Rational-Emotive Assessment with Religious Clients

Rational Emotive Behavior Therapy (REBT), when practiced effectively and flexibly, can be an excellent treatment modality for religious clients. Most of the American population acknowledges some religious belief and/or practice and religious clients sometimes present with unique disturbances and concerns about psychotherapy. In this article we discuss the rapidly changing literature relative to religiousness and mental health and highlight the ethical-professional risks of failing to carefully assess and responsibly manage client religiousness when it is personally and clinically salient. We conclude by outlining a model for focused assessment of religiousness early in REBT and recommend that REBT practitioners consider different components of religiousness and the manner in which they may impact response to treatment.     

Correlates of success following treatment for adolescent substance abuse

To date, little research is available examining the course and features of recovery from substance abuse following adolescent treatment. The current study evaluated the functioning of 142 teens for 2 years following treatment for substance abuse. Adolescent drug and alcohol outcome was examined in relation to functioning on five major life domains: academic involvement, interpersonal problems, emotional well-being, family relations, and social and occupational activities. Results of this investigation demonstrate that psychosocial functioning is associated with adolescent posttreatment drug and alcohol use. Teens who were abstinent and those with less substance use involvement generally displayed better functioning. The relationship between teen alcohol and drug use and improvement in functioning varied across psychosocial domains. Clinical implications of these findings are discussed along with advances in teen substance abuse research and treatment.     

Alcohol and substance use in the Arabian Gulf region: a review

Despite cultural, social, religious, and legal constraints on Muslim Arab nationals living in the Arabian Peninsula against the consumption of alcohol or drugs, usage and dependence do exist. The aim of this paper is to provide a systematic review, compiling and critiquing the literature in this interesting yet neglected area. Information about the current status of alcohol and substance abuse research and knowledge in the Arabian Gulf region will be presented, providing an accessible synopsis of available papers. A systematic review of English and Arabic language literature was conducted by searching electronic databases (1975-2007) and conducting hand searches of Arab published journals. Only studies investigating alcohol and/or substance use or abuse issues with participants (1) of Arab nationality, (2) living in an Arabian Gulf country, and (3) of Muslim faith were included. Within this literature, the majority of research has been conducted with clinical male participants. The most commonly abused drugs are alcohol, heroin, and hashish. Literature investigating the substance use domain with people who are not seeking treatment for addiction is extremely limited. Although the research is largely in its infancy, it does however confirm alcohol and substance abuse in Muslim, Gulf Arab nationals. We strongly urge that further research into substance use and abuse in this region is conducted. Community investigations assessing the prevalence, magnitude, and associated problems with alcohol and substance abuse and also research into valid and reliable measurements in these countries are warranted.     

Rational emotive behavior therapy research: What we know and what we need to know

Rational emotive behavior therapy (REBT) has achieved positive results in quantitative reviews of treatment outcome studies. In part because of methodological limitations of these studies, however, the generalizability of their favorable results to routine clinical practice is unknown. Also unknown are the clinical significance of outcomes achieved by REBT, the contribution made by its distinctive and specialized procedures, and the types of patients for whom REBT is particularly useful. Recommendations are provided for refining our knowledge of the effectiveness of REBT.     

Cognitive rehabilitation of chronic alcohol abusers

The current literature suggests that individuals who chronically abuse alcohol exhibit a wide variety of cognitive deficits resulting from cerebral dysfunction that is either directly or indirectly related to their alcohol consumption history. Cognitive deficits have been hypothesized as having implications for standard alcohol treatment efficacy as they may directly affect cognitively impaired individuals’ abilities to utilize various treatment modalities. Although evidence is accumulating that suggests this is actually the case, the majority of alcohol treatment programs neither directly consider the impact cognitive deficits have on treatment efficacy nor do they employ cognitive rehabilitation treatment strategies to remediate identified cognitive deficits. Few studies exist that investigate the remediability of neurobehavioral deficits or the efficacy of integrating cognitive rehabilitation strategies into more traditional treatment programs. Empirical investigations conducted to date indicate that some cognitive deficiencies secondary to alcoholism are amenable to cognitive rehabilitation and this remediation is generalizable. Rigorous well-controlled treatment outcome investigations are needed in order to determine the efficacy of cognitive rehabilitation techniques in naturalistic settings using ecological outcome measures. Also, emphasis should be placed on integrating cognitive rehabilitation techniques with proven efficacy into traditional alcoholism treatment programs.     

