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 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.     

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.     

The combined use of rational-emotive therapy and biofeedback in the treatment of childhood migraine

The available literature on the psychological treatment of childhood migraine was reviewed and evaluated. The current treatment modalities have relled essentially upon biofeedback techniques and neglected the potential cognitive factors that might lead to successful results. A case example is provided that demonstrates the combined treatment of childhood migraine using both biofeedback and rational emotive therapy (RET). Continued relief was reported during a follow-up interview conducted a year and a half after the treatment concluded. While both the biofeedback and RET elements for treatment were considered important for alleviation of the migraine condition, the subject reported that it was the RET training that proved most effective in dealing with stressors related to the onset of migraine attacks.     

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.     

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     

A rational-emotive theory of marital dysfunction and marital therapy

This article first discusses some rational-emotive perspectives on marital and couples therapy, including what constitutes a good relationship, some important differences between rational-emotive and other couples therapy approaches, and an RET classification of relationship problems. Second, this article also sketches out ways in which social exchange principles can be integrated into rational-emotive couples therapy.This is a revised version of a paper that originally appeared in A. Ellis and M. Bernard's (Eds.) 1985 text,Applications of Rational Emotive Therapy, Plenum Publishing Co., New York.     

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     

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.     

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.     

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.     

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.     

Evaluation of a comprehensive inpatient rational-emotive therapy program: Some preliminary data

Mental health practitioners are faced with a profound challenge surrounding the prevalence of adult mental disorders, the need for inpatient treatment programs, and the costs of such programs. This paper describes the development of an adult inpatient psychiatric program based on Rational-Emotive Therapy. Specific elements of this program are described briefly, and preliminary outcome data presented on 372 patients. Concerns and future directions are also discussed. Development of adult inpatient psychiatric programs based on Rational-Emotive Therapy would appear to be one method of providing effective and cost-efficient treatment within the current cost-containment atmosphere of psychiatric treatment.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 at Parkwood Hospital, Olive Branch, MS. Dr. Neimeyer is an Associate Professor and Director of Clinical Training in the Department of Psychology of Memphis State University. He has written extensively in the areas of cognitive and constructivist psychotherapy, and is co-editor of the International Journal of Personal Construct Psychology.The authors would like to thank Kat Bagley, Joe Grillo, Ivey Bright, Brooke Bensen, Cathy Michas, Brad Barris, Lori Passmore, David Wilkins, and Dee Conrad for their help with data collection. Additionally, without the assistance and support of the Parkwood Hospital administration and staff, neither this treatment program nor this paper could have been developed.Portions of this paper based on earlier data analyses were presented at the Mississippi Psychological Association Convention, September, 1990. This research was conducted at Parkwood Hospital.