Chapter 9: Rational emotive behavior therapy

possible consequenses (C)

Feelings consequence: Depression, hopelessness, Behavioral consequence: Isolation, suicidal attempts Cognitive Distortions: Awfulizing, I can't-stand-it-itis

The ABCDEs OF FEELINGS AND BEHAVIOR

activating event ("A"), the irrational belief ("iB") about the activating event, and the conse-quential feeling or behavior ("C"). Once the irrational belief is identified, the REBT therapist will dispute (D) it in an effort to develop new effective responses (E); The result is new rational beliefs (rB) that result in new consequences that are less stressful and healthier.

Ellis' view towards rebt development

after continuing to see clients in his private practice he became convinced that it was how an individual came to view or understand their situation that caused disturbing, depressive, and upsetting emotions, not the situation itself

Twelve Irrational Beliefs and Corresponding Rational Beliefs

(table 9.1) page 328 (look over chart!)

Social, cultural, and spiritual issues

*you're going to disappoint yourself—because as a fallible human being, you will get angry sometimes. *and he believes that his approach is uniquely suited for religious people in that he does not advocate changing their values. He does, however, suggest that the REBT therapist can respect a client's religious beliefs while, at the same time, challenging other beliefs that are causing emotional distress.

seven basic principles of REBT

1. Cognition, not events, are the most important determinant of human emotion. 2. Irrational thinking leads to emotional distress. 3. Distress is best dealt with by addressing irrational thinking. 4. Genetic and environmental factors are antecedents to irrational or rational thinking. 5. Strong emotions are a sign that a problem needs to be addressed. 6. Therapy should focus upon the continued and ongoing self-indoctrination of irrational thinking, not historical influences. 7. Although beliefs can be changed, changing one's beliefs takes work

3 core irrational beliefs

1. I must always be approved of and liked/loved by everyone. 2. You should always treat me well and act the way I think you should. 3. Life should always be fair and just

cognitive disputation

As clients begin to realize that it is not the event causing the feeling or behaviors, but the belief about the event, they are called upon to dispute the irrational beliefs (DIBS) that have been driving their emotional distress and dysfunctional behaviors. they involve helping clients challenge their existing irrational beliefs, and in this process, suggested not to use "Why" questions and, instead, use questions that draw out the reasons

Demands

Demanding that oneself, or another, act in a certain manner. (Irrational Belief: "You better come home early from work tonight, otherwise I'm going to leave you.")

Albert Ellis

Developed "rational emotive behavior therapy" (REBT)

Awfulizing

Exaggerating an event so that it seems horrible, terrible, awful, or catastrophic. (irrational Belief: "It's so horrible, I can't even tell you what happened—okay, my husband abused me—I can't go on!")

Demonstrating Unconditional acceptance

From the moment a client steps into the REBT therapist's office, he or she is seen as a fallible human being; allows the therapist to show unconditional acceptance toward the client, while at the same time recognize the inevitability that as fallible human beings, people will sometimes exhibit behaviors that are toxic for themselves and others. The acceptance of the individual by the therapist allows clients to freely discuss their thoughts, feelings, or behaviors

emotive disputations

In this process, clients are asked to close their eyes and focus intensely on the situation that is causing them extreme emotional upset. When the client experiences the emotional upset, he or she signals the therapist, often by lifting a prearranged finger then therapist asks client to change the self defeating emotion to an appropriate emotion. Afterwards, the therapist asks the client what he or she was able to do to change the feeling

Irrational belief (B)

Irrational beliefs 1, 3, 4, and/or Irrational core beliefs 1, 2, and 3

activating event (A)

My lover has left me. Cognitive self-statement: I can't believe she left me. I feel like I have a hole in my heart. My life is nothing without her.

demonstrating the abc's of feeling

REBT therapist will use the "ABCs" to demonstrate to clients how their irrational beliefs, not their situations, are causing emotional distress.

key concepts

Some of the key concepts that are the underpinnings of rational emotive behavior therapy include philosophical conditioning, unconditional acceptance, cognitive distortions, irrational and rational beliefs, ABCDEs of feelings and behaviors, and using a rational, scientific approach of REBT.

therapeutic techniques

Some of the major techniques in this process include demonstrating unconditional acceptance; teaching the REBT philosophy; being active and directive; challenging clients; demonstrating the ABC's of feeling and behaving; encouraging the disputing of dysfunctional cognition's, behaviors, and emotions; using humor; using metaphors and stories; and giving homework.

People-rating (damning oneself and others)

Viewing a person as if he or she has all or none of a quality (good, bad, worthless) (Irrational Belief: "I loved that woman, she was perfect. Why did she do this to me?")

I-cant-stand-it-itis

Worrying about an event to the point where it feels unbearable. (Irrational Belief: "I just can't stand those immigrants coming into the country and taking jobs away from us.")

REBT therapists view

an individual's belief system as generally being created early in life, they believe that irrational beliefs that fuel maladaptive ways of living can be changed at any point. Long-winded examination of the past is not necessary, and indeed, says Ellis, could be harmful and inhibit progress toward change

self esteem

an unstable process related to how others see us " one of the worst evils know to man" -Ellis

anti deterministic philosophy

asserts that we can choose new ways of thinking and ultimately feel better and act in healthier ways

cognitive self statements

beliefs that result in negative feelings, are always rooted in one or more of the twelve irrational beliefs or the three core beliefs and are also driven by the cognitive distortions.

Absolutistic musts and shoulds

believing that one must or should act a certain way (irrational belief:"I must be the best parent," or "You are my child and must always be polite'.)

