Abstract
In this chapter, I will consider how REBT therapists assess the problems that people bring to therapy, how and when they carry out a case conceptualisation and how they intervene on these problems. Throughout, my main, but not exclusive focus will be on therapists helping clients address their problems by encouraging them to change their irrational beliefs to their rational alternatives using a range of different methods. In doing so, I will not take the usual tack of considering assessment and conceptualisation separately from intervention. Rather I will consider them as REBT therapists approach them in action, as interdependent clinical activities within a developing working alliance (see Chap. 7 this volume). This focus also reflects REBT’s view that cognition, emotion and behavior are interdependent processes and that these need to be considered as such throughout therapy. In this chapter, I will assume that the client and therapist have given their informed consent to proceed on the basis that REBT has the potential to be helpful to the client.
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Appendix
Appendix
Appendix: A Guide to the Eight Emotional Problems and their Healthy Alternatives with Adversities, Beliefs and Associated Behaviour and Thinking
Anxiety Versus Concern
A = Adversity | You are facing a threat to your personal domain | |
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Anxiety | Concern |
C = Behaviour | You avoid the threat | You face up to the threat without using any safety-seeking measures |
You withdraw physically from the threat | ||
You ward off the threat (e.g. by rituals or superstitious behaviour) | You take constructive action to deal with the threat | |
You try to neutralise the threat (e.g. by being nice to people of whom you are afraid) | You seek support from others to help you face up to the threat and then take constructive action by yourself rather than rely on them to handle it for you or to be there to rescue you | |
You distract yourself from the threat by engaging in other activity | ||
You keep checking on the current status of the threat hoping to find that it has disappeared or become benign | ||
You prepare to meet the threat but do not over-prepare | ||
You seek reassurance from others that the threat is benign | ||
You seek support from others so that if the threat happens they will handle it or be there to rescue you | ||
You over-prepare in order to minimise the threat happening or so that you are prepared to meet it (NB it is the over-preparation that is the problem here) | ||
You tranquillise your feelings so that you don’t think about the threat | ||
You overcompensate for feeling vulnerable by seeking out an even greater threat to prove to yourself that you can cope | ||
C = Subsequent thinking | Threat-exaggerated thinking | |
You overestimate the probability of the threat occurring | You are realistic about the probability of the threat occurring | |
You underestimate your ability to cope with the threat | You view the threat realistically | |
You ruminate about the threat | You realistically appraise your ability to cope with the threat | |
You create an even more negative threat in your mind | You think about what to do concerning dealing with threat constructively rather than ruminate about the threat | |
You magnify the negative consequences of the threat and minimise its positive consequences | ||
You have more task-irrelevant thoughts than in concern | You have more task-relevant thoughts than in anxiety | |
You picture yourself dealing with the threat in a realistic way | ||
Safety-seeking thinking | ||
You withdraw mentally from the threat | ||
You try to persuade yourself that the threat is not imminent and that you are ‘imagining’ it | ||
You think in ways designed to reassure yourself that the threat is benign or if not, that its consequences will be insignificant | ||
You distract yourself from the threat e.g. by focusing on mental scenes of safety and well-being | ||
You over-prepare mentally in order to minimise the threat happening or so that you are prepared to meet it (NB once again it is the over-preparation that is the problem here) | ||
You picture yourself dealing with the threat in a masterful way | ||
You overcompensate for your feeling of vulnerability by picturing yourself dealing effectively with an even bigger threat. | ||
Depression Versus Sadness
A = Adversity | You have experienced a loss from the sociotropic and/or autonomous realms of your personal domain | |
You have experienced failure within the sociotropic and/or autonomous realms of your personal domain | ||
You or others have experienced an undeserved plight | ||
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Depression | Sadness |
C = Behaviour | You become overly dependent on and seek to cling to others (particularly in sociotropic depression) | You seek out reinforcements after a period of mourning (particularly when your inferential theme is loss) |
You bemoan your fate or that of others to anyone who will listen (particularly in pity-based depression) | You create an environment inconsistent with depressed feelings | |
You create an environment consistent with your depressed feelings You attempt to terminate feelings of depression in self-destructive ways You either push away attempts to comfort you (in autonomous depression) or use such comfort to reinforce your dependency (in sociotropic depression) or your self- or other-pity (in pity-based depression) | You express your feelings about the loss, failure or undeserved plight and talk in a non-complaining way about these feelings to significant others You allow yourself to be comforted in a way that helps you to express your feelings of sadness and mourn your loss | |
