REBT

Main components - ABC model

* ==Albert Ellis (1957)== suggested best way to deal w/ __irrational thoughts__ was for T. to identify them using ==ABC model==
* ==**A: activating event**==
* ==**B: belief (ration/irrational)**==
* ==**C: consequences**==
* e.g. depression
* A: friend ignores you on street
* B: doesn’t like you, no one likes you, worthless
* C: avoid social situations in future
* T. works w/ client on ABC of their depression & moves on to D & E aspects of therapy

Main components - D & E (ABCDE)

* T. ==challenges== the __beliefs identified in ABC model__ through __disputing__ these beliefs
* **Logical disputing:**
* self-defeating beliefs do not follow logically from the info. available
* **Empirical disputing:**
* self-defeating beliefs may not be consistent w/ reality
* **Effects of disputing:**
* to change __self-defeating beliefs into more rational beliefs__ to become more self-accepting
* Beh. part of therapy involves setting HW for client
* T. gives C. tasks that will help them dispute & challenge their own irrational beliefs
* C. identifies their own unhelpful beliefs & proves them wrong - result = beliefs begin to change

Main components - dealing w/ mustabatory thinking

* MT. seen as a __source of irrational beliefs__ - thinking certain ideas or assumptions must be true in order for an individual to be happy
* Ellis identified 3 most important irrational beliefs that a person w/ depression may have:
* ==**I must be approved or accepted by ppl. I find important**==
* ==**I must do well or v. well or I am worthless**==
* ==**The world must give me happiness or I will die**==
* An individual who holds such beliefs at the v. least going to be disappointed & at worst depressed
* Word ==__must__== is putting pressure on individual & implies there is __no flexibility__ - T. tries to challenge this way of thinking through REBT

Main components - unconditional +ve regard

* Ellis believed that an important component in successful therapy was __convincing the C. of their value as human being__
* If C. feel worthless - they will not invest effort into beh. change
* If T. provides ==respect & empathy== regardless of what C. says or does - this will facilitate a change in beliefs & attitudes

ESCAPE - Effectiveness

**Research that support REBT:**

**Engels et al (1993):**

* Concluded that REBT = __effective treatment for no. of different types of disorders__ including social phobia
* E. claimed __90% success rate__ - average from 27 sessions

**Silverman et al (1992):**

* Conducted review of __89 studies__ into effectiveness of REBT
* Shown more effective or = to other types of therapy (SD) for wide range of disorders including anxiety, depression, stress & alcohol abuse
* 49 - REBT more effective
* 40 - no difference
* These R studies = strength of REBT as therapy as it supports it is __effective__ & patients can __acc benefit__ from the therapy day to day & experience a better quality of life
* Supports underlying assumptions of CA - the way we think has an impact on they way we feel & beh

ESCAPE - Side effects

* An important strength of using REBT as therapy is that there are __no side effects__
* Some therapies e.g. anti-depressants can have serious SEs if used for long periods of time
* This is real benefit of REBT as no SEs e.g. __dependency strengthens the effectiveness__ of REBT for individual patients & makes it much more __appealing treatment__ for them
* Also makes the therapy __more ethical__ than some other therapies such as PS

ESCAPE - Cause or Symptoms

* REBT is an __effective treatment & coping mechanism__ for dealing w/ symptoms of a wide rang of psychological problems
* However REBT __does not deal w/ underlying cause__ of mental illness - they assume that mental disorders are the result of distorted & irrational thinking but do not help us understand the origin of the thoughts or why some individuals have them & not others
* Weakness of REBT as by not dealing w/ underlying reason for the thinking errors they may reappear in the future - potentially __reduces the effectiveness__ of REBT long term

ESCAPE - Appropriateness

* V. appropriate for a __variety of situations & for ppl of all ages__
* Appropriate for a __wide range of clinical problems__ e.g. anxiety, depression & eating disorders
* Appropriate for a __range of non-clinical problems__ e.g. marital problems & parenting skills
* Important strength - can be __effectively applied__ to a large no. of individuals & issues
* Allows for I’s to benefit as well as society
* Provides an effective therapy in helping I’s lead normal lives & be productive members of society

ESCAPE - Patient involvement

* One problem of REBT - __requires huge amount of effort & commitment__ i.e. high PI
* Results in __high attrition rate__ which can make assessing effectiveness difficult
* Burden of responsibility is placed on the individual to change their thinking
* Some problems include:
* **Not sticking to principles:** ppl who claimed to be following REBT principles were not putting their revised beliefs into action when they left therapy - therapy not effective
* **Too much effort**: some ppl simply do not want the direct sort of advice that REBT practitioners tend to dispense - they prefer to share their worries w/ a therapist w/o getting involved w/ cognitive effort that is ass. w/ recovery
* __High PI = weakness__ - therapy is __less likely to be effective__ when patients are required to dedicate __vast amounts of time & effort__ outside of sessions
* Effort involved can be __too much__ for some P’s resulting in __attrition__ which clearly has an impact on effectiveness
* R has found that competence & skill of T can have an impact on effectiveness of therapy
* More skilled T is at increasing PI to put in effort involved in their recovery & complete HW assignments - more effective therapy will be

ESCAPE - Ethics

* **Anxiety:**
* REBT = __forceful therapy__ in which T may quite aggressively challenge the Cs thinking using __direct & confrontational__ methods
* Deemed unethical by some who feel that this causes __unnecessary anxiety__ to C
* **Beliefs of C & T differ:**
* Issues when C & T beliefs differ e.g. v. little attention given to unique ethical problems that arise when REBT Ts treat devoutly religious Cs irrational belief to T may create moral problems for C irrational = fundamental faith
* Ethical issues could be viewed = weakness & have __-ve impact__ on how we view the __effectiveness__ of the therapy
* There is a risk that vulnerable Is will be exposed to more psychological harm which can make therapy less effective overall - also makes REBT __less ethical & appealing__ to Is than for example SD