When time is of the essence: The use of rational emotive behavior therapy (REBT) informed single-session therapy (SST) to alleviate social and golf-specific anxiety,and improve wellbeing and performance,in amateur golfers

Anxieties associated with the social evaluative nature of golf are present in the majority of athletes and impact directly on their wellbeing and objective performance. One potential intervention that could reduce social anxiety in golfers is rational emotive behavior therapy (REBT). There is limited research into the effectiveness of REBT in reducing social anxiety and even less research to assess if REBT can be delivered in time-constricted situations when the expectations for immediate results are high, as is the case with many handicap golfers. The current study used an idiographic single-case study design to assess the effects of REBT-informed single-session therapy (SST) on the social anxiety of five amateur golfers. REBT was employed in a short telephone call to target the performance issue, followed up with a single face-to-face session. Data were collected prior to, immediately following, and four weeks after the REBT intervention. Visual analysis following single-case guidelines revealed substantial reductions in irrational beliefs and social anxiety as well as improvements in wellbeing, scoring average, competition placings and handicap reductions in four out of five golfers. Discussion with golfers at a telephone follow-up indicated the positive receipt of REBT by the golfers and supported the visual analysis findings. This current study supports the effectiveness of REBT and also extends the research by demonstrating that REBT-informed SST can be an effective intervention, in a time-restricted environment, for those golfers with a clear target problem and who are ready to take care of business, providing clear implications for future research and practice.     

Developing decision making in Rugby Union match officials using rational emotive behavior therapy (REBT)

There is a dearth of applied research to inform psychological provision for match-officials. The application of rational emotive behavior therapy (REBT; Ellis, 1957) is becoming established as an effective psychological intervention with elite performers. This paper examined the effects of four one-to-one REBT sessions on irrational beliefs, anxiety, decision rumination and reinvestment, and match officiating performance with two elite rugby match officials. Using a single-case, staggered multiple-baseline across participants research design, visual and statistical analyses showed that the intervention brought about significant, immediate and maintained (12 week follow-up) reductions in irrational beliefs. Furthermore, participants also reported reductions in anxiety, and decision making reinvestment, alongside increased match official performance for one participant. The current study lends some initial support for the application of REBT with match officials, and develops understanding into potential links between irrational beliefs and decision making performance. The results are discussed in terms of theory, applied implications, limitations and future research.     

Psychological well-being and exercise addiction: The treatment effects of an REBT intervention for females

Whilst there is growing research on the benefits of Rational Emotive Behaviour Therapy (REBT) for athletic performance and wellbeing, there has been little attention on the effectiveness of REBT for the exercising population. Recent evidence suggests that REBT may be helpful for males who show signs of exercise addiction, but the effects for females are currently unknown. The current study aims to build on the extant research by adopting a single-case research design to examine the effects of REBT on irrational beliefs, exercise addiction symptomology, psychological distress, and unconditional self-acceptance (USA) of three female exercisers. Self-report data were collected at pre-, during, and post-REBT timepoints. Visual analyses revealed reductions in irrational beliefs and psychological distress, and increases in USA, maintained two-weeks post-REBT. Exercise addiction symptomology also reduced during the intervention, and this was maintained for two out of the three exercisers post-REBT. Social validation data supported these findings. The study adds weight to the efficacy of REBT in improving exercise addiction and its comorbidities.     

The Effects of Eye Movement Desensitization and Reprocessing on Prospective Imagery and Anxiety in Golfers

In this study we make a novel contribution by examining the effects of an Eye Movement Desensitization and Reprocessing (EMDR) intervention on detrimental prospective imagery in 4 amateur golfers, using a single-case multiple-baseline across-participants design. Postintervention, all participants reported reduced negative imagery effects; Participants 1, 3, and 4 showed reduced cognitive anxiety, Participants 1 and 4 reduced somatic anxiety, and Participant 3 positively relabeled somatic anxiety experiences. Social validation data demonstrated EMDR to be perceived positively and effective in delivering notable changes. Consultancy experiences of using EMDR in golf are discussed, and areas for future researchers and applied practitioners are outlined.     

A Comparison of Rubrics for Identifying Empirically Supported Practices with Single-Case Research

The use of single-case research methods for validating academic and behavioral interventions has gained considerable attention in recent years. As such, there has been a proliferation of methods for evaluating whether, and to what extent, primary research reports provide evidence of intervention effectiveness. Despite the recent interest in harnessing single-case research to identify empirically supported strategies, examination of these tools has revealed that there is a lack of consistency in the methodological criteria sampled and scoring procedures used to evaluate primary research reports. The present study examined the extent to which various evidence rubrics addressed specific methodological features of single-case research and classified studies into similar evidence categories. Results indicated that the methodological criteria included within rubrics tended to vary, particularly for criteria related to determining the generality of the intervention under study. Moreover, there was substantial discordance observed in the evidence classifications assigned to reviewed studies. These findings are discussed in the context of the still-developing nature of single-case evidence reviews. Recommendations for both research and practice are provided.     

