Cognitive Behavioral Therapy & Rational Emotive Behavior Therapy; A Summary

13 Jan Cognitive Behavioral Therapy & Rational Emotive Behavior Therapy; A Summary

Rational Emotive Behavior Therapy fits under the broader category of Cognitive Behavioral Therapy, which also includes many newer forms of therapy. Major contributors to the development of both Rational Emotive Behavior Therapy and Cognitive Behavioral Therapy, in general, were: Albert Bandura, with his Social Cognitive Theory (Zimmerman & Schunk, 2003), Aaron Beck, Albert Ellis, “the founding father of Rational Emotive Behavior Therapy” (Dryden, 2003, xiii), Jean Piaget, George Kelly, Alfred Adler, and Donald Baucom et al. (Sexton, 2003).

It should also be noted that Cognitive Behavioral Therapy (CBT) would not be what it is without its foundation in behavioral psychology and the works of Ivan Pavlov, John B. Watson, and B.F. Skinner. Much of CBT is formed on the basis of Classic and Operant Conditioning (Leichsenring et al., 2006).

Rational Emotive Behavior Therapy (REBT) was founded in 1955 by Albert Ellis. There have been many contributions from around that time until the present day, to Cognitive Behavioral Therapy in general. Originally, CBT was developed to help individuals overcome depression and anxiety, but even Ellis himself began applying it, as early as 40 years ago, to couples and family therapy (Sexton, 2003).

The main idea behind CBT is that the thoughts and beliefs of individuals and family systems affect how they operate in very powerful ways. Mistaken beliefs and negativistic thinking can both contribute to and maintain negative behavioral patterns, interactions, and even mental illness (Sexton, 2003).

REBT specifically focuses on the events (A), beliefs about the events (B), and the emotional and behavioral responses (C) that occur within individuals or families (Dryden, 2003). The idea is that while events (A) cannot necessarily be prevented or changed, in all cases, the beliefs people prescribe to them (B) can, and thus the emotional and behavioral responses (C) to these events can as well.

Successfully changing maladaptive thinking can even be powerful enough to lift a depression or help an unhappy couple renew their marriage. Additionally, REBT or other forms of CBT can be applied to help improve or manage even more biologically-based mental illnesses, both in the individual and in the family affected by it (Dryden, 2003).

Cognitive-Behavioral Therapy in Practice

The process of assessment for REBT, and other forms of CBT, involves revealing the mistaken beliefs or maladaptive thinking that is causing or contributing to a problem. For example, a depressed patient can describe thoughts such as, “I know people think I’m ugly” or “There’s just no point in trying. Nothing will ever work.” The thinking errors of mind-reading and black and white thinking can clearly be seen in these two remarks. The same two errors can be found in the thought processes of a couple. One individual may admit to thinking, “He just says I look good, but he really thinks I’m fat.” The other partner may think, “She is completely untrustworthy” (CBT Partnership, 2007).

Examining life experiences can help shed some light on the development of a person’s maladaptive thinking. Maladaptive thinking can help explain the negative emotions the person is experiencing and thus the self-defeating behaviors like alcohol and drug abuse.  For example, a female who experienced child abuse develops the belief that she is unlovable. As an adult, she feels shame and suffers from agoraphobia (CBT Partnership, 2007).  To combat the anxiety resulting from these beliefs, people commonly turn to drugs and alcohol as a form of self medication for these undesirable feelings.

In working to bring about change in the client, Leichsenring et al. (2006) states that once thinking errors are exposed, the therapist can employ a “style of trained questioning (called Socratic dialogue or guided recovery) [which] gently probes for patient meanings and stimulates alternative viewpoints or ideas” (p. 235). The idea is to work towards a “skillful collaboration” in which therapists can help patients discover healthy alternatives to their way of seeing things.  When they perceive things differently, they can begin to act differently.

Some of the most widely-used methods of CBT are systematic desensitization (a form of “counter-conditioning” that can help victims of trauma or people with phobias), Exposure/Response Prevention (for similar clients), relaxation techniques, positive and negative reinforcement, cognitive modification (changing in thinking patterns as previously described), assertiveness training, stress management and problem-solving (Leichsenring et al., 2006).

Viewpoint

Cognitive Behavioral Therapy is one of the best researched and most validated forms of therapy (eg. Leichsenring et al., 2006). REBT and CBT, in general, can be applied with almost any other type of therapy as the concepts involve specific techniques that can be generalized to almost any individual or family. Marriage and family therapy can easily include CBT techniques, whether or not the therapist is practicing a somewhat ‘pure’ therapy or taking a more eclectic approach.

While the practice of CBT is easily incorporated into most any form of therapy, as a standalone therapy it may leave some things to be desired. Its almost exclusive focus on changing maladaptive thinking and learning new responses does not include a focus on the therapeutic relationship, warmth, support, and just listening. In this author’s opinion, CBT is one of the best forms of therapy and can really help most people with most of their problems, but can and should be practiced as an important part of a broader and warmer approach.  Cognative Behavioral therapy is one of the most effective methods of treatment for helping people in drug rehab centers to overcome addiction.

References

Cognitive Behaviour Therapy (CBT) Partnership (2007). What is CBT? Retrieved April 30, 2009 from http://www.cbt-partnership.org/what_is_cbt/what_is_cbt.php.

Dryden, W. (Ed.) (2003). Rational emotive behaviour therapy : Theoretical developments. NY, USA: Brunner-Routledge.

Dryden, W., & David, D. (2008). Rational Emotive Behavior Therapy: Current status. Journal of Cognitive Psychotherapy, 22(3), 195-209.

Leichsenring, F., Hiller, W.,  Weissberg, ., & Leibing, E. (2006). Cognitive-behavioral therapy and psychodynamic psychotherapy: Techniques, efficacy, and indications. American Journal of Psychotherapy, 60(3), 233-259.

Sexton, T. (2003). Handbook of Family Therapy : The Science and Practice of Working with Families and Couples. Florence, KY, USA: Brunner-Routledge.

Zimmerman, B., & Schunk, D. (Eds.) (2003). Educational psychology: A century of contributions. Mahwah, NJ, USA: Lawrence Erlbaum Associates, Inc.

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