A Systematic Review of the Literature on the Use of Rational Emotive Behaviour Therapy in Criminal Justice Work to Reduce Re-offending

A systematic review of the published literature from 1995 to 2007 considers the published evidence on the use of interventions employing Rational Emotive Behaviour Therapy in criminal justice efforts to reduce re-offending. Thirty-six studies are briefly described, summarised and appraised for research quality using a six point scale. Twenty-four studies were excluded from further analysis due to insufficiently rigorous or weak research design and method. Twelve studies were appraised as sufficiently robust to reliably inform the research interest. Further analysis of the studies indicated an association between negative emotional states and offending behaviour, some evidence of REBT effectiveness in treating emotional disturbance in offender populations, and mixed evidence of REBT effectiveness in reducing re-offending. It is concluded that interventions using REBT might be a promising approach for aiding criminal justice aims to reduce re-offending.     

Issues in the Treatment of Native Americans With Alcohol Problems

The author reviews the literature on the treatment of Native Americans who have alcohol abuse or dependence disorders and provides an interpretation of the research on this topic. The most common alcohol treatment modalities used with Native Americans are described and critiqued, including adapted versions of standard treatments. Several practiced recommendations are made regarding revising standard treatments to make them more culturally appropriate for Native Americans.     

Empirically Documenting Clinically Significant Change in Rational Emotive Behavior Therapy

The purpose of the present article is to outline the conceptual foundation and practical methodology of the Jacobson-Truax Clinically Significant Change index, derived from psychotherapy outcome research. This way of considering what constitutes clinically significant change in psychotherapy puts a premium on social validation. It empowers clinicians to evaluate the meaningfulness of their client's progress and to communicate that progress to third parties such as other clinicians, researchers, and insurers. Application of the method is demonstrated in the case of a client treated with Rational Emotive Behavior Therapy (REBT). The discussion focuses on the advantages of this procedure for satisfying the intellectual interest of the practitioner-scientist and for furthering informed discussion of the value in various applications of REBT to clinical problems.     

A Synopsis of Rational-Emotive Behavior Therapy (REBT); Fundamental and Applied Research

The article presents a synopsis on rational-emotive behavior therapy (REBT), its fundamental theoretical framework, its applications, and future directions. The paper is organized according to the following structure: in part one, REBT fundamental/basic research is discussed; in the second part clinical/applied research in REBT is presented, including aspects of efficacy and effectiveness, discrimination of disorders for which REBT works most effectively, and its relations to other therapies. Uses and misuses of REBT and their impact on research and future developments are presented as well. While it is true that REBT research has many shortcomings, the overgeneralization and/or magnification of the negative, and the minimization of the positive are dysfunctional beliefs that maintain the false idea in the field that REBT has few empirical studies and that REBT research is in serious trouble. A balanced approach, analyzing both the strengths and weakness, suggest that REBT has hundreds of research articles and that high-quality studies tend to support REBT’s basic theory and efficacy. However, to strengthen this conclusion and to fully explore the potential of REBT, shortcomings of REBT research need to be corrected, and high-quality studies promoted. This is particularly important since, although effective, cognitive-behavioral psychotherapies have not yet reached “the desired standard” of efficacy and effectiveness, as about 30–40% of people are still nonresponsive to these interventions Thus, REBT could be a platform of reinvigorating empirical studies on the efficacy/effectiveness and theory of cognitive-behavioral models of psychopathology and human functioning. Mount Sinai School of Medicine, Biobehavioral and Integrative Medicine Programs, New York, USA.     

