Rational Emotive Behaviour Therapy Explained

Rational emotive behaviour therapy (REBT) is a form of cognitive-behavioural therapy that works with the beliefs a person holds about events, on the view that rigid and extreme beliefs contribute to emotional distress and to behaviour that gets in the person's way.

What Is REBT?

REBT was developed by the American psychologist Albert Ellis, who first set it out in 1957 under the name rational therapy. It is one of the earliest of the cognitive-behavioural therapies. [1]

REBT holds that emotional distress and behavioural difficulties are shaped largely by irrational beliefs and thought patterns. It aims to identify those patterns, question them, and put more flexible and workable beliefs in their place.

The approach rests on the idea that our emotions follow not from events themselves but from the beliefs we hold about those events. REBT therefore teaches people to notice automatic, rigid thoughts and to examine them directly.

The core of REBT is its ABCDE framework:

• A (Activating Event): the event that triggers the response.
• B (Belief): the belief about, or interpretation of, that event.
• C (Consequence): the emotional or behavioural consequence that follows from the belief.
• D (Disputation): the work of questioning the belief, testing it against evidence and logic, and asking whether holding it is useful.
• E (Effective new belief): the more flexible belief and outlook that the person arrives at and then practises.

How Does REBT Work?

REBT rests on several principles:

• Irrational beliefs contribute to emotional distress. REBT holds that beliefs which are rigid, extreme and not well matched to reality are a major source of emotional disturbance, and that identifying and questioning them is central to the work.
• Active disputation of irrational beliefs. REBT is action-oriented. Rather than concentrating on exploring the past, it works on questioning the validity of current beliefs and arriving at more flexible ones.
• Cognitive, emotional and behavioural dimensions together. REBT addresses all three, on the view that a change in thinking is bound up with changes in feeling and behaviour.
• Acceptance. A significant theme in REBT is unconditional self-acceptance, acceptance of others, and acceptance of life. This involves acknowledging one's worth regardless of achievements, failures, or the approval of others.
• Emphasis on philosophy. REBT carries a philosophical dimension, encouraging people to hold outlooks that support their mental health and resilience.

What Can I Expect From a REBT Session?

A typical REBT session is both educative and therapeutic, teaching clients how to identify, question and revise their irrational beliefs. It usually involves:

• Identification of core irrational beliefs. Sessions often start with discussing your current difficulties and identifying the activating events (A) and the beliefs (B) leading to emotional and behavioural consequences (C).
• Disputation of beliefs. The therapist introduces techniques for questioning irrational beliefs, by examining evidence, looking for logical inconsistencies, and assessing the usefulness of holding such beliefs.
• Development of new philosophies. Clients are encouraged to develop new, more flexible beliefs about life, themselves and others, including principles of tolerance and acceptance.
• Behavioural techniques. REBT also uses behavioural methods, such as role-play and homework, to practise new responses in everyday situations.
• Progress assessment. Sessions periodically review progress, address new difficulties, and apply the work to a range of life situations.

REBT sessions are collaborative, with the therapist providing guidance and the client taking an active part. The aim is that the person is able to manage their emotional and behavioural responses without the therapist over time.

Who REBT May Suit

REBT is used with a range of difficulties. People who come to it with anxiety, depression, anger, stress or difficulties with self-esteem are among those for whom it is commonly offered. Whether it is the right fit is a question for an initial consultation rather than something that can be settled in advance.

The approach asks a good deal of the person: a willingness to look at their own beliefs, to take responsibility for their responses, and to practise new ways of thinking and behaving between sessions. People who prefer, or need, to work slowly with early experience and with the therapeutic relationship itself may be better served by a different approach.

The Pros and Cons of REBT

The Advantages of REBT

• Works on rational thinking. By identifying and questioning rigid beliefs, people can arrive at more flexible ones, which can change how they feel and how they act.
• Emphasises personal agency. REBT places the person's own responses at the centre of the work rather than treating them as fixed by circumstance.
• Offers practical tools. The skills learned in REBT sessions, such as disputing rigid beliefs, can be applied to situations outside the consulting room.
• An established evidence base. A systematic review and meta-analysis of fifty years of REBT research found a medium overall effect compared with other interventions, with the largest effects for distress. The authors also noted high heterogeneity between studies and called for more rigorous trials, so the strength of the evidence varies by condition rather than being uniform. [1]
• Structured and often time-limited. REBT works to a clear framework, which some people find easier to follow than a more open-ended therapy. It is usually planned as a course of a set number of sessions rather than open-ended work: a study of people treated at the Albert Ellis Institute followed them to a twentieth session, and a review of the wider literature found that the number of sessions predicted the size of the effect at the end of treatment, though not at follow-up. [3][1]

