What is Rational Emotive Behavior Therapy (REBT)?

Although REBT is considered under the umbrella of CBT, Ellis was considered the pioneer of CBT, influential to Beck.

This therapy was originally called rational therapy until it went on to include emotion and behavior, taking into account these other fundamental components of the therapy.

REBT was developed as a departure from psychoanalysis, probably the most popular therapy at the time. Psychoanalysis was thought to be useful for making people feel better after getting everything off their chests.

However, Ellis questioned whether psychoanalysis actually helped people deal with the root cause of their problems or helped them feel better at all in the long term.

REBT is an action-oriented approach focused on helping people deal with their irrational beliefs and learn how to manage their emotions, thoughts, and behaviors in a healthier and more realistic way.

Ellis believed that humans are naturally goal-directed, but they are also self-defeating and irrational. He believed that most people are unaware that many of their thoughts about themselves are irrational and negatively affect how they behave in relationships and situations.

According to Ellis, these thoughts can result in people suffering negative emotions and engaging in self-destructive behaviors.

Ultimately, REBT recognizes that our cognition, emotions, and behavior are all connected, interacting and influencing each other.

To understand behavior during situations, it’s essential to look at the beliefs people hold about these situations and the emotions that arise from those beliefs.

REBT is a short-term form of therapy that involves different types of techniques to challenge irrational beliefs and replace them with healthier, more productive ones.

REBT focuses mostly on the present to help someone understand how their perceptions of situations can cause emotional distress, leading to unhealthy actions and behaviors that interfere with their life goals.

Once identified and understood and changed to more rational thoughts, this can help people to develop better relationships and approaches to situations and events.

REBT can be particularly helpful for people living with a variety of issues, but especially those experiencing the following:

• Depression

• Anxiety

• Addictive behaviors

• Phobias

• Procrastination

• Disorder eating habits

• Sleep problems

• Overwhelming feelings of anger, guilt, shame, or rage.

Core principles of REBT

A core concept of REBT is the ABC model. This model explains how, while we may blame external events for our unhappiness, our perception of these events lies at the heart of psychological distress.

REBT is grounded in the idea that people generally want to do well and reach their goals.

However, sometimes irrational thoughts and feelings get in the way of these goals. These beliefs are thought to influence how an individual perceives circumstances and events.

The ABC model is as follows:

• A – Activating – the activating event is when something happens in the environment that triggers a negative reaction or response.

• B – Belief – this describes the thoughts about the triggering event or situation, usually irrational thoughts about the activating event.

• C – Consequence – this is the emotional response to the belief, usually distressing emotions resulting from irrational thoughts or beliefs.

An example to illustrate this is to imagine a student who believes they must be perfect in everything they do. The activating event could be that they fail to get the top grade in an exam at school.

The triggered beliefs about this activating event could result in irrational thoughts such as ‘I am a failure,’ ‘I should feel ashamed,’ or ‘I must do better.’

The consequences of these thoughts are that the student feels shame and guilt for not being perfectly competent in what they do, they may get upset and cry, or put unnecessary stress on themselves to work even harder next time to avoid feeling this way again.

Holding irrational beliefs can make it almost impossible to respond to activating situations in a healthy way.

For instance, individuals possessing rigid expectations of themselves and others may frequently experience disappointment, regret, and anxiety.

In REBT, people are helped to distinguish between healthy negative feelings of concern and unhealthy feelings of anxiety.

Healthy negative feelings may help during times of adversity, or someone may realize they cannot do anything about the situation and learn to move on.

With anxiety, individuals tend to engage in self-defeating behavior and have unhealthy attitudes that are rigid or extreme. REBT suggests that the attitudes brought to the aversive situation largely influence whether someone will feel unhealthy negative feelings.

With rigid attitudes to adversity, such as using statements that use must, absolutely should, have to, and need to, an individual is more likely to experience extreme negative emotional consequences.

REBT encourages people to realize that they have a choice in their emotions and to take accountability for their beliefs. The therapy will also encourage the use of language that is useful.

For instance, the student from the example could say, ‘I made myself anxious about not getting the top grade. And if I can make myself anxious, then I can choose to no longer make myself anxious.’

Individuals are therefore turning away from blaming adversity for their disturbing emotions and realizing that their own thoughts and beliefs made them feel these emotions.

Techniques

During REBT, the therapist will help the client learn how to apply the ABC model to their daily lives. They would work with the individual to change those beliefs and their emotional response to situations.

An important step in this process is recognizing the underlying beliefs that lead to psychological distress. In many cases, these come as absolutes such as ‘I must,’ ‘I should,’ and ‘I can’t’ statements.

The therapist will usually discourage people from using these statements as they are unhelpful and irrational.

Problem-solving

Problem-solving is intended to help the person address the A in the ABC model.

