Rational emotive behaviour therapy focuses on uncovering irrational beliefs which may lead to unhealthy negative emotions and replacing them with more productive rational alternatives.
Underlying Theory of Rational Emotive Behaviour Therapy
Rational emotive behaviour therapy (‘REBT’) views human beings as ‘responsibly hedonistic’ in the sense that they strive to remain alive and to achieve some degree of happiness. However, it also holds that humans are prone to adopting irrational beliefs and behaviours which stand in the way of their achieving their goals and purposes. Often, these irrational attitudes or philosophies take the form of extreme or dogmatic ‘musts’, ‘shoulds’, or ‘oughts’; they contrast with rational and flexible desires, wishes, preferences and wants. The presence of extreme philosophies can make all the difference between healthy negative emotions (such as sadness or regret or concern) andunhealthy negative emotions (such as depression or guilt or anxiety). For example, one person’s philosophy after experiencing a loss might take the form: “It is unfortunate that this loss has occurred, although there is no actual reason why it should not have occurred. It is sad that it has happened, but it is not awful, and I can continue to function.” Another’s might take the form: “This absolutely should not have happened, and it is horrific that it did. These circumstances are now intolerable, and I cannot continue to function.” The first person’s response is apt to lead to sadness, while the second person may be well on their way to depression. Most importantly of all, REBT maintains that individuals have it within their power to change their beliefs and philosophies profoundly, and thereby to change radically their state of psychological health.
REBT employs the ‘ABC framework’ — depicted in the figure below — to clarify the relationship between activating events (A); our beliefs about them (B); and the cognitive, emotional or behavioural consequences of our beliefs (C). The ABC model is also used in some renditions of cognitive therapy or cognitive behavioural therapy, where it is also applied to clarify the role of mental activities or predispositions in mediating between experiences and emotional responses.
The figure below shows how the framework distinguishes between the effects of rational beliefs about negative events, which give rise to healthy negative emotions, and the effects of irrational beliefs about negative events, which lead to unhealthy negative emotions.
In addition to the ABC framework, REBT also employs three primary insights:
- While external events are of undoubted influence, psychological disturbance is largely a matter of personal choice in the sense that individuals consciously or unconsciously select both rational beliefs and irrational beliefs at (B) when negative events occur at (A)
- Past history and present life conditions strongly affect the person, but they do not, in and of themselves, disturb the person; rather, it is the individual’s responses which disturb them, and it is again a matter of individual choice whether to maintain the philosophies at (B) which cause disturbance.
- Modifying the philosophies at (B) requires persistence and hard work, but it can be done.
Therapeutic Approach of Rational Emotive Behaviour Therapy
The main purpose of REBT is to help clients to replace absolutist philosophies, full of ‘musts’ and ‘shoulds’, with more flexible ones; part of this includes learning to accept that all human beings (including themselves) are fallible and learning to increase their tolerance for frustration while aiming to achieve their goals. Although emphasizing the same ‘core conditions’ as person-centred counselling — namely, empathy, unconditional positive regard, and counsellor genuineness — in the counselling relationship, REBT views these conditions as neither necessary nor sufficient for therapeutic change to occur.
The basic process of change which REBT attempts to foster begins with the client acknowledging the existence of a problem and identifying any ‘meta-disturbances’ about that problem (i.e., problems about the problem, such as feeling guilty about being depressed). The client then identifies the underlying irrational belief which caused the original problem and comes to understand both why it is irrational and why a rational alternative would be preferable. The client challenges their irrational belief and employs a variety of cognitive, behavioural, emotive and imagery techniques to strengthen their conviction in a rational alternative. (For example, rational emotive imagery, or REI, helps clients practice changing unhealthy negative emotions into healthy ones at (C) while imagining the negative event at (A), as a way of changing their underlying philosophy at (B); this is designed to help clients move from an intellectual insight about which of their beliefs are rational and which irrational to a stronger ‘gut’ instinct about the same.) They identify impediments to progress and overcome them, and they work continuously to consolidate their gains and to prevent relapse.
To further this process, REBT advocates ‘selective eclecticism’, which means that REBT counsellors are encouraged to make use of techniques from other approaches, while still working specifically within the theoretical framework of REBT. In other words, REBT maintains theoretical coherence while pragmatically employing techniques that work.
Throughout, the counsellor may take a very directive role, actively disputing the client’s irrational beliefs, agreeing homework assignments which help the client to overcome their irrational beliefs, and in general ‘pushing’ the client to challenge themselves and to accept the discomfort which may accompany the change process.
Criticisms of Rational Emotive Behaviour Therapy
As one leading proponent of REBT has indicated, REBT is easy to practise poorly, and it is from this that one immediate criticism suggests itself from the perspective of someone who takes a philosophical approach to life anyway: inelegant REBT could be profoundly irritating! The kind of conceptual disputing favoured by REBT could easily meander off track into minutiae relatively far removed from the client’s central concern, and the mental gymnastics required to keep client and therapist on the same track could easily eat up time better spent on more productive activities. The counsellor’s and client’s estimations of relative importance could diverge rather profoundly, particularly if the client’s outlook really does embody significant irrationalities. Having said all that, each of the preceding sentences includes the qualifier ‘could‘, and with a great deal of skill, each pitfall undoubtedly could be avoided.
Perhaps more importantly, it would appear that the need to match therapeutic approach with client preference is even more pressing with REBT than with many others. In other words, it seems very important to adopt the REBT approach only with clients who truly are suitable, as it otherwise risks being strongly counter-productive. On this point, however, it is crucial to realize that some clients specifically do appreciate exactly this kind of approach, and counsellors who are unable or unwilling to provide the disputation required are probably not right for those clients.
Best Fit With Clients
REBT is much less empirically supported than some other approaches: the requisite studies simply have not been completed yet, and the relevant data points for determining the best match with clients are therefore thin on the ground. However, one may envision clients responding particularly well who are both willing and able to conceptualise their problems within the ABC framework, and who are committed to active participation in the process of identifying and changing irrational beliefs (including performing homework assignments in support of the latter). Clients will also need to be able to work collaboratively with a counsellor who will challenge and dispute with them directly, and a scientific and at least somewhat logical outlook would seem a pre-requisite. REBT would be less suitable for clients who do not meet one or more of the above. And as hinted above in the section on Criticims, one might also speculate that clients who are already highly skilled in philosophical engagement could find the approach less useful. (Perhaps REBT-style self help could be of more benefit for such clients?)