Prepared by Ana Nelia Lopez Jumamil, PhD., RP

Albert Ellis

Aaron Temkin Beck

Judith S. Beck

Donald Meichenbaum

Born 1913Pittsburgh, Pennsylvania

Graduated w/ Ph.D. Columbia University 1947

Taught at Rutgers 1948-49

Initially trained as a psychoanalyst @ Horney Institute.

Began developing RT (Rational Therapy-now called REBT) around 1955 because he was disenchanted w/ psychoanalysis; he thought it was too inefficient.

Has published hundreds of books and articles.

Founded Albert Ellis Institute in NYC and now there are institutes around US and world.

Turned 90 in September 2002 an still going strong.

ALBERT ELLISGrandfather of Cognitive Behavior TherapyDeveloped an approach to psychotherapy

known as the RATIONAL EMOTIVEBEHAVIOR THERAPY

AARON TEMKIN BECK Developed the Cognitive Theory of Depression

recognized as COGNITIVE THERAPY Founder of the Beck Institute Father of Cognitive Behavior Therapy

JUDITH S. BECK Opened the Beck Institute for Cognitive Therapy together

with his father President of the institute Cognitive Behavior Therapy: Basics and Beyond (2011a),

Cognitive Therapy for Challenging Problems: What to doWhen the Basics Dont Work (2005) and the CognitiveTherapy Worksheet Packet (2011b)

DONALD MEICHENBAUM Conducted research on the development of Cognitive

Behavior Therapy (CBT) Psychotherapeutic approach of Constructivist Narrative

Therapy

RATIONAL EMOTIVE BEHAVIORTHERAPY (REBT) Albert EllisCOGNITIVE THERAPY (CT) Aaron T. Beck and Judith S. BeckCOGNITIVE BEHAVIOR THERAPY (CBT) Donald Meichenbaum

The cognitive behavior therapies combineboth cognitive and behavioral principles andmethods in a short-treatment approach(Dattilio, 2000a).

All of the cognitive

beha vior a pproca hes sha re

the sa me ba sic

cha ra cteristics a nd

a ssumptions a s tra ditiona l

beha vior thera py.

1. A collaborative relationship between the

client and the therapist

2. The premise that psychological distress is

largely a function of disturbances in

cognitive processes

3. A focus on changing cognitions to produce

desired changes in affect and behavior

4. A present-centered, time-limited focus

5. An active and directive stance by the

therapist

6. An educational treatment focusing on

specific and structured target problems

Both CT and CBT are based on a structured

psychoeducational model, emphasize the

role of homework, place, responsibility on

the client to assume an active role both

during and outside therapy sessions.

emphasize developing a strong therapeutic

alliance and draw from a variety of

cognitive and behavioral strategies to bring

about the change.

Both cognitive therapy and cognitive

behavior therapy are based on the

assumption that a reorganization of ones

self-statements will result in a

corresponding reorganization of ones

behavior .

REBT is a philosophically-based, humanistic approach that emphasizes individuals capacity for creating their own self-enhancing and self-defeating emotions.

Ellis borrowed from philosophy. Epictetus, the Stoic philosopher said, People are not influenced by things but their view of things.

REBT holds that an individuals belief system affects whether s/he attains maximum pleasure and self-actualization. Happiness is the goal of all human beings.

REBT is a theory of how people (who want happiness) can inadvertently create personality and emotional disturbance.

REBT

First of the cognitive behavior therapies

and continues to be a major cognitive

behavioral approach.

People contribute to their own

psychological problems , as well as specific

symptoms by the rigid and extreme beliefs

they hold about events and situations.

REBT is based on the assumption that cognitions, emotions and behaviors interact significantly and have a reciprocal cause-and effect relationship.

REBT emphasized all three of these modalities and their interactions, thus qualifying it as an integrative approach.

Ellis gave credit to Alfred Adler as an influential precursor of REBT and Karen Horneys ideas on the tyranny of the shoulds are apparent in the conceptual framework of REBT.

