Abnormal Psychology

128 CHAPTER 4

Rational-emotive behavior therapy (REBT)
The form of treatment in which a patient’s
irrational thoughts are transformed into
rational ones, which in turn leads to more
positive emotions and adaptive behaviors.

Methods of Cognitive Therapy

The two pioneers in the fi eld of cognitive therapy are Albert Ellis and Aaron Beck

(see Chapters 1 and 2). Although there are some differences between the specifi c

methods these men proposed, they both placed importance on working with patients

to identify and challenge irrational and illogical thoughts and on giving patients

between-session homework.

Ellis’s Rational Emotive Behavior Therapy

To help people counter their irrational, destructive thoughts with rational ones, Ellis

developedrational-emotive therapy, in which the therapist challenges the patient’s

irrational thoughts in detail and then encourages the patient to cultivate more realistic

thoughts (Hollon & Beck, 1994, 2004). Over the years, however, Ellis incorporated

behavioral techniques into his therapy. His treatment is now referred to as rational-

emotive behavior therapy (REBT), in which a patient’s irrational thoughts are trans-

formed into rational ones, which in turn leads to more positive emotions and adaptive

behaviors. At the same time, the REBT therapist tries to promote self-acceptance,

so the patient comes to learn that shortcomings, errors, and failures are simply part

of life rather than crimes or evidence of moral weakness. Thus, this therapy also is

designed to reduce self-blame (based on faulty beliefs), which is viewed as getting in

the way of rational thinking.

The REBT therapist accomplishes these goals by systematically proceeding

through a sequence of observational and interventional steps that can be labeled A,

B, C, D, E, and F. As shown in Figure 4.3, the series is as follows: (A) An activating

event triggers (B) the patient’s belief, which leads to (C) a highly charged emotional

consequence. (Note that the event itself does not lead to the consequence; the process

ABCDEF

ABCDEF

Feeling

lonely, which

leads Leon to

wish that he

could talk to

people

Activating

event

Belief Consequence Dispute Effect Further action

ABCDEF Procedure

ABCDEF Procedure Applied to Leon

“If I talked to

people, they’d

laugh at me or

I’d embarrass

myself and it

would be

intolerable.”

Leon and his

therapist may

need to repeat

steps A– E if

Leon doesn’t

feel

significantly

better or

change his

problematic

behavior.

Becomes

anxious,

hopeless, and

depressed

Leon and his

therapist refute

the irrational

beliefs and

develop more

realistic ones

(e.g., “People

might

occasionally

laugh at me,

but that doesn’t

mean they don’t

like or respect

me. I would

be able to

tolerate it.”)

Leon should

feel at least

somewhat

less anxious

about talking

to people and

less hopeless

about his

situation.

Figure 4.3

4.3 • The ABCDEF Procedure of Rational Emotive Behavior Therapy Rational emotive behavior

therapy helps patients systematically become aware of and challenge their irrational thoughts. As patients

dispute such thoughts, develop more realistic ones, and come to accept themselves more, their symptoms—such

as feeling depressed—should lessen.