C = Subsequent thinking | You see only negative aspects of the loss, failure or undeserved plight | You are able to recognise both negative and positive aspects of the loss or failure |
You think of other losses, failures and undeserved plights that you (and in the case of the latter, others) have experienced | You think you are able to help yourself | |
You think you are unable to help yourself (helplessness) | You look to the future with hope | |
You only see pain and blackness in the future (hopelessness) | ||
You see yourself being totally dependent on others (in autonomous depression) | ||
You see yourself as being disconnected from others (in sociotropic depression) | ||
You see the world as full of undeservedness and unfairness (in plight-based depression) | ||
You tend to ruminate concerning the source of your depression and its consequences | ||
Guilt Versus Remorse
A = Adversity | You have broken your moral code | |
You have failed to live up to your moral code | ||
You have hurt someone’s feelings | ||
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Guilt | Remorse |
C = Behaviour | You escape from the unhealthy pain of guilt in self-defeating ways | You face up to the healthy pain that accompanies the realisation that you have sinned |
You beg forgiveness from the person you have wronged | You ask, but do not beg, for forgiveness | |
You promise unrealistically that you will not ‘sin’ again | You understand the reasons for your wrongdoing and act on your understanding | |
You punish yourself physically or by deprivation | You atone for the sin by taking a penalty | |
You defensively disclaim responsibility for wrongdoing You make excuses for your behaviour You reject offers of forgiveness | You make appropriate amends You do not make excuses for your behaviour or enact other defensive behaviour You accept offers for forgiveness | |
C = Subsequent thinking | You conclude that you have definitely committed the sin | You take into account all relevant data when judging whether or not you have ‘sinned’ |
You assume more personal responsibility than the situation warrants | You assume an appropriate level of personal responsibility | |
You assign far less responsibility to others than is warranted | You assign an appropriate level of responsibility to others | |
You dismiss possible mitigating factors for your behaviour | You take into account mitigating factors | |
You only see your behaviour in a guilt-related context and fail to put it into an overall context | You put your behaviour into overall context | |
You think that you will receive retribution | You think you may be penalised rather than receive retribution | |
Shame Versus Disappointment
A = Adversity | Something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others | |
You have acted in a way that falls very short of your ideal | ||
Others look down on or shun you (or a group with whom you identify) or think that they do | ||
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Shame | Disappointment |
C = Behaviour | You remove yourself from the ‘gaze’ of others | You continue to participate actively in social interaction |
You isolate yourself from others | You respond positively to attempts of others to restore social equilibrium | |
You save face by attacking other(s) who have ‘shamed’ you | ||
You defend your threatened self-esteem in self-defeating ways | ||
You ignore attempts by others to restore social equilibrium | ||
C = Subsequent thinking | You overestimate the negativity of the information revealed | You see the information revealed in a compassionate self-accepting context |
You overestimate the likelihood that the judging group will notice or be interested in the information | You are realistic about the likelihood that the judging group will notice or be interested in the information revealed | |
You overestimate the degree of disapproval you (or your reference group) will receive | You are realistic about the degree of disapproval self (or reference group) will receive | |
You overestimate how long any disapproval will last | You are realistic about how long any disapproval will last | |
Hurt Versus Sorrow
A = Adversity | Others treat you badly (and you think you do not deserve such treatment) | |
You think that the other person has devalued your relationship (i.e. someone indicates that their relationship with you is less important to them than the relationship is to you) | ||
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Hurt | Sorrow |
C = Behaviour | You stop communicating with the other person | You communicate your feelings to the other directly |
You sulk and make obvious you feel hurt without disclosing details of the matter You indirectly criticise or punish the other person for their offence You tell others how badly you have been treated, but don’t take any responsibility for any contribution you may have made to this | You request that the other person acts in a fairer manner towards you You discuss the situation with others in a balanced way, focusing on the way you have been treated and taking responsibility for any contribution you may have made to this | |
C = Subsequent thinking | You overestimate the unfairness of the other person’s behaviour | You are realistic about the degree of unfairness in the other person’s behaviour |