Ellis acknowledged his debt to the ancient Greeks especially the Stoic philosopher Epictetus.

As Stoic philosopher Epictus said:

People are distubed not by events, but by

the views which they take of them

This can be stated as People disturb

themselves by the rigid and extreme beliefs

they hold about events

The therapys basic hypothesis is that our

emotions stem mainly from our beliefs,

which influence the evaluations and

interpretations we make of the reactions we

have to life situations.

The focus is on working with thinking and

acting rather than primarily with

expressing with feelings. The therapy is

seen as an educational process.

REBT does not place much value on free

association, working with dreams, focusing

on the clients past history, expressing and

exploring feelings, or dealing with

transference.

REBT is based on the assumption that

human beings are born with a potential for

both rational or straight thinking and

irrational or crooked thinking.

People have predispositions for self

preservation, happiness, thinking and

verbalizing, loving, communion with others

and growth and self actualization.

They also have propensities for self

destruction, avoidance of thought,

procrastination, endless repetition of

mistakes, superstition, intolerance,

perfectionism and self blame, and

avoidance of actualizing growth potentials.

REBT ecnourages people to accept

themsleves even though they will make

mistakes.

We learn irrational beliefs from significant

others during childhood and then re-create

these irrational beliefs throughout our

lifetime.

We actively reinforce our self-defeating beliefs

through the processes or autosuggestion and

self-repetition, and then we behave in ways

that are consistent with these beliefs.

A major goal of REBT therapist is to

encourage clients to be less emotinally active

Ellis insists that BLAME is at the core or

most emotional disturbances.

If we want to become osychologically

healthy, we had better stop blaming

ourselves and others and learn to fully and

unconditionally accept ourselves despite

our imperfections.

I must do well and win the approval of others formy performance or else I am no good.

Other people must treat me considerately, fairly,kindly and in exactly the way I want them to treatme. If the dont, they are no good and they deserveto be condemned and punished.

I must get what I want, when I want it; and I mustnot get what I dont want. If I dont get what Iwant, its terrible, I cant stand it, and life is nogood for depriving me of what I must have.

This model provides a useful tool for understanding theclients feelings, thoughts, events and behavior (Wolfe,2007).

A the existence of a fact, or an activating event, or aninference about an event of an individual

B the persons belief about A, largely creates C, theemotional reaction

C the emotional and behavioral consequence orreaction of the individual (can either be healthy orunhealthy)

D the application of methods to help clients challengetheir irrational beliefs

E an effective philosophy F a new set of feelings

A (activating event) B (belief) C (emotional and behavioral consequence) D (disputing intervention) E (effect) F (newfeelings)

you mainly feel the way you think

Three components of the disputing process: detecting,debating and discrimintating

First, clients learn how to detect their irrationalbeliefs, particularly their shoulds and musts,their awfulizing, and their self-downing.

Then clients debate their dysfunctional beliefs bylearning how to logically and empirically questionthem and to vigorously argue themselves out of andact against believing them.

Finally, clients learnt to discriminate irrational(self-defeating) beliefs from rational beliefs (self-helping)

Cognitive resrtucturing a central

technique of cognitive therapy that teaches

people to improve themselves by replacing

irrational beliefs with rational beliefs

Restructuring involves helping clients

learn to monitor their sel-task, identify

maladaptive self-talk and substitute

adaptive self-talk for their negative self-talk

1. Fully acknowledging that we are largely

responsible for creating our own emotional

problems

2. Accepting the notion that we have the

ability to change these disturbances

significantly

3. Recognizing that our emotional problems

largely stem from irrational beliefs

4. Clearly perceiving these beliefs

5. Seeing the value of disputing such self-defeating beliefs

6. Accepting the fact that if we expect to change we betterwork hard in emotive and behavioral ways tocounteract our beliefs and the dysfunctional feelingsand actions that follow

7. Understanding what the rational alternative to theseirrational beliefs are

8. Practicing REBT methods of uprooting or changingdisturbed consequences and practicing their healthy

a lternatives for the rest of our life

Therapists have the general goal of teaching clients how to separate the evaluation of their behavior from the evaluation of themselves-their essence and totality- and how to accept themselves in spite of their imperfections.

