Rational Emotive Behavioral Psychotherapy

1. Rational Emotive Behavioral Psychotherapy Slides created by Barbara A. Cubic, Ph.D.Professor Eastern Virginia Medical School To accompany Current Psychotherapies 10

2. Learning Objectives • This presentation focuses on: • An overview of Albert Ellis' REBT • History of the development of REBT • Applications of REBT • Treatment techniques derived from REBT theory

3. Basic Concepts

4. Basic Characteristics of REBT • Practical and symptom-focused. • Philosophically-based, but techniques have empirical support. • Requires patient collaboration. • Patients change through identification of irrational thought processes. • Patient’s behaviors and thought processes are evaluated and criticized when necessary.

5. Basic Concepts of REBT Activating Events A B C D Behavior Consequences Dispute

6. Basic REBT Concepts REBT considers the importance of mind and body, or of thinking/feeling/wanting (contents of the mind) and of behavior (operations of the body).

7. People have the potential to be: Rational, self-preserving, creative, functional and to use metathought. Irrational, self-destructive, short-range hedonists, dysfunctional. Culture and family can perpetuate irrational thinking. Humans perceive, think, emote and behave simultaneously. All psychotherapies are not equally effective. A warm therapeutic relationship is not a necessary or sufficient condition for change. Basic REBT Propositions

8. REBT uses whatever techniques work; focus is not symptom-removal but real cognitive change. Neurotic thinking is the result of unrealistic, illogical thinking. The causes of an individual’s problems are not the events that have happened, but how the individual perceives them. There is an element between stimulus and response; it is thought and emotional response. Basic REBT Propositions

9. Basic REBT Propositions REBT provides clients with several powerful insights A - B - C (Insight #1) People are distressed because they are reinforcing irrational thoughts. (Insight #2) Only hard work and practice will correct irrational thinking. (Insight #3)

10. Analogy to Demonstrate REBT • Ellis often speaks of the S-O-R relationship like a billiards shot. • If you hit a ball from the same spot, at the same angle, you will get the same results. • However, if there were a person inside the ball who could control the outcome, then the outcome could be different each time.

11. Comparing REBT to Other Therapies

12. REBT Compared with Psychoanalysis • REBT does not focus on free association, complex history taking, dream analysis or sexual conflicts. • Transference is seen in REBT as often resulting from irrational beliefs. • REBT employs persuasive and directive techniques.

13. REBT Compared with Adler’s Theory • Considerable similarities between the two approaches. • Adler’s concept of fictional beliefs is similar to Ellis’s irrational beliefs. • Adler had more emphasis on: • Past memories. • Social interest. • REBT more future-oriented and behavioral.

14. REBT Compared to Jungian Therapy • There are lots of commonalities between the two approaches, especially regarding holistic view of individuals. • REBT views the Jungian focus on dreams, fantasies, symbols or archetypes as a “waste of time.”

15. REBT Compared to Client-Centered Therapy • There are lots of commonalities between the two approaches. • Both emphasize importance of unconditional positive regard, which REBT labels as full acceptance or tolerance.

16. REBT vs. Client-Centered Therapy

17. REBT Compared to Behavior Therapy • There are lots of commonalities between the two approaches. • REBT has a strong focus on cognition. • More similar to CT and multimodal therapy than BT.

18. REBT Compared with CT

19. “Ellis is an unsung hero of positive psychology.” — Martin A. Seligman, Positive Psychology Movement

20. History of REBT “As a man thinketh, so is he.”The Bible “Men are not worried by things, but by their ideas about things.” Epictetus “It is very obvious that we are not influenced by ‘facts’ but by our interpretation of the facts.”Alfred Adler

21. Early Life of Albert Ellis • Born in Pittsburgh 1913. • Raised in New York City. • Difficult childhood: • Parents divorced when he was 12. • Developed a serious kidney disorder. • Wanted to be a Great American Novelist

22. Early Life of Albert Ellis • Wrote short stories, plays, novels, comic poetry, essays and nonfiction books. • By age 28, he had finished almost two dozen unpublished, full-length manuscripts. • At 28 he turned exclusively to nonfiction writing. • Promoting what he called the "sex-family revolution."

23. Albert Ellis • 2006 — Ellis stated that the Albert Ellis Institute was following a program inconsistent with REBT. • Died July 24, 2007. • REBT Network established in 2006 and EllisREBT established in 2012. • Promotes rational emotive behavior therapy and the works of Dr. Albert Ellis. • Neither associated with the Albert Ellis Institute.

24. History of REBT • Developed by Albert Ellis, Ph.D. • After two decades of practicing psychoanalysis, he became increasingly disillusioned by the limited progress patients were making. • Berne, Frank, Kelly, Low, Phillips Rotter, and Wolpe were all influential.

