Psychoanalysis, marital therapy, and object-relations theory

This paper attempts to indicate why psychoanalysts should be interested in marital therapy. It discusses the clinical advantages and disadvantages of marital therapy as compared to psychoanalysis, describes the contributions of the classical psychoanalytic viewpoint to marital therapy, and finally, attempts to complement the classical psychoanalytic viewpoint with an object-relations viewpoint which can illuminate marital dynamics and provide interpretive content during the course of marital therapy.     

The process of rational-emotive therapy

This paper describes the process of rational-emotive psychotherapy. Not a “how to do it” cookbook, it distinguishes RET as following four overlapping stages, called rational-emotive psychodiagnosis, rational-emotive insight, and rational-emotive working through I and II. The reader is encouraged to use this model of RET's process to understand what is done in RET and why.     

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.     

Measurement of rational-emotive therapy in outcome studies

Outcome research has to date yielded little convincing evidence concerning the effectiveness and mechanisms of action of RET. One major cause of this problem appears to be the lack of empirical evidence to confirm that outcome studies have implemented RET as it is theoretically intended and with high quality. This paper reviews constructs relevant to the measurement of psychotherapy conditions in outcome studies (adherence, purity, differentiability, and quality), surveys the extent to which these constructs have been considered in prior RET outcome research, and offers recommendations for methodological improvements in future studies in this area.David A. F. Haaga, Ph.D. is Assistant Professor of Psychology at The American University, Windy Dryden, Ph.D. is Senior Lecturer in Psychology at Goldsmiths' College, University of London. Christine P. Dancey, Ph.D. is now Lecturer in Psychology at the Polytechnic of East London.     

Setting and response generalization in rational-emotive therapy: A case study

A single case study (n=1) conducted during therapy investigated the relationship between disputing irrational beliefs in vivo and setting and response generalization. Irrational beliefs associated with the subject's anger and depression were disputed at different intervals over a ten week period utilizing a multiple baseline design across four classes in a school setting (setting 1). Depression and anger were rated several times each week. The subject's level of anxiety was also rated in setting 1 but the irrational beliefs associated with it were not disputed. Anger, depression, and anxiety were rated without disputation in a separate work setting (setting 2). Affect ratings significantly decreased across both settings throughout the ten week period. Results indicated that 1) disputing irrational beliefs associated with anger and depression in setting 1 led to reductions in anxiety in this setting (response generalization), 2) anger and depression reductions in setting 2 paralleled setting 1 reductions (setting generalization), and 3) anxiety reductionsWilliam J. Ruth, PhD, Staff Psychologist and practicum supervisor, Institute for Rational-Emotive Therapy, NY City; School Psychologist, Board of Cooperative Educational Services, Southern Westchester.Raymond DiGiuseppe, PhD, ABPP, Director of Training and Research, Institute for Rational-Emotive Therapy, NY City; Graduate Professor, St. John's University, NY City; co-author,Practitioner's Guide to Rational-Emotive Therapy and RET with Alcoholics and Substance Abusers.     

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.     

The use of chaining in rational-emotive therapy

The focus of this paper is on the concept of chaining in rationalemotive therapy. Four types of chains are discussed and illustrated: (a) inference chains; (b) inference-evaluative belief chains; (c) disturbance about disturbance chains and (d) complex chains.Windy Dryden Ph.D. is a Lecturer in Psychology at Goldsmiths' College, University of London.     

Cognitive marital therapy

This article reviews recent applications of cognitive therapy to the treatment of marital distress. Three categories of cognitive phenomena that can decrease marital satisfaction and elicit dysfunctional interactions between spouses are described. First, automatic thoughts that comprise an individual's stream-of-consciousness thinking about marital events can be biased by systematic cognitive distortions. Inaccurate attributions about the causes of marital problems are a major form of such automatic thoughts. Second, individuals' behaviors toward their partners are influenced by their expectancies about the probabilities of the partner's subsequent responses, and these expectancies also are susceptible to systematic distortion. Third, an individual's unrealistic or irrational beliefs about the nature of intimate relationships can produce distress and dysfunctional behavioral responses toward the partner. Methods for assessing and modifying these dysfunctional cognitions, particularly in conjoint treatment, are described. Similarities and differences between cognitive therapy and rational-emotive therapy in the treatment of marital problems are noted.     

Reflections on the continuing evolution of rational-emotive therapy

Three basic contentions of RET are briefly discussed, with particular emphasis on their implications for psychotherapy. Personal responsibility is seen as a prime directive and the cornerstone of the other two contentions, which involve emphases on the present and on action. The philosophical and dialectical emphases of rational emotive behavior therapy are acknowledged as important aspects of its continuing evolution.     

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.     

The efficacy of rational-emotive group therapy in psychiatric inpatients

The impact of rational-emotive theory and therapy upon the practice of clinical psychology has been profound, and many purportedly objective experimental tests of its efficacy as a mode of treatment have been reported. Yet the great majority of these reports have failed to utilize actual clinical populations. This study evaluated rational-emotive group therapy with psychiatric inpatients. Results supported the claim that irrational beliefs are related to emotional disturbance. It was also shown that patients undergoing rational-emotive group therapy changed their self-reported irrational beliefs more than did a control group. Finally, there was a trend for the experimental subjects to be more likely to have been discharged from the hospital during the 90-day follow-up period than were control subjects. However, this study failed to demonstrate that change in irrational beliefs was related to improvement in psychiatric symptoms or rates of discharge from the hospital. Some of the difficulties in conducting treatment evaluation research in a psychiatric hospital setting are discussed with respect to these results.     