Substance use in lesbian, gay, and bisexual populations: an update on empirical research and implications for treatment

Historically, substance use problems were thought to be more prevalent in lesbian, gay, and bisexual (LGB) populations, and correcting skewed perceptions about substance abuse among LGB individuals is critically important. This review provides an update on empirical evidence on LGB substance use patterns and treatment outcome, with specific focus on clinical implications of findings. Compared to earlier studies, the recent research included in this review has used more sophisticated methodologies and more representative samples, and also has investigated multiple dimensions of sexual orientation in relation to substance use patterns. Findings from recent research suggest that lesbians and bisexual women are at greater risk for alcohol and drug use disorders and related problems, and that gay and bisexual men are at greater risk for illicit drug use and related problems. Several sociocultural factors have emerged as correlates of substance use patterns in LGB populations (e.g., affiliation with gay culture, HIV status), and several demographic characteristics (e.g., female, older age) do not appear to be as robust of protective factors against substance abuse for LGB individuals compared to heterosexual populations. Bisexual identity and/or behavior in particular seem to be related to increased risk for substance abuse. In terms of treatment outcome, limitations of extant research prevent conclusions about the relative impact of LGB-specific interventions, and further research that includes women and uses more equivalent comparison interventions is needed. Clinical implications of research findings are discussed for case identification, selection of treatment goals (e.g., moderation vs. abstinence), targets for intervention, and specific treatment modalities.     

Are Disease and Other Conceptions of Alcohol Abuse Related to Beliefs About Outcome and Recovery?1

Visitors to a science center (N= 189) responded to a questionnaire measuring their agreement with different conceptions of alcohol abuse (disease, sin, habit, and addiction conceptions) and their beliefs regarding treatment for alcohol abusers. Respondents who agreed with a disease concept thought alcohol abuse was a more serious problem, were more skeptical of statements about recovery, and were more likely to feel that treatment was necessary to achieve change, compared to those who disagreed with or were neutral toward the disease concept. Agreement with the sin, habit, and addiction conceptions was not related to beliefs about treatment and outcome. The utility of promoting various conceptualizations of alcohol abuse is discussed.     

The Relevance of Counseling Outcome Research: Current Trends and Practical Implications

This systematic review investigated current trends in the publication sources, research focus, and methods of 365 counseling outcome studies. The results suggest that outcome research can provide a considerable knowledge base regarding numerous client concerns and various clinical interventions in individual, career, and school counseling. Counseling practitioners with a thorough knowledge of outcome research methods who use the findings appropriately will find this literature a useful adjunct to clinical decision making. Suggestions for improving the use of counseling research are offered for both practitioners and researchers.     

Structural,Metabolic, and Functional Brain Abnormalities as a Result of Prenatal Exposure to Drugs of Abuse: Evidence from Neuroimaging

Prenatal exposure to alcohol and stimulants negatively affects the developing trajectory of the central nervous system in many ways. Recent advances in neuroimaging methods have allowed researchers to study the structural, metabolic, and functional abnormalities resulting from prenatal exposure to drugs of abuse in living human subjects. Here we review the neuroimaging literature of prenatal exposure to alcohol, cocaine, and methamphetamine. Neuroimaging studies of prenatal alcohol exposure have reported differences in the structure and metabolism of many brain systems, including in frontal, parietal, and temporal regions, in the cerebellum and basal ganglia, as well as in the white matter tracts that connect these brain regions. Functional imaging studies have identified significant differences in brain activation related to various cognitive domains as a result of prenatal alcohol exposure. The published literature of prenatal exposure to cocaine and methamphetamine is much smaller, but evidence is beginning to emerge suggesting that exposure to stimulant drugs in utero may be particularly toxic to dopamine-rich basal ganglia regions. Although the interpretation of such findings is somewhat limited by the problem of polysubstance abuse and by the difficulty of obtaining precise exposure histories in retrospective studies, such investigations provide important insights into the effects of drugs of abuse on the structure, function, and metabolism of the developing human brain. These insights may ultimately help clinicians develop better diagnostic tools and devise appropriate therapeutic interventions to improve the condition of children with prenatal exposure to drugs of abuse.     

