REBT A Therapists Guide (Notes) Ellis credits Epictetus: People are disturbed not by things but by the views

s they take of them. 10 When people are confronted with Adversity (A), it is largely their Beliefs (B), specifically irrational beliefs, that lead to disturbed Consequences (C). 10 Rational means that which helps people to achieve their basic goals and purposes. Irrational beliefs are those that interfere with goals. 19 [R]ational also means helping the group to survive and to achieve its basic goals . . .. 19 (REBT recognizes the importance of belonging to a social group.) Cognition, emotion, and behavior are intrinsically integrated and holistic, (3) and when people disturb themselves, their cognitions, emotions, and behaviors interactionally make them upset. 26 When people are disturbed, they think-feel-act in a dysfunctional, self-defeating manner, and when they undisturb themselves they almost invariably change some of their cognitions, change their emotional reactions, and change their activities. 3 The research supporting the effectiveness of REBT is strong. 6 & 7 REBT is rooted in the following postmodern ideas: 1. 2. 3. 4. We dont have any absolute certainty about reality. Our views about good and bad, right and wrong, are constructions. Human personality has large relational and social influences. People are influenced by their cultures, and there is no evidence that some cultures are better than others. 5. We have no absolute way of knowing which goals and purposes are better or worse. 14 & 15 People have a natural ability to change themselves, but REBT actively-directively tries to help them do so in collaboration with an involved therapist. 16 REBT is about helping people make profound philosophical changes. 16 REBT integrates some aspects of many therapeutic theories, and eclectically uses specific techniques from many sources . . .. 6 REBT emphasizes working flexibly and adaptively. Almost all feelings are natural, (20) but some are healthier than others. Healthy negative feelings tend to produce self-helping and community-helping actions. 21

REBT encourages striving toward success but not converting the striving to absolutistic demands. 21 [P]eople innately and by social teaching develop into rational and irrational thinkers. 22 REBT emphasizes cognitions because: 1. 2. 3. 4. Irrational beliefs are often easily accessible. Core irrational beliefs often affect several dysfunctions. Changing a core irrational belief can often change several dysfunctions. Making a profound philosophical change can make a person less susceptible to future disturbances. 5. Cognitive changes can sometimes be understood quickly. 26 People choose their beliefs based on the strength of their desires. 28 Common core irrational beliefs include: 1. 2. 3. 4. absolutistic musts and shoulds awfulizing I-cant-stand-it-it is Damning oneself and others

Core beliefs are also related to overgeneralizations, especially related to is. 29 Core beliefs influence each other. 29 Cognitions maintain dysfunctions, sometimes because people have irrational beliefs about their symptoms. 31 Three main irrational beliefs are: 1. I absolutely must under all conditions do important tasks well and be approved by significant others or else I am an inadequate and unlovable person. 2. Other people absolutely must under all conditions treat me fairly and justly or else they are rotten and damnable persons. 3. Conditions under which I live absolutely must always be the way I want them to be, give me almost immediate gratification, and not require me to work too hard to change or improve them; or else it is awful, I cant stand them, and it is impossible for me to be happy at all! Believing that Adversities directly cause Consequences is a common irrational belief. 36

Three main insights are likely to help clients: 1. Adversities often contribute to consequences, but so do beliefs. 2. Although disturbed consequences often originated in childhood and adolescence, it is the continued irrational beliefs that maintain the disturbance. 3. Changing dysfunctional consequences takes work and practice. 38 REBT is about helping people get better, not just to feel better. 38 REBT promotes active-directive therapy. Active-directive therapy often helps people change because: 1. 2. 3. 4. 5. 6. they may be biologically prone to be disturbed they may have low frustration tolerance they may view change as dangerous because it takes away their excuses they may prefer to interact with a caring therapist than to get better they may be hostiles to others who are pushing them to change they may not agree with a therapeutic approach

There are cautions for being too directive: 1. 2. 3. 4. Be aware of the limitations of the techniques you use. Monitor clients reactions and be prepared to change techniques. Have many methods available. Give unconditional acceptance and show clients how to give it to themselves. 46

Assessment starts with identifying consequences, then identifying adversities, and then identifying irrational beliefs. Before beginning interventions, make sure clients understand the ABC model and they understand that they are primarily responsible for their own reactions to life events. 58 Disputing irrational beliefs is the primary method of REBT. There are different kinds of disputations: 1. Functional disputes questioning whether the belief helps accomplish desired goals. 2. Empirical disputes questioning whether the facts are accurate. 3. Logical disputes questioning the logic of thinking processes. 4. Philosophical disputes (Which is not philosophical I the technical sense) questioning whether despite dissatisfactions if some pleasure can be derived from life anyway.

Making rational coping statements is the next step after disputing the irrational beliefs. The deeper and more profound the statements, the more helpful they are likely to be. 67 Other techniques include: 1. Modeling - asking a client to emulate someone who demonstrates the desired behavior. 2. Referenting cost benefit analysis of the behavior 3. Cognitive homework e.g. identifying and disputing irrational beliefs 4. Bibliotherapy and psychoeducational assignments books, lectures, groups 5. Proselytizing sharing the approach with others 6. Recording sessions allows clients to review ideas they may have missed and to reinforce other ideas. 7. Reframing viewing a problem from a different perspective, which gives it a different meaning. 8. Stop and monitor establish cues to stop and notice thought processes throughout the day. REBT also includes emotional techniques: 1. Rational emotive imagery 2. Forceful coping statements 3. Forceful taped disputing 4. Role playing 5. Reverse role playing 6. Humor (includes Elliss songs) 7. Unconditional acceptance by the therapist 8. Teaching unconditional self-acceptance and unconditional other acceptance 9. Encouragement 10. Encounter exercises REBT includes behavioral techniques: 1. 2. 3. 4. 5. 6. 7. 8. 9. reinforcements penalties shame-attacking exercises skill training paradoxical homework relapse prevention in vivo desensitization staying in difficult situations acting on rational beliefs