Introduction for Clients to REBT - CBT treatment Sessions.

by Meir Stolear

Introduction:The following will help you understand better thepsychological, the emontional and the behaviouralchanges that the therapy is aiming to bring about.You may find it difficult to understand it at the firstreading, however, keep it with you, as you are likelyto find it very useful once you have started your ther-apy. Essentially your therapy is based on RationalEmotive Behaviour Therapy (REBT) and the otherCognitive Behaviour Therapies (CBT).

What is REBT - CBT?REBT was originated by Dr Albert Ellis of NewYork in 1955 and it is the original CBT. Other ap-proaches followed, but there are limited differencesbetween their theoretical approaches. The psycho-logical approaches of REBT-CBT are based on sci-entific principles and research has shown them to beeffective for a wide range of problems. You and I willwork as a team to identify and understand problemsin terms of the relationship between thoughts, be-liefs, feelings and behaviour. The approach usuallyfocuses on the present difficulties, and relies on usdeveloping a shared view of your problems. Thisthen leads to the identification personalized, time-limited therapy goals and strategies which are care-fully monitored and evaluated.

REBT-CBT not only works with individuals, butis also found to be very effective with couples, fam-ilies and group therapies. Moreover, the approachescan be used to help anyone irrespective of ability,culture, race, gender or sexual perference.

What will happen in your therapy?In the sessions, you and I work together to:1. develop a shared understanding of your problems.2. identify how these problems affect your thoughts,beliefs, behaviours, feelings and daily functioning.

Based on the understanding of your problems wewill then work together as a team to identify goalsand to agree on a shared treatment plan. The focusof therapy is to enable you to generate solutions toyour problems that are more helpful than the wayyou have been dealing with them so far. This alsoenvolves using your time between therapy sessionspractising your therapeutic gains (i.e. homeworktasks).

Therapy is organised over an agreed number ofsessions (usually between 8 to 16). The number ofsessions needed will differ, depending on the natureand severity of your problems. Typically, sessionsare weekly and last an hour. After the completionof treatment I usually advise a limited number offollow-up sessions or a booster session, to maintainthe therapeutic gains and achieve more progress.

What kind of methods will be used in thetherapy?Essentially you will learn many important cognitiveand behavioural skills during your therapy whichwill be used by you to overcome your psychological,emotional and behavioural problems. These will bevery useful in preventing any more disturbances inthe future and will help to capitalise on your thera-peutic gains.

The ABCDE model explained:The most important instrument for self-care thatI hope you will learn during your therapy is theABCDE model.

The model is a simplified version of human cogni-tion (i.e. thoughts and beliefs) aiming to help peopleto assess their target problems carefully, investigatetheir thoughts and beliefs about their target prob-lems and disputes any found irrational thoughts and

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beliefs that are found, as they are assumed to be themain causes of emotional and behavioural disfunc-tions in human beings.

After analysing the problem and disputing the ir-rational cognition, the model will lead you to createan alternate rational cognition that can help you todevelop healthy emotions and behaviour, which aremost likely to help you in activating your goals inlife.

What do these letters ABCDE stand for?

*A = activating eventsUsually you, as any other human, will become awarethat something is going wrong in your life when youare not achieving your goals.

Basically speaking, most human beings, if not all,will have two major goals to acheive in their life-time. The first is to survive as long as possible andthe second is to be happy as much as possible, asbeing alive is hardly enough for most people. Yet,there are many events in life that can and will blockone or both of those basic goals at different stagesin our life. Unfortunately, some of these events willbe so severe that they are likely to activate our ir-rational cognition, which in turn is likely to lead usinto emotional and behavioural disturbances.

However, or what event will activate the irra-tionality and at what stage will differ greatly be-tween one individual and another. For example, notall people will develop irrational cognition and de-pression if or when they have lost their job. Why?Because we all have different thresholds, which aremainly based on our biological make-up, life expe-riences, levels of education and so on. Therefor,knowing your As will help you to know where yourthreshold lies.