The process of REBT involves a collaborative effort on the part of both the therapist and the client in choosing realistic and self-enhancing therapeutic goals.

The therapists task is to help clients differentiate between realistic and unrealistic goals and also self-defeating and self-enhancing goals.

A basic goal is to teach clients how to change their dysfunctional emotions and behaviors into healthy ones.

Two of the main goals of REBT are to assist clients in the process of achieving unconditional self- acceptance (USA) and unconditional other acceptance (UOA) AND to see how these are interrelated.

As clients become more able to accept themselves, they are more likely to unconditionally accept others.

The first step is to show clients how they have incorporated many irrational absolute shoulds , oughts, and musts.

The therapists disputes clients irrational beliefs and encourages clients to engage in activities that will counter their self-defeating beliefs and to replace their rigid musts with preferences

The second step in the therapeutic process is to demonstrate how clients are keeping their emotional disturbances active by continuing to think illogically and unrealistically.

Third step is helping the clients modify their thinking and minimize their irrational ideas.

The therapist encourages clients to identify the irrational beliefs they originally unquestioningly accepted and demonstrates how they are continuing to indoctrinate themselves with these beliefs

Fourth step in the therapeutic process is to challenge clients to develop a rational philosophy of life so that in the future they can avoid becoming the victim of other irrational beliefs.

The therapists takes the mystery out of the therapeutic process, teaching clients about the cognitive hypothesis of disturbance and showing how rigid and extreme irrational beliefs to disturbed negative consequences.

Once clients begin to accept that their beliefs underpin their emotions and behaviors, they are able to participate effectively in the cognitive restructuring process.

Clients learn how to apply logical thought, participate in experiential exercises, and carry out behavioral homework as a way to bring about change.

Clients can realize that life does not always work out the way that they would like to it.

Even though life is not always pleasant, clients learn that life can be bearable and that even suffering can be honourable.

The therapeutic process largely focuses on clients experiences in the present.

Clients are expected to actively work outside the therapy sessions.

Home Work- is carefully designed and agreed upon and is aimed at getting clients to carry out positive actions that induce emotional and attitudinal change.

Towards the end of therapy, clients review their progress, make plans, and identify strategies for dealing with continuing or potential problems.

Because REBT is essentially cognitive and directive behavioural process, a warm relationship between therapist and client is not required.

REBT practitioners strive to unconditionally accept all clients and to teach them to unconditionally accept others and themselves.

REBT practitioners accept their clients as imperfect beings who can be helped through a variety of techniques such as teaching, bibliotherapy, and behaviour modification

Rational emotive behaviour therapists are often open and direct in disclosing their own beliefs and values. Some are willing to share their own imperfections as a way of disputing clients unrealistic notions that therapists are completely put together person.

Rational emotive behavior therapists are

multimodal and integrative.

Rational Emotive Behavior Therapy (REBT)

Generally starts with clients disturbed feelings

and intensely explores these feelings in

connection with thoughts and behaviors.

REBT practitioners tend to use a number of different modalities (cognitive, imagery, emotive, behavioral and interpersonal ) to dispel these self defeating cognitions and to teach people how to acquire a rational approach to living.

Relies heavily on thinking, disputing,debating, challenging, interpreting,explaining, and teaching clients in how todeal with self-statements so they would nolonger believe in them, encouraging them toacquire a philosophy based on reality.

Disputing irrational beliefs Doing cognitive homework Bibliotherapy Changing ones language Psychoeducational methods

Clients go over a particular must absolute should or ought until they no longer hold that irrational belief or at least until it is diminished in strength.

Sample questions:

Why must people treat me fairly?

How do I become a total flop if I dont succeed at

important tasks I try?

