Psychological Therapies 603can be changed, behavior change can result from cognitive change (Dobson & Block,
1988). Cognitive-behavioral therapists may also use any of the tools that behavioral
therapists use to help clients alter their actions. The three basic goals of any cogni-
tive-behavioral therapy follow.
- Relieve the symptoms and help clients resolve the problems.
- Help clients develop strategies that can be used to cope with future problems.
- Help clients change the way they think from irrational, self-defeating thoughts to
more rational, self-helping, positive thoughts.
ELLIS AND RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT) Albert Ellis proposed a
version of CBT called rational emotive behavior therapy (REBT), in which clients are
taught a way to challenge their own irrational beliefs with more rational, helpful state-
ments (Ellis, 1997, 1998). Here are some examples of irrational beliefs:
- Everyone should love and approve of me (if they don’t, I am awful and unlovable).
- When things do not go the way I wanted and planned, it is terrible, and I am, of
course, going to get very disturbed. I can’t stand it!
But I’ve felt that way at times. Why are these statements so
irrational?Notice that these statements have one thing in common: It’s either all or nothing.
Can a person really expect the love and affection of every single person? Is it realistic to
expect things to work as planned every time? Rational emotive behavioral therapy is
about challenging these types of “my way or nothing” statements, helping people real-
ize that life can be good without being “perfect.” In REBT, therapists take a very direc-
tive role, challenging the client when the client makes statements like those listed earlier,
assigning homework, using behavioral techniques to modify behavior, and arguing with
clients about the rationality of their statements.
EVALUATION OF COGNITIVE AND COGNITIVE-BEHAVIORAL THERAPIES Cognitive
and cognitive-behavioral therapies are less expensive than the typical insight therapy
because they are comparatively short-term therapies. As in behavior therapy, clients
do not have to dig too deep for the hidden sources of their problems. Instead, cogni-
tive-based therapies get right to the problems themselves, helping clients deal with
their symptoms more directly. In fact, one of the criticisms of these therapies as well as
behavior therapies is that they treat the symptom, not the cause. However, it should be
noted that in the cognitive viewpoint, the maladaptive thoughts are seen as the cause
of the problems, not merely the symptoms. There is also an element of potential bias
because of the therapist’s opinions as to which thoughts are rational and which are not
(Westen, 2005).
Nevertheless, cognitive and cognitive-behavioral therapies have considerable
success in treating many types of disorders, including insomnia, depression, stress
disorders, eating disorders, anxiety disorders, personality disorders, and even—in
addition to other forms of therapy—some types of schizophrenia (Barlow et al., 2007;
Beck, 2007; Clark et al., 1989, 2009; DeRubeis et al., 1999; Holcomb, 1986; Jay & Elliot,
1990; Kendall, 1983; Kendall et al., 2008; McGinn, 2000; Meichenbaum, 1996; Mueser
et al., 2008; Resick et al., 2008; Savard et al., 2014; Trauer et al., 2015; Turk et al., 2008;
Yo u n g e t a l. , 2 0 0 8 ). A s a n o ff s h o o t o f b e h a v i o r i s m , t h e l e a r n i n g p r i n c i p l e s t h a t a re t h e
basis of cognitive-behavioral therapies are considered empirically sound (Barlow et al.,
2007; Masters et al., 1987). For a summary of the various types of psychotherapies dis-
cussed up to this point, see Table 15.2.
rational emotive behavior therapy
(REBT)
cognitive-behavioral therapy in which
clients are directly challenged in
their irrational beliefs and helped to
restructure their thinking into more
rational belief statements.