25. History of REBT • Albert Ellis authored more than 70 books and 700 articles. • His writings focused on ways to help people overcome destructive, self-defeating emotions and beliefs to ultimately improve their lives. • Albert Ellis is listed as the 2nd most influential person in the history of psychotherapy.

26. History of REBT Major influences were: • Asian and stoic philosophers • Alfred Adler • Paul DuBois’ persuasive forms of psychotherapy • Others include Herzberg, Bernheim, Salter, Thorne, Alexander, French, Dollard, Miler, Stekel, Wolberg

27. History of REBT • 1957 — Ellis writes How to Live with a “Neurotic.” • 1975 — Ellis writes A New Guide to Rational Living, which continues to be one of the most popular self-help books to date. • 1977 — Ellis writesHandbook of Rational-Emotive Therapy.

28. Current Status of REBT • Albert Ellis Institute established in 1959 teaches principles of healthy living. • Albert Ellis Foundation established in 2006 to promote REBT. • Journal of Rational-Emotive and Cognitive Behavior Therapy reports latest findings.

29. Current Status of REBT • Albert Ellis Institute established in 1959 — Research supports several REBT premises: • Thoughts and feelings are not two disparate processes. • Beliefs are more important than events. • Metathought occurs (often captured in images). • Changing thoughts, behaviors, or emotions changes other modalities.

30. Understanding the Theory Behind REBT

31. Ellis' Theory of Personality

32. Ellis' Theory of Personality “Basic tenet of REBT is that emotional upsets, as distinguished from feelings of sorrow, regret, annoyance, and frustration, largely stem from irrational beliefs.” — Albert Ellis

33. Should Ought Awful Must I Want I Need Problematic Beliefs Center Around Words/Concepts Like…

34. Turning a Symptom into an Activating Event A1 B1 C1 A 2 B 2 C 2 I feel anxious, depressed and worthless. I did poorly on my job today. Isn’t that horrible? Isn’t that horrible? Intensified feelings of anxiety, depression and worthlessness Anxiety, depression, worthlessness

35. Turning a Symptom into an Activating Event A1, A2, A3, A4, A5 A6, … Ellis' explanation of how psychoanalysis or therapies focusing on the past work.

36. Ellis' Theory of Personality “This is the basic personality theory of REBT. Humans largely create their own distress.” — Albert Ellis

37. Albert Ellis Agrees with…

38. Albert Ellis Agrees with….

39. REBT Compared with CT

40. The Psychotherapy Process

41. According to Ellis, we experience: • Activating Events (A) daily, prompting us to look at, interpret, or think about what is occurring. • Our interpretation of events results in Beliefs (B) about the event, the world and our role in the event. • Once we develop a belief, we experience Emotional Consequences (C) based on our beliefs.

42. Ways Individuals Alleviate Pain: Distraction • Leads to less demands of others. • Individual becomes less anxious. • Palliative

43. Ways Individuals Alleviate Pain: Satisfying Demands • If demands are catered to, the individual feels better but does not get better. • Therapist can: • Give love and approval. • Provide pleasurable sensations. • Teach methods to have demands met. • Give reassurance. • Ultimate impact is demandingness reinforced.

44. Ways Individuals Alleviate Pain: Magic and Mysticism • Magical solutions are often offered to children and even to adolescents and adults. • Generally, magical solutions only temporarily placate the individual.

45. Ways Individuals Alleviate Pain: Giving up Demandingness • Most elegant of the solutions listed. • REBT’s goal is to achieve minimal demandingness/maximal tolerance. • Temporary, palliative techniques may be used in REBT with clients who refuse more permanent resolution. • Goal is minimization of musturbation, perfectionism, grandiosity, and low frustration tolerance.

46. Main Goals of REBT • REBT assists patients in seeing how giving up perfectionism improves their lives. • REBT teaches patients to differentiate between desires and “musts.” • Behavioral techniques are used in REBT to change habits as well as cognition.

47. REBT Psychotherapy “REBT helps clients acquire a more realistic, tolerant philosophy of life … REBT practitioners often employ a rapid-fire, active-directive-persuasive-philosophical methodology.” —Albert Ellis

48. Mechanisms of Psychotherapy • No matter what feelings (which, by the way, do not distract the therapist) the patient discusses, the focus is on the patient’s irrational beliefs. • REBT therapists do not hesitate to contradict a patient’s beliefs and are often one step ahead while showing acceptance. • REBT therapists may do more talking than their patients.

49. Mechanisms of Psychotherapy • Strongest philosophical approach possible is used. • Therapist doesn’t just tell the patient their beliefs are irrational, but also attempts to encourage the patient to see this for themselves.

50. Beliefs Ellis Would Label Irrational • It is a dire necessity to be loved. • Certain acts are awful or wicked; people who perform such acts are awful and wicked. • It is horrible when things are not the way we like them to be. • Human misery is externally caused. • If something causes anxiety we should be terribly upset and endlessly obsess about it. • It is easier to avoid than to face life’s difficulties and responsibilities.