Rational-Emotive Behavior Therapy

Illustration of the ABCDE model of Rational-Emotive Therapy according to Albert Ellis

The rational emotive behavior therapy ( REBT ) is a psychological process and is both conversation and behavior-oriented. After a long development process, it now belongs to the group of behavioral therapies and especially to cognitive behavioral therapies . The focus is on the human being as a goal-oriented and social being who suffers from being prevented from achieving goals by blocking attitudes and feelings. By illustrating changed attributions it is shown that one is not helplessly at the mercy of this suffering, but that with the help of one's own mental powers one can learn to actively change feelings and behavior. The therapy starts with (present and past) conflicts on the level of attitudes, feelings and behavior.

REVT is a comprehensive, integrative, active-directive, philosophically and empirically sound psychotherapy that focuses on solving emotional problems and behavioral disorders, and thus enables people to lead a happier and more fulfilled life. The terminology rational and emotive makes it clear that this is an emotion-focused and experience-oriented psychotherapy. Even if REVT is now (methodologically correct) subsumed under behavioral therapy, the emphasis is on the fact that REVT (such as conversation psychotherapy and gestalt therapy ) v. a. is a humanistic psychotherapy.

In the following, only the cognitive methods are discussed, but it is important to note that the REVT consists not only of these, but of (interwoven) cognitive, behavioral and emotive methods. Albert Ellis criticized the fact that the REVT is often reduced to the cognitive methods (here especially the disputation), and also often to the application of a (then simplified, superficial) ABC scheme.

Background / theory

Rational Emotive Behavior Therapy (REVT, formerly RET), founded by Albert Ellis in 1955, led to the "cognitive turnaround" in behavioral therapy and is considered a pioneering approach in cognitive behavioral therapy (CBT). Together with AT Beck's cognitive therapy (KT), it represents an important basis for CBT today. Further roots of CBT lie in Meichenbaum's cognitive behavior modification, Mahoney’s development-oriented cognitive therapy and the like. a. In addition, the REVT has an explicitly formulated philosophical background ( Stoa , Epicureanism , skepticism , existential philosophy , constructivism and philosophy of language ). The original REVT concept of self and external acceptance also distinguishes it from other forms of cognitive behavioral therapy (e.g. multimodal therapy according to Arnold A. Lazarus or self-management therapy according to Frederick Kanfer ), although this basic attitude of REVT also differs from some of the more recent representatives Developments of the CBT were received, so z. B. in the Acceptance and Commitment Therapy (ACT) according to Hayes or the so-called " dialectical behavioral therapy " according to Marsha Linehan . REVT is a holistic, action-oriented humanistic psychotherapy approach with the aim of emotional growth: clients are encouraged to experience and express their feelings consciously, emphasizing the connection between thinking, feeling and acting.

History / origin

The RET or REVT (renamed by Albert Ellis himself) was developed in 1955 by the American psychologist Albert Ellis , who was born in Pittsburgh, Pennsylvania . He previously worked psychoanalytically, but was dissatisfied with the results of his work. In Germany, the Ellis method named after him (cf. Schwartz, 2014) has been used with increasing use since around 1980. The first books published in Germany on this subject ("RE-Therapy", "Rational-Emotive Therapy in Clinical Practice") by D. Schwartz and Keßler and Hoellen appeared in 1981 and 1982 and have made the method widely available in Germany contributed. REVT is a humanistic psychotherapy approach and was developed on the background of a learning psychology-empirical science model.

Basics

Rational-Emotive Behavioral Therapy is based on the so-called " ABC model " (also known as the "ABCDE model" ). A triggering external or internal psychological event (A = activating event, adversity ), such as B. the death of a family member is assessed on the basis of certain conscious or unconscious beliefs, assessment patterns, attitudes or rules of life (B = beliefs or belief systems ) that are activated in the triggering situation. This evaluation can be rational, thus logically and empirically verifiable as well as appropriate to the situation, or irrational, i.e. illogical and empirically not verifiable as well as situation-inappropriate. As a consequence (C = consequences ) of this evaluation, there are then emotional reactions and behaviors (e.g. sadness, worry, fear) which, with a prior rational evaluation, lead to healthy emotions (so-called healthy negative emotions such as sadness or concern) and goal-oriented behavior or, in the case of irrational evaluation, lead to unhealthy emotions (so-called unhealthy negative emotions such as depression or fear) and dysfunctional behavior. Thus the evaluation of the individual determines his reaction to the adverse events (Adversities, A). If the event is assessed as irrelevant (i.e. not assessed), this does not lead to an emotional reaction. A unique selling point of REVT is its so-called binary emotion model. In contrast to the KT approach according to Beck, the REVT sees emotions such as grief or worry (healthy negative emotions) versus depression or panic (unhealthy negative emotions) as qualitatively different emotions, whereas according to the unitary emotion model, grief and depression are only distinguished quantitatively .

