Mario De La Garza, M.Ed. University of North Texas Theoretical Models of Counseling and Psychotherapy, 3rd Edition Chapter 10: Rational Emotive Behavior Therapy Mario De La Garza, M.Ed. University of North Texas

Albert Ellis The oldest of three children Struggled with serious kidney problems Father was physically absent; Mother was emotionally absent Figured out a way to survive on his own Trained as a psychoanalyst, but found it’s passive approach incongruent with his views Died in 2007

Development of Theory Ellis found passive style of analysis to have little effect on belief system of clients. Ellis formulated a personality change process using direct confrontation modeled after his experiments and experiences. RT → RET → REBT

Philosophical Underpinnings Epistemology – branch of philosophy studying the nature of knowledge and asking the question, “How do we know what we know?” Knowledge based on individuals’ selective interpretations How a person perceives events and people will affect how that person thinks/feels/behaves. Epictetus: “Humans are disturbed not by things, but by the views they take of things.”

Philosophical Underpinnings Relativism: no absolute truth or reality exists Dialectics: the role of logical thought and human reason in the acquisition of knowledge Consider all evidence before coming to a conclusion Responsible hedonism: the creation of short- and long-term goals to maximize pleasure potential

Philosophical Underpinnings Humanism: appreciating the individuality, creativity, and autonomy of a person People have innate worth. Dysfunction arises when this worth is not valued (self-criticism and comparing).

Function of the Psyche Humans innately want to survive, feel pleasure, and attain self-actualization. Humans are largely influenced by two innate tendencies: The overwhelming tendency to think and behave irrationally The tendency to think rationally and dispute irrational thoughts

Structure of the Psyche Ellis’s ABC model: a universal processing system Activating event or experience (A) Beliefs about A (B) Emotional/Behavioral /Cognitivre consequence (C) Most people believe A causes C. Actually, one’s beliefs (B) about A cause C.

Role of the Environment Biology and the environment interact to create psychological disturbance. Neither biology nor the environment is absolutely causative. A person’s unique perception and experience will also influence psychological functioning.

Healthy Functioning Rational thinking = Healthy Rational people exhibit: Flexibility A willingness to make mistakes and learn The ability to base interpretations and conclusions on realistic data

Healthy Functioning You are free; define yourself. Live in dialogue with your fellow human beings. Your own experience is the highest authority. Be fully present in the immediacy of the moment. There is no truth except action. You must learn to accept certain limits in life.

Unhealthy Functioning Irrational thinking = Unhealthy - Demands: Dogmatic beliefs about self, others, and the world, “I must be liked by others”. - Awfulizing Beliefs: Rigid and intense consequences that flow from dogmatic demands, “I must be liked by others and if I am not, then I am a total failure”. - Low frustration tolerance beliefs: Occur when people insist that life be less frustrating, “I must be liked by others and I can’t stand it when I am not”.

Unhealthy Functioning - Depreciation beliefs: Flow from demands about self, others and the world and demean the whole based on one failure, “I must be liked by others and if I am not, then I am a complete loser”.

Client’s Role Acknowledge the problem Identify and overcome secondary disturbance Identify the irrational beliefs that underpin primary problem Understand why the irrational beliefs are irrational Understand why rational beliefs would be more realistic and have better outcomes

Client’s Role 6. Challenge irrational belief(s) and strengthen rational alternative. 7. Learn cognitive, emotional, and behavioral techniques to strengthen rational conviction. 8. Identify and overcome obstacles to change. 10. Keep working against tendency to think and act irrationally.

Counselor’s Role Provide unconditional acceptance. Be active and directive in disputing irrational beliefs (of client and of self). Have a good sense of humor. Be willing to take risks. Accept oneself as imperfect. Be present-focused.

Stages Beginning Stage Middle Stage Ending Stage Build rapport. Teach client basics of REBT. Middle Stage Client uses ABC model to dispute irrational beliefs. Ending Stage Resolution of presenting problems Client demonstrates ability to continue to use REBT to dispute irrational beliefs and solve other problems.

Techniques Cognitive Techniques Emotive Techniques Rational self-statements Becoming an REBT teacher Semantic precision Emotive Techniques Imagery Humor Shame-attacking exercises Behavioral Techniques Activity-oriented homework

Interface with Recent Developments in Mental Health Nature/Nurture Ellis posited an interactive role of biology and environment in determining psychological functioning DSM 5 Diagnosis Emphasis is not on diagnosis but on disputing irrational beliefs Open to using it for business purposes (ie insurance) Pharmacotherapy REBT therapists support using medication as adjunct to psychotherapy.

Interface with Recent Developments in Mental Health Managed Care and Brief Therapy Well suited for brief therapy Diagnosis not clinically relevant but pragmatically necessary in this age of managed care REBT most helpful with single-issue clients Technical Eclecticism REBT practitioners can use a wide array of techniques from various schools of thought—as long as these techniques help people think more rationally.

Interface with Recent Developments in Mental Health Diversity Issues REBT supports flexibility in thinking and attitudes about self and others. Gender role work Ellis believed people are born bisexual and have the ability to enjoy sex with any partner. Spirituality Ellis’s view of religion as irrational changed over time. Religious/spiritual philosophies and REBT have been found to have commonalities. Effectiveness of psychotherapy Research supports REBT as an effective mode of change.

Limitations Because of some clients’ personalities or cultures, they dislike some aspects of the counselor’s role: Little empathic focus on emotions Confrontational and disputational Can seem more argumentative than understanding/caring/supportive

Contributions Refinement of Adler’s work into a more present-oriented and focused approach ABC model Ellis’s forceful personality

References Fall, K. A., Holden, J. M., & Marquis, A. (2016). Theoretical models of counseling and psychotherapy (3rd ed.). New York, NY: Routledge.