The REBT Competency Scale for Clinical and Research Applications

This paper presents the REBT Competency Scale which can be used in the evaluation of adherence to an REBT treatment model in clinical and research applications. The scale has been developed to map closely onto the REBT treatment protocol developed by Dryden et al. (A primer on rational emotive behaviour therapy, Research Press, Champaign, 2003). Based on this treatment protocol 21 core steps (tasks) were identified for effective REBT practice. Each step is operationally defined, the rater is reminded of how the step relates to REBT theory and practice and scoring criteria are established that enable a rating of the therapists performance of the task. The potential uses for and application of the scale in clinical and research settings are considered.     

Distress Tolerance and Rational-Emotive Behavior Therapy: A New Role for Behavioral Analogue Tasks

Rational-emotive behavior therapy (REBT) is a widely utilized treatment approach for many mental disorders, but it has been “relatively neglected in the professional scientific literature” (Ellis 2003b). This neglect has been attributed in part to a lack of solid REBT outcome studies, which in turn stems from the difficulty of measuring constructs of interest in REBT, such as irrational beliefs, via self-report measures. In light of these concerns, the current paper aims to identify the potential utility of behavioral analogue laboratory tasks for advancing the understanding of mechanisms in REBT, as well as treatment outcome using this therapeutic approach. Specifically, we focus on the utilization of behavioral measures of distress tolerance and their application to the key REBT construct of frustration intolerance. In identifying the parallels across distress tolerance and frustration intolerance, we consider how the incorporation of distress tolerance tasks into REBT research can be useful in evaluating the role of frustration intolerance in the initiation, maintenance, and treatment of disordered behavior across a broad range of clinical disorders.

Acceptance in Cognitive Behavioral Psychotherapies: Different or the Same?

Acceptance is a key construct in both rational emotive behavior therapy (REBT) and acceptance and commitment therapy (ACT). The objectives of this study were to assess and compare the properties of ACT acceptance with those of REBT acceptance in predicting emotions. A sample of 112 subjects, comprising different educational and occupational status, completed three measures of acceptance (REBT and ACT), two of mindfulness, as well as completing depression and anxiety scales. Both ACT acceptance as process and REBT acceptance could predict significant ACT acceptance as outcome. Mindfulness as a trait also predicted the level of ACT outcome acceptance as well as the level of REBT acceptance, but mindfulness as process predicted only ACT outcome acceptance. The results show that REBT acceptance, ACT acceptance and mindfulness can explain anxiety and depression in different ways. The results show that the difference between ACT acceptance and REBT acceptance primary concern the process of acceptance, most likely due to the underlying cognitive processing. The outcome acceptance and emotional level are similar in the two conditions. Future research should employ multiple cognitive measurements.     

The practice of rational emotive and cognitive behavior therapy with offenders

The case for rational emotive behavior therapy (REBT) and cognitive behavior therapy (CBT) with offenders is reviewed. Philosophical and practical problems in conducting REBT assessment and treatment with this population are identified. Suggestions regarding offender treatment address goals and content of therapy, the therapeutic relationship, overcoming client resistance, and self-care for the practitioner. Therapists of offenders are encouraged to apply REBT to themselves to increase effectiveness and reduce risk. In this regard, clinicians are offered suggestions regarding accepting the offender, maintaining a goal-oriented focus, and taking responsibility for the quality but not the outcome of their work.     

The Distinction Between Quantitative and Qualitative Dimensions of Emotions: Clinical Implications

REBT theoreticians and practitioners describe two sets of emotions (and behaviors) as a reaction to adversity, whether these are functional or dysfunctional. This article deals with the ways in which REBT practitioners and theoreticians interpret these two sets of reactions, using either a quantitative or qualitative method. It favors the qualitative approach and illustrates it with a graphical representation of the two sets. The use of graphs turns out to be particularly useful for explaining certain phenomena to clients and for teaching novice practitioners. It also provides a framework for establishing an effective new thought or rational belief.