Examining the Efficacy of Rational-Emotive Behavior Therapy (REBT) on Irrational Beliefs and Anxiety in Elite Youth Cricketers

The use of rational-emotive behavior therapy (REBT) in sport psychology has received scant research attention. Therefore, this study examines the efficacy of REBT (comprising three counselling sessions and two homework assignments) in decreasing irrational beliefs and cognitive-anxiety in four elite youth cricketers using a single-case multiple-baseline across-participants design. Visual and statistical analyses indicated that REBT reduced irrational beliefs and cognitive-anxiety in all participants. The applied issues surrounding the use of REBT in a youth sport context are discussed, along with guidance for its future use in sport psychology research.     

The Value of Social Validation in Single-Case Methods in Sport and Exercise Psychology

Social validation is used to determine satisfaction with an intervention and has been utilized in many single-case studies within sport and exercise psychology research and consultancy. This article reviews current social validation procedures and makes recommendations of how a more thorough consideration of the technique could add greater value to the understanding of single-case protocols within research and applied practice. Recommendations include using semi-structured interviews for data collection, using content analysis to analyze these data, reporting social validation results in a thorough manner, collecting social validation information from significant others, and collecting social validation data as frequently as possible.     

Exploring the Effects of Rational Emotive Behavior Therapy on the Irrational Beliefs and Self-Determined Motivation of Triathletes

The present study addresses proposals that Rational Emotive Behavior Therapy (REBT) can influence self-determined motivation. Triathletes received REBT education, followed by either Rational Emotive Personal-Disclosure Mutual-Sharing (REPDMS) or Personal-Disclosure Mutual-Sharing. Measurements of irrational beliefs and self-determined motivation were collected prior to REBT (baseline), during the REBT education period, and after the REPDMS session (postintervention). An ABC single-case design was adopted, allowing for statistical and visual analysis of data over time and between groups. Findings indicate that REBT led to decreased irrational beliefs and increased self-determined motivation. REPDMS appeared to have no influence on irrational beliefs over and above REBT education.     

Muscularity rationality: An examination of the use of Rational Emotive Behaviour Therapy (REBT) upon exercisers at risk of muscle dysmorphia

Research in the area of body image suggests that muscularity dissatisfaction is a prominent concern among men and women. At its apex, this concern manifests into a convoluted and debilitating body image disorder termed muscle dysmorphia (MD), characterised by a marked preoccupation with ones (subjective) muscularity and leanness inadequacy. Prevention of MD is critical, however, empirical evidence informing intervention protocols are profoundly scarce. The principal aim of this study was to examine the effectiveness of a one-to-one Rational Emotive Behaviour Therapy (REBT) intervention, comprising five, 60-min one-to-one sessions, in decreasing MD symptomatology, irrational beliefs and increasing unconditional self-acceptance in a mixed-sex cohort of four exercisers at-risk of MD. A single-case, staggered multiple-baseline across participant A-B design was adopted to examine the effects of REBT. Visual and statistical analyses, and social validation data, indicated reductions in MD, irrational beliefs, and increases in unconditional self-acceptance across all participants from pre-post intervention phases, with reductions upheld at a 6-month follow-up. This study highlights the potential role of rational and irrational beliefs in the onset and maintenance of MD. This study is the first to report the application of a CBT approach to MD symptomology, and has demonstrated the use of REBT as a potential preventative approach for individuals at risk of MD. Practitioners working with individuals at risk of MD should take a benefit-focussed approach to support individuals in developing unconditional self-acceptance beliefs, as well as a problem-focussed approach to support individuals in reducing irrational beliefs.     

Current Perspectives on Interventions for Self-Injurious Behavior of Children with Autism Spectrum Disorder: A Systematic Review of the Literature

Our purpose in this systematic review was to identify, evaluate, and summarize the single-case research design studies examining behavioral interventions to address self-injurious behavior for young children with autism spectrum disorder. We identified 24 studies published between 2000 and 2016 that met the inclusion criteria. We reviewed and coded each study across five content areas using systematic procedures. These content areas consisted of the methodological quality of single-case research designs, children’s demographic information, conditions under which the intervention was implemented, characteristics of intervention, and outcomes. Our findings indicate that procedural integrity data were reported for only one study and social validity for two studies. The majority of studies were implemented by researchers or therapists in the school setting. For 24 of 30 children included in the studies reviewed, the authors taught a replacement behavior selected on the basis of an assessment conducted prior to intervention. All authors reported a decrease in the self-injurious behavior post-intervention. A limited number of authors examined generalization and maintenance of low rates of self-injurious behavior. Limitations of the present review and future directions and implications for research and practice are discussed.     

