Nine Experts Describe the Essence of Rational-Emotive Therapy While Standing on One Foot

The purpose of this study was to determine the extent of agreement among a panel of rational-emotive therapy (RET) experts about the essence of RET. The panel of experts consisted of the 9 members of The International Training Standards and Review Committee of the Institute for Rational-Emotive Therapy in New York. The question that the experts were asked was an adaptation of a Talmudic story known in Jewish lore as “While Standing on One Foot.” Responses were assigned to either of 2 categories: general cognitive behavior therapy (CBT) or RET-specific. There seems to be a range of responses that capture the essence of RET. A strong case can be made for subsuming many aspects of CBT under RET because much of what is associated with CBT has its origins in RET. The confusion about where RET ends and general CBT begins goes to the very heart of RET's status today.     

Group rational-emotive and cognitive-behavioral therapy.

The theory of rational-emotive therapy (RET) and of cognitive-behavioral therapy (CBT) is briefly explained and is applied to group therapy. It is shown how RET and CBT therapy groups deal with transference, countertransference, levels of group intervention, process versus content orientation, identifying underlying group process themes, here-and-now activation, working with difficult group members, activity levels of therapist and group members, and other group problems. Although they particularly concentrate on people's tendencies to construct and create their own "emotional" difficulties, RET and CBT group procedures fully acknowledge the interactions of human thoughts, feelings, and actions and active-directively employ a variety of cognitive, emotive, and behavioral group therapy techniques.     

NINE EXPERTS DESCRIBE THE ESSENCE OF RATIONAL-EMOTIVE THERAPY WHILE STANDING ON ONE FOOT

The purpose of this study was to determine the extent of agreement among a panel of rational-emotive therapy (RET) experts about the essence of RET. The panel of experts consisted of the 9 members of The International Training Standards and Review Committee of the Institute for Rational-Emotive Therapy in New York. The question that the experts were asked was an adaptation of a Talmudic story known in Jewish lore as “While Standing on One Foot.” Responses were assigned to either of 2 categories: general cognitive behavior therapy (CBT) or RET-specific. There seems to be a range of responses that capture the essence of RET. A strong case can be made for subsuming many aspects of CBT under RET because much of what is associated with CBT has its origins in RET. The confusion about where RET ends and general CBT begins goes to the very heart of RET’s status today. Reprinted from Journal of Counseling & Development, March/April 1996, Volume 74. ACA. Reprinted with permission. No further reproduction authorized without written permission from the American Counseling Association. Stephen G. Weinrach, who maintained a private practice in Havertown, Pennsylvania, was a professor of counseling and human relations at Villanova University, Villanova, Pennsylvania, and a Fellow of the Institute for Rational-Emotive Therapy in New York. The author was grateful to Michael Bernard, Raymond DiGiuseppe, Windy Dryden, Albert Ellis, Howard Kassinove, G. Barry Morris, Ann Vernon, and Janet Wolfe for their responses on which this article was based. The author expressed particular appreciation to Martin Gerstein, Jeffrey K. Messing, Ellen Finkelstein, Joanne Christopher, and Colleen Deeter, who provided valuable editorial assistance. Raymond DiGiuseppe and Windy Dryden made the publication of this study possible through their generous assistance and incisive knowledge of rational-emotive therapy.     

Symptom substitution: A rational-emotive perspective

Theorists who endorse the concept of symptom substitution reject treatments of psychopathology that do not address the underlying causes of symptoms. They hypothesize that such treatments lead to worsening or relapsing of original symptoms, or the substitution of new for old symptoms. In contrast to behavioristic approaches that dispute this hypothesis, Ellis accepts the concept of symptom substitution. Unlike the psychodynamic positions which are credited with the concept, however, rational-emotive therapy (RET) focuses on changing underlying irrational philosophies and beliefs. Symptom substitution is believed to be prevented in RET by teaching clients to dispute irrational thinking in an ongoing way.The author gratefully acknowledges Leonard G. Rorer for his assistance in the preparation of this article.     