Potential Downsides of REBT

• Requires a high level of engagement. REBT depends on the person taking an active part, including between-session work. That level of engagement is not always possible, and is not a failing when it is not.
• Focus on the present. REBT works with how current beliefs affect emotions and behaviour. It may not go as deeply into past trauma or early experience as other therapies do.
• Risk of intellectualisation. There is a risk of reasoning about a difficulty without contacting the feeling in it, particularly for people who find emotional awareness hard.
• Not suitable for everyone. People living with certain psychological difficulties or cognitive impairments may find the cognitive demands of REBT hard to work with.

Considering REBT

If you are considering REBT, the practical steps are:

• Find a qualified REBT therapist. Look for a therapist registered with the relevant professional body in your country who has training and experience in REBT.
• Schedule an initial consultation. This is an opportunity to discuss your difficulties and what you want from therapy, and to work out with the therapist whether REBT is a reasonable fit.
• Expect to take an active part. REBT involves work during sessions and exercises or homework between them.
• Ask questions. It is reasonable to ask a therapist how they work, roughly how long they expect the work to take, and what to do if it is not helping.

Conclusion

REBT is a structured psychological therapy that works with the beliefs a person holds about events and their part in emotional distress. It teaches skills for questioning rigid beliefs and for arriving at more flexible ones. If you are considering REBT, find a qualified therapist and use an initial consultation to decide, with them, whether it suits what you are bringing.

Key Takeaways

• REBT holds that rigid, extreme beliefs about events contribute to emotional distress, and that more flexible beliefs can be worked towards.
• The ABCDE framework sets out activating event, belief, consequence, disputation and effective new belief.
• REBT offers practical tools that a person can use outside sessions.
• It depends on active participation, including work between sessions, which will not suit everyone.
• REBT is often more structured and time-limited than open-ended therapies. Evidence across conditions is mixed in strength, and the fit is best judged with a therapist rather than assumed.

Frequently Asked Questions

What makes REBT different from other forms of therapy?

REBT concentrates on identifying and disputing rigid beliefs directly, which distinguishes it from therapies that give more weight to emotional processing or to exploring earlier experience.

How long does a course of REBT take?

REBT is usually offered as a time-limited course rather than open-ended work. A study of 349 people treated at the Albert Ellis Institute between 2007 and 2016 measured their functioning after three sessions and again at the twentieth, and reported improvement at both points, with a medium effect size. [3] That gives a sense of the scale of a full course, but it is not a prescription. What your own work needs depends on what you are bringing, how long it has been present, and what you and the therapist agree you are working towards. Length is worth discussing at the outset and reviewing as you go.

Can REBT be conducted online?

Many therapists offer REBT online, which can help where travel, location or scheduling makes in-person sessions difficult. Whether online work is appropriate depends on the person and the difficulty, and is worth raising at the first consultation.

Is REBT suitable for children and adolescents?

REBT is used with younger people, with the language and exercises adapted to their age. A therapist who works with children and adolescents will be able to say whether it suits a particular child.

References

• [1] David, D., Cotet, C., Matu, S., Mogoase, C., & Stefan, S. (2018). 50 years of rational-emotive and cognitive-behavioral therapy: A systematic review and meta-analysis. Journal of Clinical Psychology, 74(3), 304–318. https://pmc.ncbi.nlm.nih.gov/articles/PMC5836900/
• [2] Oxford Bibliographies in Psychology. Rational Emotive Behavior Therapy. Oxford University Press. https://www.oxfordbibliographies.com/display/document/obo-9780199828340/obo-9780199828340-0147.xml
• [3] David, O. A., Cîmpean, A., Costescu, C., DiGiuseppe, R., Doyle, K., Hickey, M., & David, D. (2021). Effectiveness of outpatient rational emotive behavior therapy over one decade. American Journal of Psychotherapy, 74(4), 157–164. doi:10.1176/appi.psychotherapy.20200009. https://pubmed.ncbi.nlm.nih.gov/34325525/