By applying the ABC theory, the therapistteaches the client how to think differently,or models for them, as opposed to otherforms of Cognitive behavior therapy.

In carrying out homework, clients areencouraged to put themselves in risk-taking situations that will allow them tochallenge self-limiting beliefs.

Clients are encouraged to carry out specific assignments

during the sessions and, especially, in everyday situations

between sessions.

In this way, clients gradually learn to deal with anxiety

and challenge basic irrational thinking.

As therapy is seen as an educational process, clients are

also encouraged to read REBT self-help books, such as

Elliss How to Make Yourself Happy and Remarkably Less

Disturbable (1999). They also listen to and evaluate

tapes of their own therapy session.

REBT and other CBT approaches can be delivered to some degree in a bibliotherapeutic format.

Best to utilize bibliotherapy as an adjunctive form of treatment.

Advantages include cost effectiveness, widespread availability and the potential of reaching a broad spectrum of populations.

musts

oughts

shoulds

It would be absolutely awful if..

They learn to say

It would be inconvenient if

REBT programs introduce clients to various educational materials.

Therapists educate clients about the nature of their problems and how treatment is likely to proceed.

They ask clients how particular concepts apply to them.

RATIONAL EMOTIVE IMAGERY USING HUMOR ROLE PLAYING SHAME ATTACKING EXERCISES

Although REBT employs a variety of emotive and forceful

therapeutic strategies, it does so in a selective and

discriminating manner.

These strategies are used both during therapy sessions and as

homework assignments in daily life.

Their purpose is not simply to provide a cathartic experience

but to help clients change some of their thoughts, emotions,

and behaviors.

This technique is a form of intense mental practice designed to establish new emotional patterns.

Clients imagine themselves thinking, feeling, and behaving exactly the way they would think, feel, and behave in real life.

Ellis (2001a, 2001b) maintains that if we keep practicing REI several times a week for a few weeks, we can reach the point that we no longer feel upset over negative events.

Situation: You have to inform a staff member their request for promotion has been turned down due to their poor performance record. Anxiety

He will be upset. I couldn't stand feeling responsible. I must find a way to say it without him getting upset.

Concern

It will be uncomfortable, but it won't kill me. While I would prefer him not to get upset, his emotions are his responsibility - I cannot control his feelings or be responsible for them.

Procedures1 Example2

The steps, showing an illustrative example, are as follows:

1. Imagine, vividly and clearly, the event or situation with which you have trouble.

Allow yourself to feel strongly the self-defeating emotion which follows.

Note the thoughts creating that emotion.

Force the emotion to change to a more functional (but realistic) feeling. It is possible to do this, even though briefly.

Note the thoughts you used to change the emotion.

Practice the technique daily for a while.

The exercises are aimed at increasing self acceptance and mature responsibility.

Helping clients see that much of what they think of as being shameful has to do with the way they define reality for themselves.

Clients may accept a homework assignment to take the risk of doing something that they are ordinarily afraid to do because of what others might think.

Force and energy are a basic part of shame-attacking exercises.

It helps client go from intellectual to emotionalinsight by showing clients how to conductforceful dialogues with themselves in which theyexpress their unsubstantiated beliefs and thenpowerfully dispute them.

Reverse role playing- the therapist strongly clingto the clients self-defeating philosophy and askthe client to vigorously debate with the therapistto give up these dysfunctional ideas.

Operant conditioning

Self-management principles

Systematic desensitization

Relaxation techniques

Modeling

Treatment of anxiety, hostility, character disorders,

psychotic disorders, depression, to problems of sex,

love, and marriage, to child rearing and adolescence,

to social skills training and self-management

Developed to make psychotherapy shorter and make it

more efficient than most other systems; Hence, often

a brief therapy

ABC approach to changing basic disturbance-creating attitudes can be learned in 1-10sessions.

Most clients who are seen for individualtherapy have 1 session weekly for anywherefrom 5 to 50 sessions

Also suitable for group therapy