Constructing bridges and systemic connections: In brief dynamic therapy

The author outlines how the conceptual framework which underpins cyclical psychodynamics, a branch of relational psychoanalysis, provides an opportunity for a coherent integration of constructivist CBT principles and techniques and family systems theory within a model of brief dynamic therapy. Drawing upon Wachtel’s articulation of a more flexible notion of the internal world and one in which current interpersonal patterns are seen to shape the psyche and internal conflicts, the author goes on to identify ways in which attending to a client’s behaviour and the ways in which affective experience is expressed interpersonally can open the way to an integration of therapeutic features from constructivist CBT and family systems theory. The contribution that coaching a client in the ways in which they behave interpersonally in the context of both family and workplace relationships can make to therapeutic effectiveness is explored. These themes are illustrated with a case study.     

The client-therapist relationship in rational-emotive therapy

In this article, an analysis of rational-emotive therapy (RET) is made with particular attention to the client-therapist relationship as well as to the personal therapeutic style and influence of its founder, Albert Ellis, on patients in therapy. Features of RET and its practice by Albert Ellis which appear to foster the therapist-client relationship include: 1. varying therapy style depending on client characteristics; 2. persistently pointing out client's irrational thoughts as a way of demonstrating therapist's helping efforts; 3. successful completion by client of assigned homework; 4. therapy is focused on current, meaningful problems of client; 5. RET therapists' communication to client's of their own faith in the validity of RET therapy; 6. use by therapist of compliments about client's brightness, competence and likelihood of success in therapy. While RET may not be everybody's cup of tea (e.g., religious individuals), it does appear that the aspects noted above contribute to the fostering of a positive relationship in therapy and can be influential in producing positive outcomes in therapy. The present article is a condensed and updated version of a previously published chapter: Garfield, S.L., The client-therapist relationship in rational-emotive therapy. In M.E. Bernard & R. DiGiuseppe (Eds.),Inside rational-emotive therapy (pp. 113–134). San Francisco, CA: Academic Press.     

Expanding the ABCs of RET

The original ABCs of rational-emotive therapy (RET)—where A stands for the Activating events in people's lives, B for their Beliefs about these events, and C for the emotional and behavioral Consequences or Concomitants of their Beliefs—have proved very popular and therapeutically useful since RET was created in 1955. These ABCs have been expanded over the years by Ellis and other writers on RET. This article presents an up-to-date and more detailed expansion of the ABCs, with special emphasis on expanding the more common rational Beliefs (rBs) and irrational Beliefs (iBs)     

Rational-emotive therapy and the reduction of interpersonal anxiety in junior high school students

This study evaluated the effectiveness of rational-emotive therapy and rational-emotive imagery. Fifty-nine junior high school students who volunteered to participate in treatment for interpersonal anxiety were randomly assigned to rational-emotive therapy without imagery (RET), rational-emotive therapy with imagery (REI), relationship-oriented counseling (ROC), and waiting-list control (WLC) groups. Groups met for seven 50-minute treatment sessions during a three-week period. Assessments were conducted at pretreatment, posttreatment, and three-week follow-up. Both self-report and sociometric measures were used to evaluate treatment outcome. At postassessment, both the RET and REI groups were rated on sociometric measures as significantly less interpersonally anxious than the WLC group. Mean scores favored the RET and REI groups, but no significant differences between these groups and the ROC group were obtained. The self-report measure did not significantly differentiate between groups, but the REI group demonstrated significant pre- to follow-up changes. Both the RET and REI groups yielded greater reductions in irrational thinking than did the ROC and WLC groups. In addition, the pattern of the results supported the use of rational-emotive imagery as a component of rational-emotive therapy. The practical implications of these findings are discussed.     

A Historical and Theoretical Review of Cognitive Behavioral Therapies: From Structural Self-Knowledge to Functional Processes

This paper critically examines the historical conceptualization of cognitive behavioral psychotherapy approaches (CBT) as a direct clinical counterpart of the cognitive revolution. The main “second wave” cognitive psychotherapies, either standard cognitive therapy (CT) or constructivist, in spite of their differences, share a common conceptualization of psychopathological factors as superordinate structural cognitive content belonging to the self: self-beliefs, self-schemata, personality organizations and so on. On the other hand, rational emotive behavior therapy (REBT) is an exception given that in REBT self-knowledge is not the core psychopathological tenet, being rather a derivate mechanism. Moreover, in non clinical cognitive science cognition is conceived as a regulatory function that operates retroactively and not in a hierarchically super- ordered fashion centered on the self. A historical review suggests that in both CT and constructivist model the structuralistic model of self-centered cognition may have emerged for both cultural and scientific reasons: self-centered cognitive models may be more readily understandable to clinicians as they allow for a straightforward identification of operationalizable self-beliefs. The emergence of new “third wave” process-centered CBT approaches may represent a comeback to functionalism, where cognition is considered again a regulatory function and not a structure. In addition, REBT’s interest in dysfunctional evaluations not focused on the self presaged this clinical and scientific turning point toward functionalism.     