The revised ABC's of rational-emotive therapy (RET)

Although I was perceptive enough to realize, in my first paper on rational-emotive therapy (RET) in 1956, that cognitions, emotions, and behaviors almost always are not pure or disparate but significantly include each other, I have appreciably added to this concept and have stressed forceful emotive and educative, as well as strong behavioral, techniques of RET in recent years. I have also increasingly pointed out that the ABC's of RET-A standing for Activating Events, B for Beliefs about these events, and C for emotional and behavioral Consequences of these Beliefs-also influence, include, and interact with each other. The present paper gives salient details of how A's, B's, and C's, as well as cognitions, emotions, and behaviors all importantly affect one another and how they become combined into dysfunctional, demanding core Basic Philosophic Assumptions that lead to neurotic disturbances. To change and to keep changing these dysfunctional basic assumptions, RET uses a number of intellectual, affective, and action techniques that often are applied in a forceful, persistent, active-directive manner. It is more cognitive than most of the other cognitive-behavior therapies in that it tries to help many (not all) clients to make an elegant or profound philosophic change (Ellis, 1979b, 1985b). But it is also more emotive and behavioral than most other popular therapies in that it assumes that neurotic individuals' core basic philosophies assumptions are, as Muran (in press) points out, tacit cognitive-affective-motoric structures that account for emotional experiences in the face of external stimuli, and that therefore therapists had better teach their clients (and the general public) several powerful cognitive-emotive-behavioral methods of helping themselves change.Albert Ellis is President of the Institute for Rational-Emotive Therapy, 45 East 65th Street, New York, NY, 10021     

Evolutionary psychology and rational-emotive theory: Time to open the floodgates

Main tenets, issues, and controversies for evolutionary psychology (EP), particularly its cognitive aspects, are introduced, clarified, and applied to the theory and philosophy of rational-emotive therapy (RET). Specifically, key concepts in EP are applied to Ellis' genetic postulate for cognitive demandingness and grandiosity, and are incorporated into Ruth's (1992) RET evolutionary proposal. The following issues are examined for demanding and grandiose thinking: nature (genetic) vs. nurture (learned), plasticity vs. unmodifiability, acquisition ease and modification-elimination difficulty, natural inseparability of cognition and emotion, natural inseparability of cognitive content and process, social selection pressures and the human psyche, competitive individualism vs. natural self-interest, evolutionary counter-balancing and false mutually exclusive dichotomies, epigenetic rules and Darwinian algorithms, current adaptions vs. ancestral remnants, child and adult adaption, Darwinism vs. Lamarckism, and ethical considerations.William J. Ruth, Ph.D., Staff Psychologist and Practicum Supervisor. School PsychologistPrivate Practice and Independent Research, Hartsdale, NY.     

A solution-focused approach to rational-emotive behavior therapy: toward a theoretical integration

A theoretical integration of rational emotive behavior therapy (REBT) and solution-focused therapy is described. It is suggested that the integrative conceptualization underscores these models’ complementary aspects by addressing the limitations of each and enhancing their respective strengths. The clinical theory and process of the integrative model is explicated along with a case example. Directions for future theory building, research, and practice are considered. Address correspondence to Jeffrey T. Guterman, Barry University, 11300 NE 2 Avenue, Adrian Dominican School of Education, Counseling Program, Powers Building, Miami Shores, FL 33161–6695, USA; e-mail: jguterman@mail.barry.edu     

The effects of rational-emotive therapy and relaxation training on premenstrual syndrome: A preliminary study

Six female subjects who were between 31 and 44 years of age attended a premenstrual syndrome (PMS) clinic and participated in a group therapy program designed to alleviate their premenstrual symptoms. Rational-emotive therapy (RET) and relaxation training were offered in addition to ongoing progesterone treatment in an effort to alleviate severe psychological symptoms thought to be occasioned by the hormonal changes occurring during the premenstrual week. Pre-treatment assessments were carried out using Moos' Menstrual Distress Questionnaire, Broadbent's Cognitive Failures Questionnaire, and Eysenck's Personality Questionnaire. Additionally, levels of self-reported psychological and physical menstrual distress symptoms were estimated by the subjects at each premenstruum throughout the ten-week therapy program. At the end of the ten week therapy program hormone treatment was discontinued. Significant pre-test to post-test differences were found in a number of psychological and physical symptoms of menstrual distress, in cognitive functioning and neuroticism, following the combined group treatment. Improvements in psychological functioning during premenstruum were observed at a one-year follow-up. RET and relaxation together with hormonal therapy produced a substantial reduction in PMS symptoms in comparison with drug treatment alone.     

Alleviating the distress of caregivers of Alzheimer's disease patients: A rational-emotive therapy model

Caring for a person with senile dementia of the Alzheimer type places an enormous emotional burden upon the caregiver. Common responses of caregivers include denial, anger, guilt, self-pity and depression. These negative emotions exacerbate the difficulties of caring for the patient, as well as constrict the caregiver's ability to develop appropriate coping skills for his/ her own life. Rational-emotive therapy (RET) specifies the maladaptive cognitions which elicit and sustain maladaptive emotions and behaviors, and provides a model for cognitive, affective and behavioral change. Excerpts from therapy sessions are presented to illustrate the process.Rose Oliver, private practice; Graduate Fellow and Supervisory Faculty, Institute for Rational Emotive Therapy, 45 East 65th Street, New York, NY 10021. Frances A. Bock, private practice; Adjunct Associate Professor, Psychology Department, Hofstra University, Hempstead, NY 11550; Graduate Fellow and Supervisory Faculty, Institute for Rational Emotive Therapy, 45 East 65th Street, New York, NY 10021.     

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.