Rational Emotive Behaviour Therapy (REBT)


Trans-diagnostic, evidence based and philosophical CBT Model

REBT is one of the cognitive behaviour therapies under the CBT umbrella. It is a trans-diagnostic, evidence based, and philosophical model developed by Albert Ellis. It is grounded in acceptance.
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There is 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 the large scale meta studies, 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.

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.”

An individual’s emotions, thoughts and behaviours can be healthy and functional, or unhealthy and dysfunctional. It, therefore, follows that an individual’s beliefs can also be rational, healthy and functional, or irrational, unhealthy and dysfunctional.

A B C
Event/Trigger Belief Consequences
Past Emotions
Present Cognitions
Future Behaviour
Real/Imaginary Action tendencies
Internal/External Physical symptoms


Rational/Healthy Irrational/Unhealthy

Irrational beliefs are rigid, inconsistent with reality, illogical and unhelpful to the individual in pursuit of his/her goals.

Rational beliefs are flexible, consistent with reality, logical and helpful to the individual in pursuit of his/her goals.

Irrational beliefs largely take the form of rigid demands and self-depreciation, awfulising and low frustration tolerance beliefs.

Demands

A demand is the rigid expression of a desire for something and takes the form of an absolute such as ‘must,’ ‘I have to’, ‘I absolutely should’ e.g. ‘I must not fail’.

A demand is essentially a ‘non acceptance’ belief. It is inconsistent with reality.

Acceptance does not mean ‘approval’. It simply means the acceptance and acknowledgement of the A.

Self depreciation belief

This is a global negative rating of the self. The self is rated as ‘totally bad’, ‘total failure’ and so on e.g. ‘I am a failure or worthless because I failed’.

Awfulising

‘Awfulising’ is an unrealistic rating of how bad it is that a person’s demand has not been met. The badness of the situation is rated at 100% or more bad. The person believes that it is the worst thing that he/she can ever experience. e.g. ‘it’s awful that I failed’.

Low Frustration Tolerance (LFT)

Also known as LFT, this is an irrational rating of a person’s ability to handle or cope with difficulty or frustration e.g. ‘I cannot tolerate failure’.

The combination of a demand and an LFT belief or a demand with an LFT and awfulising belief is termed ‘discomfort disturbance’.

Summary

REBT is a trans-diagnostic, evidence based, psycho-educational and philosophical CBT effective for both clinical and non clinical problems.

References

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.

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.
Dryden, W., & Neenan, M. (1996). Dictionary of Rational Emotive Behaviour Therapy. London: Whurr Publishers Ltd.

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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