Brief Christian and Non-Christian Rational-Emotive Therapy With Depressed Christian Clients: An Exploratory Study

The current outcome study operationalized a brief “Christian” form of rational-emotive therapy (CRET) and compared the therapeutic efficacy of this treatment with a standard version of brief rational-emotive therapy (RET) with depressed Christian clients. Results indicated that both treatments were effective in reducing depression and automatic negative thoughts, while only the CRET reduced clients' irrational beliefs. No between-group differences were obtained for clients' perceptions of the counselor. Findings are discussed in terms of applied integration issues and the long-standing antagonism of rational-emotive philosophy toward religious beliefs.     

Cognitive-Behavioral Processes Based on Using the ABC Analysis by Trainees’ for Their Personal Development

As cognitive-behavior therapy (CBT) has proven to be an evidence-based intervention for many mental health problems, the requirement for training programs has increased. Although there is promising data on the skills outcomes of such programs, trainees’ affective/behavioral changes mechanisms and in their faulty thinking patterns during the personal development of such training are unknown. The aim of this study is to investigate which are the most common irrational/dysfunctional beliefs of trainees during a cognitive-behavioral intervention training and their maladaptive consequences, as well as the methods of restructuring that they prefer to change these beliefs into rational/functional ones and achieve more adaptive consequences. 94 participants in a cognitive-behavioral interventions training program filled out 340 ABC, forms related to negative events at work and in personal life, as part of the personal development component in the training program. The obtained qualitative data was coded by three trained ratters in accordance to the current cognitive model of CBT. Contingencies analysis showed that demandingness, awfulizing and global evaluation (GE) are most frequently associated with anxiety, while low frustration tolerance is associated with anger. Comfort, affiliation, achievement themes were most frequently associated with anxiety, while fairness was most frequently associated with anger. Pragmatic cognitive restructuring was the most frequently used by trainees. We found evidence that confirmed many of the theoretical predictions form the cognitive model of CBT in respect to the associations between irrational/dysfunctional cognitions and dysfunctional emotions as well as some particularities for this specific population.     

Cognitive appraisal of daily hassles in college students displaying high or low irrational beliefs

It is argued that Lazarus' construct of cognitive appraisal in life stress might usefully be related to Ellis' ABC model. To test the hypothesized role of cognitive appraisal in Lazarus' model of life stress, 240 male and female undergraduate students completed the Hassles Scale and the Irrational Beliefs Test (IBT). Based upon their scores on the IBT, subjects displaying high irrational beliefs differed significantly from subjects displaying low irrational beliefs in reported hassles frequency (higher for high irrational belief subjects) and reported hassles intensity (greater for high irrational belief subjects). Results are interpreted specifically as supportive of the cognitive appraisal construct in Lazarus' life stress model and generally as quite consistent with RET theory. An attempt is made to relate the cognitive appraisal construct to the ABC model in RET theory.Susan Mills Harran is a graduate of the M.S. Psychology program at Villanova University and is currently a Ph.D. candidate in clinical psychology at Hahneman University.Daniel J. Ziegler is Professor of Psychology, former Chair of the Psychology Department, and current Dean of the Graduate School at Villanova University.     

Use of the Survey of Personal Beliefs Scale: Further validation of a measure of irrational beliefs with psychiatric inpatients

