Rational-Emotive Behavior Therapy

A therapeutic technique that reduces maladaptive behaviors by showing clients that their behavior is caused by irrational thoughts.

Rational-emotive behavior therapy (REBT) belongs to a class of therapies termed "cognitive-behavioral" therapies. The defining features of these therapies are an emphasis on achieving measurable goals by manipulating internal and external reinforcers. That is, cognitive-behavioral therapists help clients identify the thoughts and beliefs that might be prolonging their distress or anxiety. The assumption is that attitudes and expectations that we have for ourselves influence how we cope and respond to challenge.

Rational-emotive behavior therapy is the creation of psychologist Albert Ellis. Ellis believes that people are born with a predisposition to be either rational or irrational, and that mental disorders are the product of faulty learning. Specifically, REBT conceptualizes psychological disturbances as the products of maladaptive and irrational cognitions (thoughts) that have been learned, and which cause and are in turn caused by emotions and behaviors. It is not only the events in our lives, but also our interpretation of those events that can cause psychological disturbances. This is an optimistic theory, inasmuch as it predicts that, since mental disorders are the result of learning, they can be unlearned. The ultimate goals of REBT are to teach clients to think more rationally, to feel more appropriately, and to behave more adaptively.

As a therapy, REBT is active and sometimes confrontational. Cognitive, emotive, and behavioral methods are used in combination to facilitate client change. Some of the cognitive methods include: disputing irrational beliefs (e.g., pointing out how irrational it would be for a client to believe he/she had to be good at everything in order to consider himself/herself worthwhile); thought stopping (the therapist interrupts the maladaptive thought by yelling "STOP"); reframing (situations are looked at from a more positive angle); and problem solving. The emotive techniques, including role playing, modeling, the use of humor, and shame-attacking exercises, are all aimed at diffusing the upsetting emotions connected with certain behaviors or situations. Finally, behavioral techniques such as the use of homework assignments, risk-taking exercises, systematic desensitization (which involves incremental exposure to the frightening situation while focusing on remaining relaxed), and bibliotherapy (reading about the disorder) are all used to teach clients that they can safely and comfortably substitute adaptive behaviors for the maladaptive ones they have relied on in the past.

REBT uses something called the ABCDE model to help clients understand how their thoughts, feelings, and behaviors are related. The A stands for "activating events," which are related to rational or irrational "beliefs" (B). The beliefs involve "consequences" (C), which, if the belief is irrational, may be emotional disturbances. The D represents the therapist "disputing" the irrational belief and the E stands for the more "effective" way of thinking that marks success with REBT.

Consider, as an example, a student who performs badly on an exam. The poor grade is the activating event. The student's irrational belief is that, because of this bad grade, he or she is neither intelligent nor a worthwhile person. The consequence is depressed mood and perhaps feelings of anxiety connected to test-taking. These reactions could, in turn, result in avoidance of classes and tests or withdrawal from academically related activities. In REBT, the therapist would dispute the student's belief that the bad grade represents incompetence or worthlessness. The therapist would help the student to adopt more effective behaviors and beliefs, such as the belief that the poor grade is simply a reflection of course difficulty or the student's inadequate preparation, rather than a measure of the student's worth as a person.

REBT has been extensively researched. Many studies have demonstrated its success in treating various psychological troubles ranging from depression to anxiety disorders and even eating disorders such as bulimia. Additionally, REBT has been shown to work in both individual and group counseling settings. Because REBT teaches clients to monitor and alter their thoughts, feelings and behaviors, it teaches clients to help themselves. This feature is one of its greatest strengths, and is reflected in low relapse rates, compared to drug treatment in the absence of any accompanying therapy. Further advantages of REBT include its rapid symptom reduction and the short duration of therapy; therapeutic goals are frequently achieved within 10 to 20 sessions.