What Is Rational Emotive Behavior Therapy? (REBT)

Rational emotive behavioral therapy (sometimes also termed rational emotive therapy) is a form of cognitive behavioral therapy developed by Dr. Albert Ellis. This type of therapy focuses on a person’s belief system, attitudes, and thought processes as the mechanism of changing an individual’s behavior.

Background

The late psychologist Dr. Albert Ellis was originally trained as a psychoanalyst (from the Freudian school of psychotherapy) and also studied some of the aspects of behavioral psychology. In his training, Dr. Ellis learned to focus on the experiences, beliefs, and impressions developed during childhood and adolescence of his clients as the main mechanism of change.

Ellis became convinced that the correct approach to understanding people and fostering change in them was to connect the interplay between the person’s environment and the person’s mental processes. Ellis eventually came to the conclusion that the individual’s expectations determine their viewpoint and how they behave. Ellis believed that focusing on changing expectations and beliefs was the key to successful therapeutic intervention.

The ABC’s

According to the book Rational and Irrational Beliefs: Research, Theory, and Clinical Practice and other works written by Dr. Ellis and his peers, he borrowed the ABC acronym from the behaviorist school and added his own interpretation to it.

Ellis used the ABC acronym and expanded on it (ABCDE) to describe the fundamental model of REBT:

• Activating events: These are common issues and obstacles that everyone encounters in the world as a result of interacting with other people.
• Beliefs: These are actual mental representations that individuals have that represent their estimation of whether they can deal with adversity in a positive manner and move toward positive outcomes.
• Consequences: These are events that occur as a result of the interaction between the person’s beliefs and the anticipating events.
• Disruption: The joint efforts of the therapist and client working together can lead to a disruption of a dysfunctional and irrational belief system.
• Effects: As a result of the identification, disruption, and reorganization of irrational and dysfunctional beliefs, the therapeutic process can work to develop a new set of consequences that are consistent with a more realistic outlook.

Ellis came to the conclusion that having negative beliefs, including beliefs that were totally irrational or just unrealistic, reinforced negative expectations and negative consequences of one’s behavior. If one could address these negative expectations and irrational beliefs, one could also influence the consequences of an individual’s behavior to move in a more positive direction.

Ellis referred to the process of obtaining rational beliefs and attitudes consistent with the real world as a state of mental wellness. REBT became the process Ellis used to reshape the irrational and dysfunctional belief system of individuals who were having trouble with different types of behavioral issues, including severe psychopathology such as major depressive disorder, anxiety disorder, personality disorders, and even substance use disorders.

Irrational Beliefs

Ellis recognized that in order to address all the potential types of irrational dysfunctional belief systems that individuals have, there needed to be some form of a descriptive system that could sort different but related types of irrational beliefs into categories based on their overarching presentation. Ellis determined that there were three basic categories of irrational beliefs that most individuals express. He described these as “musts” to denote that individuals believe these irrational belief systems as all-or-nothing attitudes or cognitions. These “musts” become activated by certain environmental conditions.

The goal of REBT is to first identify how an individual expresses these “musts” (people often express these differently even though they are similar in everyone) and then understand how they relate to the individual’s behavior, particularly to dysfunctional behaviors. Once the therapist has developed this framework, the goal becomes to challenge these irrational beliefs and assist the individual in developing more realistic, positive, and functional beliefs and attitudes that will result in positive and fulfilling behaviors.

Ellis described three basic “musts” of REBT:

1. Expectations or demands of oneself: These “musts” are often reflected in self-statements or beliefs, such as, “People must like me,” or “I cannot make mistakes,” etc. Often, they are not globally expressed but just felt when they are being violated, such as when an individual senses that someone does not like them or when a person tries to explain away or hide a mistake. If individuals are unable to live up to this belief, they somehow view themselves as being inadequate or inferior. This results in significant distress for many, and some individuals may often make global self-statements regarding their worth based on these unrealistic demands. These demands can lead to consequences, such as depression, anxiety, guilt, etc. For some individuals, these demands may be so unrealistic that they could never be achieved by anyone.
2. Expectations or demands of others: This set of “musts” is often perceived as feelings or self-statements regarding how individuals expect others to treat or view them. When these “musts” are irrational, they contain beliefs, such as, “People must treat me according to my expectations or they are bad,” or similar types of internal perceptions of the world and others. Because these irrational views can never fully be fulfilled, individuals may experience frustration, regret, or anger, and even express violence or aggression toward others.
3. Expectations or demands of the world: These include things like “Life must be fair,” or the feeling that one should be able to control all events that occur around or to them. These expectations are so unrealistic that they could never be realized. These are the types of expectations that often lead to issues with substance misuse, self-pity, and depression or anxiety.

An REBT therapist develops a close working relationship with the client and establishes trust before identifying these belief systems. Once identified, the therapist helps the individual alter their belief systems to be more consistent manner with reality by having them challenge these beliefs in the therapy sessions and in the real world. Once it is established that these inflexible belief systems are irrational, the therapist helps the individual change them to a more functional and rational manner. While this process is easily stated, therapist require years of training and practice to develop the skills needed to apply the theory.

Objectives

According to sources such as the Journal of Rational Emotive and Cognitive Behavioral Therapy and others, the aim of REBT is to help people understand how they contribute to their own distress by maintaining these irrational belief systems, help them develop more realistic schemas regarding the world and others, and help them behave in a manner that is more consistent with reality. The fundamental objectives of the process of REBT follow:

• A working relationship between the therapist and the client must be developed.
• The therapist and client then work together to identify the specific issues of irrational thinking that the client engages in and how they affect the client’s behavior.
• As the relationship continues, the client realizes that they must assume quite a bit of responsibility for their own behavior. This is reinforced by the therapist; however, it is also understood that certain events that happen in the world are not the responsibility of the client.
• Eventually, the sessions get to the point where the client can assume more control of their own existence. REBT therapists attempt to transfer as much autonomy to the client as possible and get them to be as self-sufficient as possible.

The entire process is a time-limited process that is not expected to continue for years, as what occurs in many types of therapy, such as more traditional Freudian therapy. Often, the therapist and client set a target number of sessions and a target time period to allow them to solve the specific set of problems.

Does It Work?

The simple answer to this question is “yes, it does work.” REBT has empirical support to indicate that it can be successfully used to address a number of issues, including substance use disorders, severe personality disorders that are often very difficult to treat, major depressive disorder, a number of anxiety disorders, trauma and stress-related disorders, and various other issues. Cognitive behavioral therapy treatments like REBT work best for individuals who are motivated to work on their issues and open to being challenged. For some individuals, REBT can be used to help enhance motivation; however, individuals who are not willing to become engaged in the therapeutic process will not have the same level of success as individuals who are willing to get deeply involved in the therapeutic process.

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