According to Ellis, mental disorders are caused by “irrational” beliefs or evaluation patterns. Beliefs are called “irrational” if they are subjectively stressful and hinder the realization of one's own goals in life. As a result of an inappropriate reaction, the irrational conviction is questioned (D = disputation ) and a cognitive restructuring follows (E = effect ). “Rational” beliefs, on the other hand, are helpful and productive with regard to emotions and behavior.

The irrational beliefs described by Ellis are grouped into four basic categories:

Absolute demands : wishes become absolute demands ("I have to ...", "the others have to ...");
Global negative self and external evaluations : instead of individual characteristics, the whole person is evaluated as inferior ("I am worthless / a failure ...", "the other person is no good ...");
Catastrophizing : negative events are overstated ("it would be absolutely terrible if ...");
Low tolerance for frustration : Belief in not being able to endure negative events (“I couldn't take it if…”).

Many irrational beliefs are a combination of absolute requirements (category 1) and assessments of categories 2 to 4. The requirement to have to do everything leads to non-compliance, for example. B. to the conclusion that they are worthless or cannot stand it.

aims

The aim of the procedure is to recognize and change the irrational (self-damaging, non-goal-oriented) evaluations. Ideally, this should help the patient to have a “more rational” view of life and enable him to deal appropriately with future problems. A variety of disorders in the psychological and psychosomatic area, z. B. Treating depression and anxiety .

The focus is on the perception of oneself and others, and the extent to which one's own beliefs are beneficial or detrimental to self-worth is examined, so that patients or clients can learn to accept themselves and their way of life and to take responsibility for their actions. The focus is on the possibility that certain changes can be made on their own and that the clients are not helplessly exposed to problems or conflicts.

The term negative triad arose from this : the patient has negative views and cognitive misconceptions (such as arbitrary conclusions, selective abstraction, over-generalization, exaggeration and understatement, as well as dysfunctional evaluation modes such as catastrophizing, must-think and generalized personal judgment) about himself yourself , the environment and the future . Looking at this triad from the point of view of attribution theory would indicate an internal, global and stable attitude towards things. As already described above, the aim is to change these attributions.

The age group of clients is not specified. Children, adolescents and also young and older adults can be treated so that there are no age restrictions as long as the client already or still understands what the therapy is aimed at.

Application / procedure

There is a division into individual and group therapy . In therapy, irrational beliefs are made conscious, questioned (disputation) and changed in the sense of a cognitive restructuring. These feelings resulting from the convictions and attitudes should be intensively experienced and changed at the same time.

The changes to the settings may take place. a. through the Socratic dialogue . As a result, the current beliefs and philosophies of life are critically questioned by examining their usefulness, their logic or their empirical verifiability (disputation). The therapist asks open questions and tries to guide the client to recognize their own contradictions. This is done by means of imagination exercises (emotive disputation) in which negative feelings are evoked and changed, behavioral exercises (behavioral disputation) in which clients expose themselves to an embarrassing situation in order to find out that their fears will not arise, by means of identification of automatic thoughts, assessment of cognitive ones Distortions and changes in dysfunctional cognitions. It is worked out which thoughts are directly connected with the occurrence of the present stressful feelings, which cognitive distortions are based on the vicious circle of worries, doubts, tension, apprehensions, physical anxiety and avoidance behavior and how these self-damaging dysfunctional cognitive schemes are changed or through more helpful ones can be replaced. Homework between the different sessions is used to put new insights into practice (behavioral disputation). This is an important part of the so-called working-through process (German: process of working through ) (in order to transform intellectual insight into emotional insight). A combination with other techniques from the emotive, cognitive and behavioral area, also from other therapy schools, is possible and useful.

