 – 1678

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