Two Theoretical Perspectives on Cognitive Behaviour Therapy (CBT)

Albert Ellis and Aaron Beck

We will briefly explain the two main schools of Cognitive and Behavioural Therapies. Both have a scientific theory that can be, and has been, tested as well as a structured framework and process of therapy.

The Ellis Model

Rational Emotive Behaviour Therapy (REBT) was founded in 1955 by Albert Ellis and has the longest history of any of the cognitive behaviour therapies. This book has focused on using Ellis’s model because of its philosophical basis, and we have found that this resonates well with our students and clients.

At heart of REBT is the theory it is not the event, but the belief or view you hold about the event, that triggers emotional, cognitive, behavioural and physical symptoms.

Ellis’s REBT is about helping people to:

Understand their emotions, behaviour and goals;
Identify their unhealthy or unhelpful beliefs that are sabotaging their happiness and goals;
Challenge them and replace them with their healthier version in order to become undisturbed and eventually happy through consistent and constructive action.

It helps us develop resiliency and self acceptance by enabling us to face our worst case scenarios and ‘what ifs’ rather than ignore them. This can lead to a powerful philosophical shift which can enable us to focus on our desires, wants and wishes without becoming disturbed or stuck about the ‘what if ’. We learn to view setbacks and failures as purely temporary as opposed to life or soul destroying, while remaining motivated and focused on our desires and goals.

The Beck Model

Beck’s Cognitive Therapy (CT) model theory says that our emotions and behaviour are influenced by the way we think and by how make sense of the world. Our interpretations and assumptions developed from personal experience often conflict with the real world. Beck encouraged his patients to focus their attention on their ‘automatic thoughts’.

Clients are helped to test their assumptions and views of the world in order to check if they
fit with reality. When clients learn that their perceptions and interpretations are distorted or unhelpful they then work at correcting them.

The overarching goals of CT according to Beck are:

Correcting faulty information processing, modify dysfunctional beliefs and assumptions that maintain maladaptive behaviours and emotions.
To first recognise the automatic thoughts that are cognitive distortions, evaluate them and then change them to be more adaptive. By focusing on automatic thoughts, the therapist can identify the client’s faulty underlying assumptions.

Difference between the Ellis and Beck Models

Both schools are open to influence from each other and in practice ideas from both can be utilised, as appropriate, to achieve successful outcomes for clients. However, they remain distinct. The main distinctions are

testing assumptions and
philosophical basis

Testing Assumptions

In Ellis’s model the client’s assumptions are assumed to be true and are not immediately put to a reality test. In Beck’s model the client’s assumptions are tested for validity first. The reason for this is that REBT theory states that a client’s assumptions are a consequence of holding unhealthy beliefs, so these assumptions are assumed to be true in order to ‘cut to the chase’ and identify the unhealthy beliefs. It deals with the questions of ‘what if’ and ‘non acceptance’ at the outset.

Treating Symptoms or Generalised Philosophy?

Beck’s model is based on the treatment of the symptom and is protocol driven. REBT treats the symptom but its aim is to effect ‘profound philosophic change and a radically new outlook on life’ (Albert Ellis) by transforming deeply held core beliefs about the self, others and the world.

Both are evidence based but have distinct differences in theory and process. REBT tends to be more active and directive than CT and looks at identifying, challenging and changing unhealthy, dogmatic, non acceptance beliefs. A drawback to RECBT is that some people may prefer a more protocol based treatment strategy. Beck’s CT model is more cautious and aims for some kind of improvement and return to normal functioning, symptom relief or symptom management but offers a variety of problem-solving techniques. On the negative side, this approach misses the chance to offer people a robust philosophy that is trans-diagnostic and one that is based on acceptance with tools to help clients become their own therapists when faced with different problems in the future.

Ellis or Beck? That Is the Question . . .

Both are great thinkers and have made an enormous contribution to the understanding and application of psychological health. We specialise in REBT but also integrate the two models together as appropriate.