This involves addressing the activating event or adversity head-on. Some common problem-solving methods include:

• Teaching assertiveness

• Learning social skills

• Learning decision-making skills

• Learning conflict resolution skills

Cognitive restructuring

Cognitive restructuring focuses on helping the person to change their irrational beliefs with techniques such as:

• Disputing irrational beliefs

• Reframing

• Rationalizing techniques

• Guided imagery and visualization

• Using humor

• Exposing yourself to the fear

Coping techniques

Coping techniques are taught to be learned in situations where the person cannot change the event or is struggling even though they are using rational thinking. Some coping techniques include:

• Relaxation

• Hypnosis

• Meditation

• Mindfulness

• Breathing exercises

Acceptance

The therapist will usually teach their clients three forms of acceptance:

• Unconditional self-acceptance – this is where the person recognizes that they have good and bad points – they are flawed, but this doesn’t make them any less worthy than another person.

• Unconditional other-acceptance – this is where the person recognizes that some people won’t treat them fairly, and there is no reason why everyone should treat them fairly. Although others will not treat them fairly, these people are no less worthy than any other person.

• Unconditional life-acceptance – this is where the person recognizes that life is not always going to go the way they want, and there is no reason why it must go the way they want. They learn to accept that they may experience some unpleasant things in life, but life itself is never awful and is usually always bearable.

REBT Activities

Imagining the worst

Often, people will catastrophize situations, meaning that they use worst-case thinking. Catastrophizing is a common cognitive distortion where people fear the uncertainty of potential negative events despite a lack of objective evidence to support this.

REBT therapists can encourage clients to imagine the worst-case scenario when attempting to avoid thinking about it for fear of becoming more anxious. Utilizing the worst-case scenario can help the client realize the following:

• The worst-case scenario is unrealistic and, therefore, unlikely to happen.

• Even if it did occur, the worst-case will probably still be tolerable.

• If the worst does happen, they would still be able to manage the outcomes and prevent them from becoming catastrophic.

Blown out of all proportion

This activity involves the use of imagery and humor to tackle irrational thoughts. The therapist will ask the client to imagine the thing they fear the most actually happening.

However, instead of encouraging them to visualize this realistically, the therapist will ask them to visualize it to an extreme level.

When their worst fears become exaggerated, they can become humorous. The idea is that laughing at blown-up fears will help the client get more control over them.

Disputing irrational beliefs (DIBS)

DIBS is one of the most popular cognitive restructuring techniques in which the therapist questions the client’s beliefs head-on, causing them to rethink them, or they could ask the client to imagine another point of view that they may not have considered before.

Rather than the therapist being warm and supportive all the time, Ellis suggests that therapists should sometimes be blunt and honest to push people toward challenging their thoughts.

Disputing is a skill that can be learned in the long term to help people to manage their emotional responses and limit some of their harmful beliefs.

A DIBS activity may include writing down a core belief someone holds, then considering the following:

• Are there any objective facts to support this belief?

• What proof is there that this belief is true/false?

• What is the worst outcome that could occur?

Ellis recommended recording the irrational belief and then writing several statements to dispute this, so the person can see more evidence suggesting their belief is false rather than true.

As well as the work and activities completed in therapy sessions, the therapist will likely give work to do at home between sessions so that the individual can apply the skills they have learned in sessions to their daily life.

Effectiveness

Research suggests that REBT is effective at reducing irrational beliefs and changing behavior.

There is a wide range of applications for REBT.

In practice, REBT has been applied to various domains, such as clinical psychology, education, organizational settings, and counseling. Since it is focused on education and taking action, it can be effective for various situations and mental health conditions.

Many studies have shown the positive effects of this therapy, supporting REBT as a validated method to change negative responses and lead people to a happier life.

Mental health

REBT is generally accepted as an effective type of therapy, finding it can help with conditions such as depression, anxiety, obsessive-compulsive disorder, and disruptive behavior.

The positive effects of REBT also appear to last even after therapy has ended. REBT was also found to be as effective as cognitive therapy and medication for the treatment of depression, with REBT being more effective than medication after six months (David et al., 2008).

Another study found that REBT group counseling reduced school students’ anxiety compared to regular group counseling (Misdeni et al., 2019).

Ellis suggested that during the group REBT approach, members are taught to detect each other and refute irrational beliefs.

Burnout at school and work

REBT may be effective for reducing symptoms of burnout for students and has been shown to continue to work even months after therapy concluded.

Group REBT has also been shown to reduce job-related stress and burnout while increasing job satisfaction and commitment.

Sports

REBT has become popular as a treatment option for athletes who are experiencing mental health issues. This may be because many athletes may have rigid beliefs that they need to be the best in their sport.

REBT can be used to restore and maintain their mental health, helping them learn how to change their sometimes-unhelpful outlook and manage their emotions.

Although this therapy can improve an athlete’s performance, the goal of REBT in sports psychology is to care for their mental well-being first and foremost. Overall, REBT has been shown to decrease irrational beliefs and reduce anxiety for athletes.

Alcohol and drug addiction

In 2010, up to 18% of drug and alcohol treatment centers in the United States were using REBT as their main treatment.

This type of therapy aims to facilitate sobriety and return to health and happiness by returning and/or lessening irrational thoughts and negative emotions that lead to addictive behaviors.