A Review of Interventions Designed to Increase Sharing Behaviors in Children with Social Delays or Deficits

Sharing materials is a complex social behavior that may lead to long-term development of friendships and concomitant increases in related prosocial behaviors. Given the complexities of sharing behaviors, children with social delays or deficits may not recognize when, how, and with whom to share. Because children with social delays or deficits, especially those with disabilities, may not engage in typical sharing behaviors, and because these behaviors are important, identifying interventions for sharing and related social behaviors are crucial. The purpose of this review was to identify sharing interventions, evaluate methodological rigor, and assess intervention effectiveness. Twenty single-case designs published in 11 articles were included. Some studies reported variable results and had considerable methodological limitations. Results of high-quality studies are promising and provide a foundation for future research on sharing behaviors.     

Assessing the Factorial Validity of the Attitudes and Belief Scale 2-Abbreviated Version: A Call for the Development a Gold Standard Method of Measuring Rational and Irrational Beliefs

Rational emotive behaviour therapy (REBT) does not possess a measure of rational and irrational beliefs that meets internationally recognised standards for acceptable psychometric properties. Without such a measure the theory/practice of REBT cannot be rigorously evaluated, thus undermining its scientific veracity. The current study investigates the validity and reliability of a recently developed measure of rational and irrational beliefs: the Attitudes and Belief Scale 2-Abbreviated Version (ABS-2-AV). University students from three countries completed the ABS-2-AV (N = 397). An alternative models framework using confirmatory factor analysis indicated that a theoretically consistent eight-factor model of the ABS-2-AV provided the best fit of the data. A number of post hoc modifications were required in order to achieve acceptable model fit results, and these modifications revealed important methodological limitations with the ABS-2-AV. Results indicated that the validity of the ABS-2-AV was undermined due to items measuring both the psychological process of interest (rational and irrational beliefs) and the context in which these beliefs processes are presented. This is a serious methodological limitation of the ABS-2 and all questionnaires derived from it, including the ABS-2-AV. This methodological limitation resulted in the ABS-2-AV possessing poor internal reliability. These limitations are discussed in relation to the broader REBT literature and the impact such problems have on research and practice. A call is made for REBT researchers to come together to develop a “gold standard” method of assessing rational and irrational beliefs that meets international standard for psychometric excellence.     

Behaviorally Based Interventions for Teaching Social Interaction Skills to Children with ASD in Inclusive Settings: A Meta-analysis

Behaviorally based interventions have been demonstrated to be effective to teach social interaction skills for children with autism spectrum disorders in general education. However, the overall and moderating effects of these interventions have not been previously investigated in inclusive settings. The goal of this study was to investigate the overall effectiveness and contextual factors that moderate intervention effectiveness in inclusive settings. Findings showed overall high effect size based on studies previously considered of methodological quality in single-case research. Interventions are demonstrated to be highly effective for children aged 2–10 years. While differences were found according to target social skills and behavioral components used, no differential effects were found regarding intervention implementer and peer training. The findings highlight the practical significance of behavioral interventions and guide educators toward more suitable evidence-based practices in inclusive settings.     

Rational emotive behaviour therapy in high schools to educate in mental health and empower youth health. A randomized controlled study of a brief intervention

Rational emotive behaviour therapy (REBT) is effective in reducing distress in several target groups. No other study has tested the mental health effects on adolescents in a high school setting while expanding a Cognitive Behaviour-based therapy, REBT, into the concept of mental health literacy. The format of the ABC model, which is an important element of REBT, functioned as a working manual in and between three sessions. This study tested whether knowledge and practical use of the ABC model increased self-esteem and hope, and reduced symptoms of anxiety and depression, and dysfunctional thinking. Sixty-two high school students with subclinical levels of anxiety and depression were randomly allocated into three groups; three individual REBT sessions, or three individual attentional placebo (ATP) sessions or no sessions (control). However, dysfunctional thinking, self-esteem and hope were not measured in the control group. Repeated measures with ANOVA and t-tests were conducted. Both REBT and ATP significantly reduced symptoms of anxiety and depression, but only REBT was significantly different from the control group at the six-month follow-up. Only REBT significantly reduced dysfunctional thinking, and both REBT and ATP significantly increased self-esteem and hope. REBT had both an immediate and a long-term effect. The findings show the potential positive effects of educating well-documented psychological techniques as ordinary education in school. Further research might contribute to decide whether or not to change the school system by enclosing mental health literacy classes for all students.     