Basis for rebt's view of human nature

believing that we are fallible human beings who have the potential for rational or irrational thinking

fallible

capable of being wrong, mistaken, or inaccurate

self defeating thoughts

catastrophic thinking, perfectionist thinking, desire for complete approval, and the illusion of transparency

step 2: teaching the REBT philosophy

client must understand the broader philosophy of REBT. Therapists need to actively encourage clients to take on this philosophy if they are to make any substantive changes

behavioral disputations

clients are often encouraged to practice behavioral disputations that challenge the irrational beliefs that are responsible for the behaviors(identifying risk taking behaviors and attacking exercise techniques used)

step 3: demonstrating how the clients situation fits the REBT model

clients are ready to hear how the therapist's hypothesis applies to the clients situation. therapist present them with her hypothesis in the ABC formulation. to facilitate this process, a handout that addresses the 12 irrational beliefs or the 3 core irrational beliefs is distributed

step 5

clients become more comfortable with REBT and able to apply it to other aspects/ other problems of life; they develop an incr. acceptance of self and better to accept others in their differences and fallibility; thus client adopts new style of relating to the world and replaces irrational beliefs w/ rational beliefs

philosophical conditioning

each persons philosophy is unique ( ex. values, beliefs, understanding); has a tendency to become habitual, supports either rational or irrational beliefs, and is reinforced and sustained by the individual; can support irrational beliefs that lead to emotional distress and dysfunctional behaviors or rational beliefs that lead to healthy ways of living in the world; Philosophies are nondeterministic

basis for irrational/ rational development

early child rearing practices, family dynamics, societal influences, and innate biology

teaching the rebt philosophy

encouraging them to read books and printed materials that describe REBT, offering them audio and visual aids that speak to the philosophy, and giving them website addresses for sites that explain REBT

step 1: assess clients situation and hypothesize how the ABC's apply

it is the job of the REBT therapist to listen and actively assess the client's situation, understand the client's upsetness, and come up with a hypothesis as to how the client is cognitively distorting events and causing himself or herself distress. Assessment occurs in a number of ways, including the use of standardized tests, biographical data inventories, client self-report, and interviewing

Giving Homework

it would be common for REBT therapists to ask clients to practice, on their own, any of the disputation techniques mentioned or any of a number of other techniques, such as behavioral conditioning, bibliotherapy aimed at reading materials to reinforce new ways of being, expression of feelings, assertiveness training, or role-playing new behaviors. All of these techniques are tried with the intent of maintaining the new, more rational belief system.

philosophical discourse

leads the discussion, asks questions, and attempts to have the client see how his or her thinking process is illogical and leads to emotional distress and dysfunctional behaviors

learning theory and existential- humanistic philosophy

learning theory in the sense that we learned a way of thinking, feeling, and acting that is self-perpetuating, and existential-humanistic, because we can choose to learn new and healthier ways of thinking, feeling, and behaving

irrational thinking

magnification, all-or-nothing thinking, over generalization, minimization-- leads to emotional distress, dysfunctional behaviors, and neurotic ways of living, as well as people who tend to be critical of others and of themselves

socratic dialogue

method to help clients rationally examine their philosophical precepts

Ellis' critics on psychoanalysis

questioned the scientific basis of psychoanalysis and began to shape a new approach that had at its core how neuroses could be explained as conditioned though and behaviors and treated through the use of directive techniques

Unconditional acceptance

rebt asserts that healthy functioning comes through acceptance of self, others and life; not accepting self or others dooms us to a life of despair; critical that rebt therapists do not scold clients, clients are encouraged and taught how to accept themselves and to not rely on others for their self esteem ( different from unconditional positive regard)

cognitive distortions

responsible for irrational thinking; also includes absolutistic musts and shoulds, awfulizing, I-can't-stand-it-itis, demands, and people-ratings ( one or more of the 12 irrational beliefs and or one or more of the 3 core irrational beliefs)

challenging clients

should not be confused with heavy duty confrontation. Challenging occurs when therapists suggest to their clients that they examine their current way of understanding their thinking, feeling, and behavioral processes. Subsequently, if they believe that change would be helpful, clients can choose to adopt more rational beliefs, as well as healthier behaviors and feelings

encouraging the disputing of dysfunctional cognition's, behaviors, and emotions

they are encouraged by the therapist to dispute the unhealthy ones and replace them with healthy ones. Disputations can occur cognitively, behaviorally, or emotionally.

why did Ellis change the name to rational emotive therapy

thinking feelings and behaviors go hand in hand and over the years his approach began to incorporate more behavioral and feeling techniques ( rational therapy-> rational emotive therapy)

step 4: directing the change process

time to actively work on making change. Change can occur on three levels—cognitive, feeling, and behavioral—and often occurs through the use of disputations

Using Humor

to help clients see the ridiculousness of their plight; Pointing out the humor of a situation can help clients see the pointlessness and irony it.

Being active and directive

use of empathy no a critical tool for rebt therapist. basic listening to understand the situation; the REBT therapist will administer assessment techniques, question the client, and encourage the client to talk, as they gather info. from the client to assess how the client distorts; encouraged to practice specific interventions aimed at changing the way he or she thinks, acts, and feels

psycho educational approach (to counseling)

which means that it teaches the individual more effective ways of living in the world and helps the individual learn about his or her psychological self

metaphors and stories

will sometimes be used in an effort to illustrate and reinforce points that the REBT therapist is trying to make