Development of valid instruments for measuring underlying irrational beliefs is necessary for ongoing research of Rational-Emotive Therapy (RET). This study was designed to further evaluate the validity of one such measure, the Survey of Personal Beliefs (SPB). Adult psychiatric inpatients completed the SPB and measures of depression, hopelessness, and anxiety, as well as a conceptually similar measure of irrational thinking, the Belief Scale. It was predicted that if construct validity exists for the SPB then a significant correlation would exist between irrational beliefs as measured by the SPB and depression, hopelessness, and anxiety. It was also predicted that if the scale has construct validity, then patients being treated with RET would demonstrate a greater reduction in irrational thinking based on SPB scores than would inpatients receiving treatment not based on RET. To evaluate for discriminate validity, it was predicted that the SPB would correlate more highly with a conceptually similar measure of irrational thinking than with measures of depression, hopelessness, and anxiety. The findings of this study offer support for the validity of the SPB. Additional and unexpected findings as well as recommendations are discussed.Dr. Nottingham is an Associate Fellow and Approved Supervisor of the Institute for Rational-Emotive Therapy. He is in independent practice with Germantown Psychological Associates, P.C. and is Director of Psychology and Clinical Director of Adult Mental Health Services at Parkwood Hospital, Olive Branch, MS.I would like to thank Ivey Bright, Brad Barris, and Dee Conrad for their assistance in data collection. Additionally, without the assistance and support of the Parkwood Hospital administration and staff, this research could not have been completed.     

What Do People Really Think of Me? Evaluating Bias in Interpersonal Predictions Over the Course of Cognitive-Behavioral Therapy of Depression

Cognitive behavioral therapy (CBT) of depression is hypothesized to achieve its effects by correcting negative biases. However, little research has tested how biases change over the course of CBT. We focus on biases in interpersonal judgments and examine whether changes in biases occur in CBT and are associated with symptom improvements. A sample of 126 adults (60% women, mean age 31.7, 83% White) participated in CBT of depression. Observers provided ratings of patients participating in two interpersonal tasks on three occasions. Patients were asked to predict observers’ ratings. In a thin slice (TS) task, observers evaluated how patients came across in a brief segment in which patients talked about themselves. In a Standard Interaction Task (SIT), observers rated the social skills patients displayed in challenging role plays. The difference between patient predictions and observer ratings provided measures of bias in these interpersonal judgments. TS and SIT bias became significantly less pessimistic and more realistic over the course of CBT. Improvements in TS bias were associated with a faster reduction in symptoms, whereas there was a non-significant trend for improvement in SIT bias being associated with faster symptom reduction. Consistent with the CBT model, negative interpersonal biases became more realistic throughout a course of CBT for depression and at least some of the changes in bias were related to therapeutic outcomes. We encourage future researchers to continue examining for whom and under which conditions correcting such biases produces the greatest benefits.     

Cognitive Barriers to Successful Weight Management: 7 Stymie Beasts

This paper focuses on one of the most significant barriers, especially for teenagers and their families, to the effectiveness of cognitive behavioral therapy (CBT) for weight management: high rates of attrition. Cognitive barriers contribute to attrition and to decreasing commitment to full engagement in the process (deliberate practice). Excuses capture the essence of one type of those cognitive barriers. Excuses are defined as shifts in attribution from self-focused causes of struggles to achieve goals to more externally-focused causes—resulting in decreasing full engagement. Those excuses (shifts in attribution) do not just happen. People make decisions to implement those shifts away from personal responsibility. Ten cognitive biases lie at the heart of such problematic delusional decision making. This paper identifies seven excuses created by that biased decision making as anthropomorphisms called Stymie Beasts. Such unique simply worded visually distinctive creatures may help improve recall and focus on these powerful antagonists to successful weight control. Then, the use of two CBT techniques, Therapeutic Understanding of Science (TUS) and Rational Emotive Therapy (RET), illustrated with examples for all seven Stymie Beasts, shows how CBT may prevent and dismantle those Beasts (excuses). Ideas for future research using randomized controlled trials to test these notions are also presented.     

Characteristics and Components of the TADS CBT Approach

In this paper, we describe the Acute phase of a cognitive-behavioral therapy (CBT) developed for and utilized in the Treatment for Adolescents with Depression Study (TADS). The Acute phase of TADS CBT consists of eight skills that were considered essential to any CBT intervention for adolescent depression (e.g., mood monitoring, increasing pleasant activities, identifying cognitive distortions and developing realistic counter-thoughts). In addition, five optional individual CBT skills (e.g., relaxation, affect regulation) can be incorporated into treatment, depending on the needs of the adolescent. We describe each of these individual skills by reviewing the rationale for their inclusion in the treatment protocol and describing the format that is used to teach the skill area. Recommendations are provided for dealing with common challenges that can occur in the teaching of each skill module. It is our hope that clinicians will find this a useful introduction to this particular form of treatment and a practical guide to dealing with clinical problems common to the delivery of any cognitive behavioral intervention with depressed teens.     