literature

U. Baumann, M. Perrez (Ed.): Textbook Clinical Psychology - Psychotherapy . Huber, Göttingen 1998, ISBN 978-3-456-85007-8 .
F. Dorsch, H. Haecker, KH Stapf: Dorsch Psychological Dictionary. 14th edition. Huber Verlag, Bern 2004, ISBN 978-3-456-83966-0 .
Windy Dryden: Rational Emotive Behavior Therapy. Routledge, London / New York 2009, ISBN 978-0-585-14185-5 .
W. Dryden, R. DiGiuseppe, M. Neenan: A Primer on Rational Emotive Behavior Therapy. 3. Edition. 2010, ISBN 978-0-878-22636-8 .
Albert Ellis : Basics and methods of rational-emotional behavior therapy . Pfeiffer, Munich 1993, ISBN 978-3-608-89079-2 .
A. Ellis, D. Schwartz, P. Jacobi: Coach dich Hemmer-Wüst, Würzburg 2004, ISBN 978-3-89634-439-7 .
T. Forster, W. Hoffmann, CT Eschenröder, H. Zimmermann: Behavioral therapeutic procedures. - in: Munich (Heyne); in: Schwertfeger, B. & Koch, K. (Ed.): The therapy guide. The most important forms and methods, Heyne, Munich 1995, ISBN 978-3-453-09133-7 .
H.-J. Gebhardt, B. Wutka: Behavioral Therapy. - in: Zygowski, H. (ed.): Psychotherapy and Society. Therapeutic Schools in Criticism, Rowohlt, Reinbek bei Hamburg 1987, pp. 72-97, ISBN 978-3-499-55440-7 .
BH Keßler, B. Hoellen: Rational-emotive therapy in clinical practice. An introduction. Beltz, Weinheim 1982, ISBN 978-3-407-54623-4 .
D. Schwartz: Understanding feelings and changing them in a positive way. A life help book for rational-emotional behavior therapy. cip medien, Munich 2011, ISBN 978-3-932096-26-6 .
D. Schwartz: Reason and Emotion. The Ellis Method. Borgmann, Dortmund 2014, ISBN 978-3-86145-344-4 .
D. Schwartz: Rational-Emotive Behavioral Therapy 2014 - still alive and kicking. In: Journal for Rational-Emotive & Cognitive Behavioral Therapy 2014, ISSN 1439-5754 .
V. Waters, D. Schwartz and others: Fritzchen Flounder and Nora Nachtigall. Rational-Emotive Stories for Children. Hans Huber Verlag, Göttingen 2004, ISBN 978-3-456-84033-8 .
D. Schwartz: Reason and Communication. How emotions affect our communication. Borgmann Verlag, Dortmund 2012, ISBN 978-3-86145-333-8 .
Beate Wilken: Methods of cognitive restructuring. A guide to psychotherapeutic practice. 7th edition 2015, Kohlhammer, Stuttgart, ISBN 978-3-17-026872-2 .
Journal of Rational-Emotive & Cognitive Behavior Therapy. ISSN 1439-5754 . (published annually, since 1990)

Individual evidence

^ A. Ellis: Humanistic Psychotherapy. The rational-emotive approach. McGraw-Hill, New York 1973.
↑ Colin Feltham (Ed.): Which Psychotherapy ?: Leading Exponents Explain Their Differences. SAGE, 1997.
↑ cf. et al. Dryden et al .: A Primer on Rational Emotive Behavior Therapy. 2010; Schwartz: Rational-Emotive Behavioral Therapy 2014 - still alive and kicking. 2014.

[1] A. Ellis: Humanistic Psychotherapy. The rational-emotive approach. McGraw-Hill, New York 1973.

[2] Colin Feltham (Ed.): Which Psychotherapy ?: Leading Exponents Explain Their Differences. SAGE, 1997.

[3] . et al. Dryden et al .: A Primer on Rational Emotive Behavior Therapy. 2010; Schwartz: Rational-Emotive Behavioral Therapy 2014 - still alive and kicking. 2014.