*B = BeliefsBeliefs is about what you believe about the inter-pretation that you gave to the bad events that hap-pened for you at A. For example, you may have lostyour job and in order to make sense of this eventyou may interpret it as an act against you. Now you

are left with the choice between believing that yourinterpretation is true or untrue.

Basically, when it comes to beliefs, we need toknow if our beliefs are rational (rBs) or irrational(iBs). Usually rBs are flexible, realistic and unde-manding, whereas iBs are rigid, unrealistic and de-manding.

For example, if you are holding rBs about losingyour job, you may say something like this to your-self:It is really unfair that I had to lose my job,but the world is an unfair place to be and Ihave had the misfortune to experience thatkind of mishap. Its very bad to lose my jobat this stage of my life, yet I can be gratefulthat I did not experience something far worsethan that. Its hard to go out there and lookfor a new job, but I am overall a capable per-son and I can find a way of bringing back anincome and comfort into my life, even if it isnot an easy task.

On the other hand IBs would be something likethis:It is really unfair that I lost my job, but itabsolutely should not have happened to me.It is a real disaster. Who will ever want toemploy a useless person like me? How will Iever be able to bring some income and com-fort into my life without a job? I am doomed,my life means nothing without my job.

The rBs and iBs coexist side by side as you cansee on the graph below. However, as stated earlier,much depends on our threshold which will determinewhich set of our beliefs will be the one to overrulethe other.

*C = ConsequenceAs stated earlier, the way that we will feel and actafter experiencing a bad event in our life will beheavily dependant on our personal A+B (i.e. ourinterpretation of the events and our beliefs aboutour interpretations).

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If we have been rational overall after experienc-ing a bad event it is likely that we will feel bad,but not disturbed, and that means that we will actto promote happiness in ourselves after recoveringfrom the initial shook. However, if we have been ir-rational overall, that means that we will become toodisturbed to act in a self-helping way.

In REBT-CBT we see two kind of negative emo-tions: one we call healthy negative emotions and theother we call uhealthy negative emotions.

Many studies now show that the more unhealthynegative emotions the person has, the more irra-tional the person is. It is not clear yet if the emotionsare the cause of the rationality or vise versa. How-ever, what is clear is that when people suffer fromunhealthy negative emotions, they no longer sufferfrom them or reduce them, once they have replacedtheir irrational cognition with rational cognition.

The following emotions are regarded byREBT-CBT as healthy negative emotions:sadness, concern, healthy anger, regret,disappointment, concern about relationship andhealthy envy.

Whereas the following emotions are re-garded as unhealthy negative emotions:Depression, anxiety, unhealthy anger, shame, hurt,jealousy, unhealthy envy.

*D = Disputing irrational beliefs.At this stage you will know what your Bs are andnow you need to test them to see if they are rBs oriBs.

Their are three systems by which you can do this:1. Empirical disputing, where you ask yourselfquestions such as;- Where is the evidence that shows that my beliefsare true?- Where is the universal law that shows that mybeliefs are true?

2. Logical disputing, where you ask yourselfquestions such as:- Is it sensible to demand all that I will for?- Is it logical to turn my desires into demands?

3. Pragmatic disputing, where you ask yourselfquestions such as;- Have my beliefs helped me so far?- Have my beliefs been able to help me find solutionsto my problems?

*E = EffectAt this stage you will be able to create your own rBswhich will replace your iBs. You will learn to usecognitive and behavioural modifications techniquesthat will reinforce your rBs, which in turn will effectyour moods and actions for the better over time.That is to say, are you not only going to feel betterbut will become better.

Now dont think that this kind of therapy is aneasy fix, it is not. In order to feel the therapys fullrewards you will have to work on yourself, (usingthe skills you have learned with me) well after thetherapy has ended. After all, you will need to changethe cognition of a lifetime to the new cognition andthat is not easy. However, just because it is not aneasy option it doesnt mean its impossible. In otherwords, dont only think about the short term gainsthat you may have from the therapy, but also thinkabout the long term gains that you can give yourselfby adopting your new rBs.

People are not disturbed by things, but bythe view they take of them(Epictetus, 55 AC to 135 AC)

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