Rational emotive behavior therapy

Rational emotive behavioral therapy (REBT) was created by Albert Ellis in the 1950s when he started to focus on the effect of thoughts on emotions and behavior, which was a significant departure from the theories of the time. While Aaron Beck is usually considered the father of cognitive psychology, Ellis, a lesser known psychologist, may deservedly lay claim to the title. Ellis laid the foundation that Beck and other CBT practitioners would continue to build upon to the present day. 

What is REBT?

REBT was the first psychological theory to hypothesize that thoughts lead to feelings. Further, It was easy to understand and relatively brief compared to psychoanalysis, the predominant therapy at the time. To fully comprehend the theory behind REBT, you first need to learn your ABCs.

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The ABCs of REBT

The ABC model outlines the development of irrational thoughts and how they lead to specific consequences. 

A= Activating Event 

An activating event is a trigger that is the basis for an irrational belief. It starts the process but is not responsible for how you feel. For example, say you get fired at work. That is an activating event.

B= Irrational Belief

An irrational belief is formed in response to the activating event. This is a belief that you use to cope with whatever happened. Using the above example, a person might think that they are “too stupid” to keep a job or “unworthy”. As you can see, an irrational belief is neither helpful nor necessarily realistic. 

C= Emotional and Behavioral Consequences

The irrational belief results in emotional and behavioral consequences. In this case, the unemployed person may feel sad and lose their self-confidence (emotional). They might then stay in bed all day and have no motivation for finding another job (behavioral). What is important to note, according to Ellis, is that the person’s feelings and behavior are a result of how they think about the activating event, not the event itself. 

The steps of REBT

Keeping the ABC model in mind, let’s illustrate the steps of REBT:

• Develop rapport. Developing rapport is important in any therapy but maybe especially so with REBT. The process of challenging irrational thoughts can seem a bit cold and harsh. Having a good rapport will buffer those problems and help the client more easily accept what you are saying. 

• Identify irrational beliefs. The next step is to identify irrational thoughts. These are any thoughts that pop into your head in relation to the activating event. Ellis had particular terms for irrational and rigid thought patterns that he found to cause negative consequences. For example, “musterbating” was when a client thought that situations must play out in a certain way. Thoughts like “‘should’, ‘ought’, and ‘supposed to’” were all examples of this form of thinking. “Musterbating” is problematic because we know that we can’t control situations or other people and, therefore, these beliefs often lead to unreasonable expectations. “Catastrophizing” is another common belief pattern recognized by Ellis, where a person thinks a situation is much worse than in actuality. This is bound to cause feelings of negativity and despair.
  
  Quick Tip: When asking clients about their beliefs, tell them to provide the unedited version, not a summary or paraphrase. 
  

• Challenge the irrational belief. This is the main job of the therapist in REBT and also the hardest. It is also known as disputing. You have to convince the client that how they think is neither adaptive nor realistic. What is an effective way to do this, you may ask? Poke holes in their beliefs using Socratic questioning. For example, “could there be other reasons you were let go from your job?” or “does losing this job necessarily mean that you are stupid?"

• Find an alternative belief. Once you have helped the client challenge their faulty thought, you can help them replace it with a more adaptive and realistic belief. Using our previous example, this may include, “I am not the only person to lose this job, they must be downsizing,” or “I am a smart person, this job was just not a fit for my skills.” These more rational thoughts will lead to more positive emotions and behaviors. For example, instead of feeling depressed and staying in bed all day, the person may feel disappointed but prepared to start looking for a new job they might like even better. 

The best resource for a REBT therapist is the thought record. This is a worksheet that allows the client to record their irrational beliefs and then take them through the process of challenging those thoughts and coming up with a healthier belief. It is a valuable tool for clients to practice the REBT process until they learn how to do it on their own.