REBT has been shown to work quite effectively for people with these addictions.

The therapy works to change the way these individuals think about situations, have more positive emotional reactions, and alter the way they act.

REBT vs. CBT

There is some debate about the relationship between REBT and CBT. Some see REBT as a type of CBT, while others argue they are very distinct approaches.

REBT is thought of as the original form of CBT and inspired Aaron Beck to develop his idea of cognitive therapy, which may be why the therapies have some overlaps and are based on similar principles.

Both approaches recognize that harmful and irrational thinking patterns can cause emotional suffering. REBT and CBT help people identify these unhelpful thoughts and then help to change them.

These therapies also maintain the understanding that our thoughts, feelings, and behaviors are all connected and influence each other.

REBT is based on the theory that emotional disturbances such as shame, guilt, depression, and anxiety are largely self-constructed by a person’s thoughts and belief systems.

It seeks to address this self-defeated thinking. CBT works on looking at automatic thoughts that have been learned and become fixed during childhood and since becoming dysfunctional patterns, then seeks to undo these automatic thoughts.

REBT is highly philosophical in that it addresses the philosophic basis of emotional disturbance and teaches unconditional self-acceptance as its solution to low self-esteem.

Acceptance involves avoiding self-judgment and recognizing that humans can and will make mistakes. CBT is more concrete in comparison and focuses on other people accepting them rather than unconditional self-acceptance. CBT also focuses on reinforcing positive qualities to boost self-esteem.

This approach from CBT could have some potential pitfalls, including lower self-esteem when the person does poorly or makes comparisons to others.

These therapies have different views on anger. While CBT views some anger as healthy and appropriate depending on the situation, REBT maintains that all anger has a commanding and condemning core.

REBT teaches people effective assertiveness and problem-solving when it comes to anger. Although CBT also teaches assertiveness, it fails to uproot the philosophic root of anger.

The REBT therapist may use humor as a therapeutic tool which CBT may not. The REBT therapist may also be more confrontational with their client. A CBT therapist is directive but not as much as REBT, coming across as politer.

Finally, CBT is a more popular approach, has more research supporting it, and is shown to be effective for many disorders. REBT also has some research that supports it and has shown to be similarly effective, but not as much as CBT.

When deciding which therapy to choose, it may depend on the individual’s preferred approach, their specific problems, and what they hope to gain from therapy.

How to seek REBT

If you feel that REBT may be the right therapy for you, it is useful to begin by checking with your doctor for any recommendations from local therapists or mental health professionals who offer this approach.

It can be helpful to take notes of specific things that you would like to address in therapy, such as considering if there are any specific traits you look for in a therapist.

Try to look for a licensed mental health professional with training in REBT and CBT if possible. It is important to find someone you are comfortable with, so do not be discouraged if you find that the first therapist you begin sessions with is not a good fit.

You may find that you need a few sessions to see if they are a good fit, but some people may also need to see a few therapists before they find the right one.

What to expect

During your first therapy session, the therapist will likely discuss your goals and the activating event/s which prompted you to seek treatment, so it will be helpful to come prepared with what you want help with.

The therapist may also want to delve into the REBT techniques right away – this form is very active and focused, so the therapist is not likely to spend lots of time on casual conversation.

REBT is a relatively short-term treatment, with most people only requiring 10-20 sessions to accomplish their treatment goals.

It is important to stick to the treatment plan and consider if this is something you can commit to and make time for since missing sessions can make it harder to overcome your problems.

REBT is very action-orientated, and you will likely be set homework assignments to complete between sessions to allow you to practice what you have learned. It is important to complete the homework set by the therapist to gain as much as possible from the therapy.

REBT is not a passive process; you will have to take responsibility for your own treatment.

You will likely have to step outside of your comfort zone to get the benefits of this therapy. For some people, having the therapist dispute, their thoughts can feel confrontational or aggressive.

Facing these irrational beliefs can be difficult for some as it may not be easy to accept that these beliefs are unhealthy. Changing these thoughts can be even more challenging as it may involve learning to let go of long-held beliefs.

Therefore, it is important to go into REBT with an open mind and be willing to try new ways of thinking and different behaviors. The willingness to do this can impact how beneficial REBT is for you.

References

David, D., Szentagotai, A., Lupu, V., & Cosman, D. (2008). Rational emotive behavior therapy, cognitive therapy, and medication in the treatment of major depressive disorder: a randomized clinical trial, posttreatment outcomes, and six‐month follow‐up. Journal of clinical psychology, 64(6), 728-746.

Marsinun, R. (2016). The effectiveness of Rational Emotive Behavior (REB) counseling to reduce anxiety in facing student exams at SMPN 150 Jakarta. In Proceedings of the National Seminar Series (pp. 306-327).

Misdeni, M., Syahniar, S., & Marjohan, M. (2019). The effectiveness of rational emotive behavior therapy approach using a group setting to overcome anxiety of students facing examinations. International Journal of Research in Counseling and Education, 3(2), 82-88.