Teaching the rebt philosophy

TEACHING THE REBT PHILOSOPHY

Encourage clients to read books and printed materials

Listen to audio and visual aids

Visit web sites that explain the REBT philosophy

Listening and the use of empathy are not the critical tools

Some listening is always necessaryUsing questions and encouraging the client to

talk, the REBT therapist will conduct a client assessment

Assessment: giving test, gathering biographical information, & discussion of the client’s life circumstances

The information obtained will be used to assess how the client distorts events and uses irrational thinking

The client might be directed to obtain materials that will increase his/her understanding of the REBT philosophy & is encouraged to practice specific interventions aimed at changing the way he/she thinks, acts, and feels.

BEING ACTIVE AND DIRECTIVE

It should not be confused with heavy-duty confrontation

The therapist suggest to their clients that they examine their current way of thinking, feeling, and behavioral processes.

You are not going to tell them what to feel, what to do or what to think. Rather, you are going to help them to understand what their options are about what to believe and what the likely emotional, behavioral, and thinking consequences are of these belief options. Once they have understood this, your job is to help them choose the belief option that best helps them to achieve their healthy emotional, behavioral, and thinking goals.

CHALLENGING CLIENTS

To demonstrate to clients how irrational beliefs are causing emotional distress, not the situation or the activating event.

ABC’S OF FEELING AND BEHAVING

Example:

I am having an ongoing problem with my mother. She turned 70, my father recently died, and I would like her to live with me. she’s insistent that she wants to live on her own forever. However, she never listens to anything I say and refuses to move in with me. I know she is perfectly capable of making her own decisions, but if she lived with me, she would be much be better off. I just think she is taking a risk with her life! If I don’t do something soon, I know something bad will happen. What if she falls and can’t get to phone? I am waking up in the middle of the night having panic attacks about this. I haven’t had a good night’s sleep in a month. Can you get her to listen to me?


Activating event (A): father recently died and mom now lives alone.

Irrational belief (iB): this is client is awfulizing the situation with his mother and placing demands on himself. The client believes that things must be the way he wants them to be(ib3), that unhappiness is caused by conditions outside his control(iB4), and that he had better worry about these things; otherwise, they might happen(iB5).

Consequences(C): the client is having panic attacks and sleeping poorly– all the result of the irrational beliefs, not the activating event.


As clients realized that many of their cognitions, behaviors, and emotions have not been healthy. Thus, they are encouraged by the therapist to dispute the unhealthy ones and replace them with healthy ones.

Disputations can occur cognitively, behaviorally, or emotionally.

ENCOURAGING THE DISPUTING OF DYSFUNCTIONAL COGNITIONS,

BEHAVIORS, AND EMOTIONS

Cognitive Disputation – as clients begin to realize that it is not the event causing the feeling or behaviors, but the beliefs about the event.

Dispute the Irrational Beliefs (DIBS)Yankura and Dryden (1990) encourage clients to ask

the following disputing questions:o Where is the evidence of this belief?o Is that really true?o Why must it be so?o Is there another way to think about this?o What’s the worst thing that could happen? Would that

really be awful?o What’s this way of thinking about things going to get

me?



Behavioral disputations – clients are generally encourage to practice behaviors that challenge the emotional beliefs that are responsible for the behaviors.

Example“:Instead of trying to convince her mom to move in with

him, the client might ask her what kind of help, if any, she would like. Or why not have the son ask her mother if he can help her plan a cruise or assist her in meeting new people?

Shame-attacking Exercise – purposeful acting out of a situation that might normally cause embarrassment, it’s a technique that reinforces the fact that approval from others is not necessary.



Activating event (A): Father recently died and mom now lives alone.

Irrational belief (iB): There is no evidence that Mom is doing poorly, and I can wait and see how she does. I cannot control her decisions and cannot excessively worry about something I cannot control.

Consequences(C): Concern, but not excessive worry about mother’s situation; offer help if she wants, but don’t try to force my opinions on her.

Emotive Disputations

Rational-emotive imagery – in this process , clients are asked to closed their eyes and focus intensely on the situation that is causing them extreme emotional upset. When the client experiences the emotional upset, he/she signals the therapist, often by lifting a prearranged finger. The therapist then asks the client to change the self-defeating emotion to an appropriate emotion, usually assigned by the therapist. After the client accomplishes this, the therapist asks the client what he/she was able to do to change the feeling.

It teaches the client that one can have control over one’s thoughts, and ultimately, over one’s emotions and behaviors.



REBT assumes that people had better take things seriously, but not too seriously.

The therapist will sometimes humor to help clients see the ridiculousness of their plight.

The fearful son who is afraid of his mother’s future. It’s ironic, and almost funny, that she is perfectly satisfied in life, and he is the one with the pathology!

HUMOR

A less directed method

Will sometime be used in an effort to illustrate and reinforce points that the REBT therapist is trying to make.

Example: You know, your mother reminds me of the Empire

State Building. Despite the fact that the building is aging, and from another era, it still stands erect and strong in the middle of the city.

METAPHORS AND STORIES

Therapist will often actively encourage their clients to practice many techniques at home.

All of these techniques are tried with the intent of maintaining the new, more rational belief system.

HOMEWORK

1. Assess client’s situation and hypothesize how the ABC’s apply

2. Teaching the REBT philosophy

3. Demonstrating how the client’s situation fits the REBT model

4. Directing the change process

5. Reinforcing the change and terminating the relationship

THE THERAPEUTIC PROCESS

REBT is largely a form of tolerance training. It encourages you to think, feel, and act the ways you want --- but warns against rigidity and fanaticism.

Whatever you believe, do not do it in an absolutist manner. Truth is relative, and your beliefs are only your truth in a moment in time.

It advocates for tolerance --- tolerance toward self and tolerance toward others.

The bottom line: Understand differences and don’t be absolutist or dogmatic, and don’t rigidly practice “shoulds” or “musts” toward yourself or others.

SOCIAL, CULTURAL, AND SPIRITUAL ISSUES

Ellis suggested that his approach has use with a wide variety of clients but would not be helpful for individuals who have strong, absolutist tendencies or ways of thinking.

Ellis’s approach has been shown to work with clients exhibiting a wide range of symptoms, although it is probably not as useful with those who have long-term entrenched problems or severe thought disorders, or resistant clients.

It was suggested that this kind of brief approach fits well in today’s managed-health-care system

Education

Teaching the rebt philosophy