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