There is an abundance of therapeutic approaches in addiction. As the addiction epidemic continues, researchers and therapists are looking for new and effective ways to treat substance use disorders in a way that leads to long-lasting sobriety. One of these treatment options is Rational Emotive Behavior Therapy. It’s one of the most common forms of psychotherapy used in addiction treatment.
Learn more about Rational Emotive Behavior Therapy, how it works, and whether or not it’s effective.
Rational Emotive Behavior Therapy, or REBT, is a form of cognitive behavioral therapy (CBT), which is one of the most commonly recommended therapy approaches in addiction treatment. CBT is a broad category of therapies that can include many different approaches, including REBT, which is one of the most popular. REBT is based on the idea that behaviors can be modified by changing your perception in order to treat symptoms.
One of the core philosophies of this type of therapy is that circumstances don’t cause symptoms; your perception of those circumstances causes symptoms. In other words, the way you respond to circumstances in your life affects how you experience negative symptoms or positively cope with challenges. When it comes to addiction treatment, triggers and stress don’t cause you to relapse, but your perception of those events and your coping response can.
The focus on rational thinking also defines REBT. Your therapist helps you work through issues, promotes rational thoughts, and challenges irrational thinking. The idea of rationality and irrationality is a central tenet of REBT, and it grounds the therapy from a humanistic perspective.
A humanistic approach to treatment means the therapy is focused on improving your own self-image and self-actualization. It also means that REBT often emphasizes positivity and promoting a positive outlook.
In REBT, your therapist will avoid making you feel judged. Instead, behaviors and irrational responses that lead to negative behavior are judged.
REBT was pioneered by a psychologist named Albert Ellis in the 1950s. His theories are based on the idea of the central human condition, which is that humans are inherently irrational and self-defeating. Treating cognitive-behavioral problems requires a person to challenge irrational beliefs.
Some of the main irrational beliefs that Ellis said people hold to are:
Because of these irrational expectations for perfection, Ellis also believed that it’s important for therapists to avoid using words like “must” and speaking in absolutes.
Rational Emotive Behavior Therapy works through what Ellis called the ABC model. The model involves identifying activating events (or adversity), beliefs in response to that event, and consequences of those beliefs.
For instance, an activating effect could be some stressor in your life, like being late for work. Your belief in response to that stressor might be that you will inevitably be fired, which causes you to react by driving recklessly. The consequence is the result of that reaction, which could be that you get in a speeding ticket. Consequences can lead back to new activating events, which trigger a new ABC cycle.
In REBT, the ABC model is used to facilitate positive outcomes. So, when an activating event like being late occurs, REBT would encourage a belief response that being late for work happens to everyone sometimes and that it won’t likely lead to immediately losing your job. The result is a calmer ride to work, avoiding tickets, and worse outcomes.
Other approaches to REBT include role-playing, shame attacking, reframing, homework, and the use of humor. All of these elements are used to help identify activating events and using learned coping responses. It’s also used to gain insight into different events in your life by realizing that symptoms are caused by perception and belief and that it’s important to dispute irrational beliefs continually.
Rational Emotive Behavior Therapy has several benefits in addiction treatment and in a variety of other applications. However, it also has some criticisms. Here are a few of each:
Thoughts and behaviors are accessible. Other treatment models might focus on memories, past events, and childhood issues, which aren’t as accessible or as easy to remember as your current thoughts and feelings. It may be easier for an individual to engage with a treatment approach that just seeks to explore what they are going through right now.
REBT is also an evidence-based treatment, which means that it has shown to be effective in scientific studies. Research also has shown that the therapy has been effective when it comes to reducing irrational beliefs and treating the symptoms of behavioral problems.
Since REBT is centered on facilitating a philosophical change, the therapy can be effective in treating a wide variety of disorders and people. A philosophical change can also be very long-lasting, facilitating long-term sobriety and freedom from active addiction.
The core philosophy that “thoughts cause symptoms” has been scrutinized because, even though it’s logical, it’s debatable. Symptoms of psychological problems may be caused by specific disorders, biochemical issues, and other issues that warp thoughts. However, REBT advocates point out that that doesn’t mean REBT can’t be effective. What causes symptoms to appear may not matter if REBT can effectively address symptoms, thinking, and disorders.
REBT also uses a “therapist as expert” model, which means the therapist takes an authoritative position in treatment. Other forms of therapy prefer to approach treatment where the individual self-explores to find answers with some assistance from the therapist. REBT involves a lot of involvement from a therapist, which some see as a negative. However, heavy therapist involvement may be essential to promote self-actualization and self-efficacy.
Dartmouth College. (2006). Understanding our response to stress and adversity. from https://www.dartmouth.edu/~eap/abcstress2.pdf
Lyons, L. C., & Woods, P. J. (2002, July 1). The efficacy of rational-emotive therapy: A quantitative review of the outcome research. from https://www.sciencedirect.com/science/article/pii/0272735891901139
Psychology Today. (n.d.). Rational Emotive Behavior Therapy. from https://www.psychologytoday.com/us/therapy-types/rational-emotive-behavior-therapy