SMART ABC Tutorial

1. SMART ABC Tutorial • In this tutorial, you’ll learn what the ABC process is and how to use it. • First, we’ll briefly look at REBT theory, the basis for the SMART ABC Tool. • Then, we’ll do an example ABC to help you get started. • You may want to print out an ABC Worksheetto fill in as we go along.

2. What is an ABC? • The ABC process is a method to identify and dispute our irrational beliefs, thoughts and feelings. • By doing so we can come up with new, rational beliefs, thoughts and feelings. • This helps us resist urges and regain control.

3. Basic REBT Principles • There are 3 aspects of human functioning: • Thoughts • Feelings • Behaviors • People or events don’t make us feel good or bad. • It is our perceptions of them that result in our feeling good or bad. • These perceptions influence our behavior.

4. Origins of REBT • REBT (Rational Emotive Behavior Therapy) was developed by Dr. Albert Ellis in the 1950’s. • His proposal that thinking creates feelings and actions was in direct opposition to his training in and practice of psychoanalysis.

5. The REBT Approach to Addiction • REBT views addiction as a complex maladaptive behavior. It does not employ a disease model of addiction. • In SMART we do not label ourselves “alcoholics” or “addicts”. • REBT is supported by research on relapse prevention, motivational enhancement, and behavioral change processes. • REBT emphasizes self-responsibility, self-motivation, and self-discipline as the primary means of stopping substance use.

6. The Basic ABC • A = Activating Event • What do you think happened? • What would a camera see? • B = Beliefs about Activating Event • What did you tell yourself? • C = Consequences • How did you act? • How did you feel?

7. The Basic ABC Diagram Activating Event A Belief B Consequence C

8. Example: At a Party • A = Activating Event • I’m at a party. • B = Belief • Parties must be exciting, or I feel left out. • I must have a drink to relax and have fun. • This is awful and I can’t stand being here. • I’m a bad person because I need a drink. • C = Consequences • I feel anxiety. • I have a drink.

9. Four Categories of Irrational Beliefs • Dogmatic demands • Musts, absolutes, shoulds • Awfulizing • It’s awful, terrible, horrible • Low Frustration Tolerance (LFT) • I can’t stand it, I need it • Self/Other Rating • I’m or he/she is bad, worthless

10. Disputing Irrational Beliefs • After identifying A, B and C, we move on to D. • D = Disputing Irrational Beliefs (iB’s) • Where is holding this belief getting me? Is it helpful or self-defeating? • Where is the evidence to support my belief? It is consistent with reality? • Is my belief logical? Does it follow from my preferences? • Is it really awful (as bad as it could be)? • Can I really not stand it?

11. Example: At a Party • D = Dispute Irrational Beliefs (iB’s) • Why is this so terrible? • Where’s the proof that I can’t handle it? • What does it mean when I say I can’t handle it? Will I actually explode? • Must I always get what I want? • Is it in my long-term best interest to believe that I must have a drink? • Is this belief going to lead to my desired behavior?

12. Irrational vs. Rational Beliefs • Irrational beliefs are the result of irrational thoughts. • Irrational beliefs lead to unhealthy feelings and behaviors. • Rational beliefs are reasonable, objective, flexible and constructive. • Rational beliefs lead to survival, happiness and healthy feelings and behaviors.

13. Irrational vs. Rational Diagram Rational Belief rB Healthy Consequence C Rational Beliefs lead to healthy feelings & behaviors Activating Event A Irrational Beliefs lead to unhealthy feelings & behaviors Irrational Belief iB Unhealthy Consequence C

14. New Effective Beliefs • After Disputing (D), we move on to E. • E = New Effect (New Rational Beliefs) • New healthy negative emotions • Disappointment • Concern • Annoyance • Sadness • Regret • Frustration • New constructive behaviors

15. To Dispute or Not Dispute: Diagram Drink to feel accepted & therefore reduce anxiety Activating Event A Irrational Belief iB Consequence C D Dispute iB and remain abstinent I’m at a party Parties must be exciting, or I feel left out Anxiety

16. Example: At a Party • E = New Effect (New Rational Beliefs) • This is difficult, but I can have fun without drinking. • This is uncomfortable, but I can handle being here. • It is in my long-term interest to abstain from using. I want to be a clean and sober person. • While it may be upsetting, it’s not life-threatening. • I may strongly desire a drink, but I can survive without one. • While drinking may bring short-term relaxation, I know from my past that it leads to trouble.

17. Example: At a Party • E = New Effect (New constructive behaviors) • I remain abstinent. • I stay at the party and have fun. • I move closer to my goal of being clean and sober.

18. Summary: ABC Flow Chart Activating Event (A) Irrational Belief (iB) Unhealthy Consequence (C) Disputation (D) Effective Change (E) Rational Belief (rB) Healthy Consequence (C)

19. The Extended ABC • Some facilitators extend the Basic ABC (with it’s D and E) to include F and G. • F = New Feelings • After disputing irrational beliefs and making them rational, how do you feel? • Annoyed not angry, concerned not anxious, sad not depressed? • G = Goals • How does the E (New Effect) help you reach your goals? • In the short-term? In the long-term?

20. Example: At a Party • F = New Feelings • I feel uncomfortable and frustrated, but those are healthy negative emotions I can handle. • I feel stronger and proud of myself for meeting the challenge. • G = Goals • I met my goal of not drinking today. • I am closer to being the clean and sober person I want to be. • With a clear mind I will be able to achieve my medium- and long-term goals.

21. Example of Goal Setting • Short-term • Why are you at this SMART meeting today? • Because I want to stop drinking. • Medium-term • Why do you want to stop drinking? • So I can finish my bachelor’s/master’s degree. • Long-term • Why do you want to finish your degree? • So I can get married and start a family. • Very long-term • Why do you want to get married and start a family? • So I can live a full, happy and healthy life.

22. The Chained ABC • ABC’s can be chained together to deal with secondary upsets. • The C of the ABC for the secondary upset becomes the A of the ABC for the primary upset. • This is sometimes called “being upset about being upset”. • Ask you meeting facilitator for more details.

23. When to Use the ABC’s • ABC’s are helpful in resisting urges. • When possible, it is best to anticipate those urges and prepare an ABC ahead of time. • With practice, you will be able to remember and apply your ABC in the heat of the moment. • Eventually, applying them will become automatic and you may not even notice you’re doing it. • Urges will weaken over time.

24. The Three P’s • In SMART, we frequently refer to PPP: • Practice • Patience • Persistence • Keep practicing your ABC’s and other tools. They get easier over time. • This is a process. Be patient with yourself and give yourself time to learn to apply these new tools. • Persist in pursuing abstinence. If you lapse or relapse, come discuss what happened.

25. What Can I Do Next? • Print out a few copies of an ABC Worksheet. • Think of a few A’s (Activating Events) that frequently lead you to use, and fill out a worksheet for each. • In this way you’ll be better prepared to resist the urge the next time you face those A’s. • Move on to the CBA (Cost/Benefit Analysis) Tutorialto help build motivation to abstain.