Irrational and Metacognitive Beliefs Mediate the Relationship Between Content Beliefs and GAD Symptoms: A Study on a Normal Population

Cognitive Behavioral Therapy (CBT), Rational Emotive Behavior Therapy (REBT) and Metacognitive Therapy (MCT) models show both similarities and differences in conceptualizing anxiety. This work assumes that REBT’s irrational and MCT’s metacognitive beliefs play a mediation role while CBT’s disorder specific content beliefs act as triggers. This hypothesis is tested using a regression model in which metacognitive and irrational beliefs play a mediation role while content disorder beliefs are independent variables. This paper applied this model to generalized anxiety disorder (GAD), a psychiatric diagnosis in which anxiety is the major feature. In GAD, the specific content beliefs are negative problem orientation and intolerance of uncertainty. Therefore, 149 non clinical subjects completed 4 self-report questionnaires: the Negative Orientation to the Problems Questionnaire and the Intolerance of Uncertainty Scale as measures for content cognitive beliefs, the Attitudes and Beliefs Scale for irrational beliefs, and the Metacognitive Questionnaire 30 Items Version for metacognitive beliefs. The generalized anxiety disorder questionnaire was chosen in order to measure anxiety as dependent variable. Regression analyses confirmed that irrational and metacognitive beliefs mediate the relation between cognitive content beliefs and GAD. We clinically interpret mediation as a second level regulation.     

A dictionary of rational-emotive feelings and behaviors

Rational-emotive therapy (RET) hypothesizes that people mainly make themselves emotionally disturbed and dysfunctional in their behavior by starting with rational Beliefs (rBs) about their Goals (G) and then by consciously or unconsciously converting these into irrational Beliefs (iBs) or dogmatic, absolutistic musts and commands. To help clients and others to clearly see the differences between their rational Beliefs and their irrational Beliefs, to understand the disordered feelings and behaviors to which the latter lead, and to help them become more rational, less disturbed, and less dysfunctional in their activities, the authors have constructed and herewith present a dictionary of rational-emotive equivalents.Ted Crawford is a Consultant on Communication and Group Processes in Santa Barbara, California. Albert Ellis, Ph.D., is the Executive Director of the Institute for Rational-Emotive Therapy in New York City.     

Note on ian Gilmore's distinction between quantitative and qualitative inappropriate or irrational beliefs

Note clarifying my view that RET practitioners and theorists had better see appropriate (or rational) and inappropriate (or irrational) beliefs in qualitative rather than quantitative terms.     

Would Confucius benefit from psychotherapy? The compatibility of cognitive behaviour therapy and Chinese values

The purpose of the present paper is to explore the conceptual compatibility between cognitive behaviour therapy (CBT) and the common values of Chinese Culture. In order to address such a question, the distinctive processes attributed to CBT (e.g., teaching of skills, emphasis on homework, cognitive processes, present/future focus), as summarized in the meta-analysis by Blagys and Hilsenroth [(2002). Distinctive activities of cognitive-behavioral therapy: A review of the comparative psychotherapy process literature. Clinical Psychology Review, 22, 671-706], and the core values of Chinese Culture, determined through an integration of The Hofstede Project, [Hofstede, G.H. (1980). Culture's consequences: International differences in work related values. Beverly Hills: Sage]. The Chinese Value Survey [Chinese Culture Connection (1987). Chinese values and the search for culture-free dimensions of culture. Journal of Cross-Cultural Psychology, 18, 143-164]. The Schwartz Value Survey [Schwartz, S.H. (1994). Cultural dimensions of values: Towards an understanding of national differences. In Kim, U., Trandis, H.C., Katiticibasi, C., Choi, S.C., & Yoon, G. (eds.), Individualism and collectivism: Theory, method and application (pp. 85-119). Thousand Oaks, CA: Sage] were used. A strong degree of compatibility between the two was found and it is argued that rather than developing new indigenized therapies, with some structural changes to the processes of CBT, this therapy can be effective for Chinese clients. It is further proposed that Chinese clients may benefit from challenging their irrational cognitions that are bound up in their strict adherence to social norms. Future recommendations for increasing the compatibility of CBT to Chinese culture are discussed.