Meta- and statistical analysis of single-case intervention research data: Quantitative gifts and a wish list

In this commentary, we add to the spirit of the articles appearing in the special series devoted to meta- and statistical analysis of single-case intervention-design data. Following a brief discussion of historical factors leading to our initial involvement in statistical analysis of such data, we discuss: (a) the value added by including statistical-analysis recommendations in the What Works Clearinghouse Standards for single-case intervention designs; (b) the importance of visual analysis in single-case intervention research, along with the distinctive role that could be played by single-case effect-size measures; and (c) the elevated internal validity and statistical-conclusion validity afforded by the incorporation of various forms of randomization into basic single-case design structures. For the future, we envision more widespread application of quantitative analyses, as critical adjuncts to visual analysis, in both primary single-case intervention research studies and literature reviews in the behavioral, educational, and health sciences.     

Perfectionism and its relationship with anticipatory processing in social anxiety

Cognitive‐behavioural models suggest that perfectionistic beliefs and anticipatory processing are key maintaining factors of social anxiety. The present study examined the moderating and mediating role that anticipatory processing has on the relationship between perfectionism and social anxiety. The sample consisted of 245 individuals from the general community who completed an online questionnaire package comprising depression, perfectionism, and social anxiety measures. Participants also rated their levels of anticipatory processing in response to vignettes describing an upcoming social interaction and performance situation. Results showed that maladaptive perfectionism and maladaptive anticipatory processing were positively associated with social anxiety. Furthermore, maladaptive anticipatory processes (stagnant deliberation and outcome fantasy) remained significantly and positively associated with social anxiety even after controlling for depression and maladaptive perfectionism, whereas adaptive anticipatory processes (plan rehearsal and problem analysis) were not significantly associated with social anxiety. These findings support current classifications of anticipatory processing in social anxiety. Contrary to predictions, maladaptive anticipatory processing did not moderate the relationship between maladaptive perfectionism and social anxiety. An exploratory analysis indicated that maladaptive anticipatory processing mediated the relationship between maladaptive perfectionism and social anxiety. Implications for therapeutic intervention are discussed.     

Single-case effect size calculation: Comparing regression and non-parametric approaches across previously published reading intervention data sets

Growing from demands for accountability and research-based practice in the field of education, there is recent focus on developing standards for the implementation and analysis of single-case designs. Effect size methods for single-case designs provide a useful way to discuss treatment magnitude in the context of individual intervention. Although a standard effect size methodology does not yet exist within single-case research, panel experts recently recommended pairing regression and non-parametric approaches when analyzing effect size data. This study compared two single-case effect size methods: the regression-based, Allison-MT method and the newer, non-parametric, Tau-U method. Using previously published research that measured the Words read Correct per Minute (WCPM) variable, these two methods were examined by comparing differences in overall effect size scores and rankings of intervention effect. Results indicated that the regression method produced significantly larger effect sizes than the non-parametric method, but the rankings of the effect size scores had a strong, positive relation. Implications of these findings for research and practice are discussed.     

Treatment of Poststroke Anxiety in an Older Adult Male: A Single-Case Analysis

A single-case analysis was carried out to study the nonpharmacological treatment of post-stroke anxiety in an older adult male. The intervention consisted of a biofeedback-assisted program of autogenic training; efficacy was demonstrated using multiple discontinuations and reinstatements of treatment. Physiological indices and self-report measures of anxiety and depression documented treatment success, although a moderate increase in fear was evident on the Fear Survey Schedule II at the final follow-up assessment.     

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.     

Increasing the Rigor of Procedural Fidelity Assessment: An Empirical Comparison of Direct Observation and Permanent Product Review Methods

Although it is widely accepted that procedural fidelity data are important for making valid decisions about intervention effectiveness, there is little empirical guidance for researchers and practitioners regarding how to assess procedural fidelity. A first step in moving procedural fidelity assessment research forward is to develop a comprehensive understanding of the relation between currently recommended assessment methods, systematic direct observation (SDO) and permanent product review (PPR). To this end, we first discuss methodological issues related to procedural fidelity assessment via SDO and PPR, and how they are evidenced in the behavioral intervention outcome literature. Second, we present a single-case design study in which teachers’ implementation of behavior support plans was assessed via SDO and PPR. Third, we analyze the SDO and PPR data with regard to (a) relation between the methods; (b) methodological issues including definitions of procedural fidelity and intervention steps, representativeness of intervention steps, and collection of an adequate sample; and (c) association with student outcomes. Finally, we discuss implications for research and practice.