You think that the other person does not care for you or is indifferent to you | You think that the other person has acted badly rather than as demonstrating lack of caring or indifference | |
You see yourself as alone, uncared for or misunderstood | You see yourself as being in a poor situation, but still connected to, cared for by and understood by others not directly involved in the situation | |
You tend to think of past ‘hurts’ You think that the other person has to make the first move to you and you dismiss the possibility of making the first move towards that person | If you think of past hurts you do so with less frequency and less intensity than when you feel hurt | |
You are open to the idea of making the first move towards the other person | ||
Unhealthy Anger Versus Healthy Anger
A = Adversity | You think that you have been frustrated in some way or your movement towards an important goal has been obstructed in some way | |
Someone has treated you badly | ||
Someone has transgressed one of your personal rules | ||
You have transgressed one of your own personal rules | ||
Someone or something has threatened your self-esteem or disrespected you | ||
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Unhealthy anger | Healthy anger |
C = Behaviour | You attack the other(s) physically You attack the other(s) verbally | You assert yourself with the other(s) You request, but do not demand, behavioural change from the other(s) |
You attack the other(s) passive-aggressively | You leave an unsatisfactory situation non-aggressively after taking steps to deal with it | |
You displace the attack on to another person, animal or object | ||
You withdraw aggressively | ||
You recruit allies against the other(s) | ||
C = Subsequent thinking | You overestimate the extent to which the other(s) acted deliberately | You think that the other(s) may have acted deliberately, but you also recognise that this may not have been the case |
You see malicious intent in the motives of the other(s) | You are able to see the point of view of the other(s) | |
You see yourself as definitely right and the other(s) as definitely wrong | You have fleeting, rather than sustained thoughts to exact revenge | |
You are unable to see the point of view of the other(s) | You think that other(s) may have had malicious intent in their motives, but you also recognise that this may not have been the case | |
You plot to exact revenge | You think that you are probably rather than definitely right and the other(s) as probably rather than definitely wrong | |
You ruminate about the other’s behaviour and imagine coming out on top | ||
Jealousy Versus Concern for Your Relationship
A = Adversity | A threat is posed to your relationship with your partner from a third person. | |
A threat is posed by uncertainty you face concerning your partner’s whereabouts, behaviour or thinking in the context of the first threat | ||
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Jealousy | Concern for your relationship |
C = Behaviour | You seek constant reassurance that you are loved | You allow your partner to initiate expressing love for you without prompting her or seeking reassurance once she has done so |
You monitor the actions and feelings of your partner | You allow your partner freedom without monitoring his/her feelings, actions and whereabouts | |
You search for evidence that your partner is involved with someone else You attempt to restrict the movements or activities of your partner You set tests which your partner has to pass You retaliate for your partner’s presumed infidelity You sulk | You allow your partner to show natural interest in members of the opposite sex without setting tests You communicate your concern for your relationship in an open and non-blaming manner | |
C = Subsequent thinking | You exaggerate any threat to your relationship that does exist | You tend not to exaggerate any threat to your relationship that does exist |
You think the loss of your relationship is imminent | You do not misconstrue ordinary conversations between your partner and another men/women | |
You misconstrue your partner’s ordinary conversations with relevant others as having romantic or sexual connotations | You do not construct visual images of your partner’s infidelity | |
You construct visual images of your partner’s infidelity | You accept that your partner will find others attractive but you do not see this as a threat | |
If your partner admits to finding another person attractive, you think that s/he finds that person more attractive than you and that s/he will leave you for this other person | ||
Malicious Envy Versus Non-malicious Envy
A = Adversity | Another person possesses and enjoys something desirable that you do not have | |
B = Belief | Irrational (rigid and extreme) | Rational (flexible and non-extreme) |
C = Emotion | Malicious envy | Non-malicious envy |
C = Behaviour | You disparage verbally the person who has the desired possession to others | You strive to obtain the desired possession if it is truly what you want |
You disparage verbally the desired possession to others | ||
If you had the chance you would take away the desired possession from the other (either so that you will have it or that the other is deprived of it) | ||
If you had the chance you would spoil or destroy the desired possession so that the other person does not have it | ||
C = Subsequent thinking | You tend to denigrate in your mind the value of the desired possession and/or the person who possesses it | You honestly admit to yourself that you desire the desired possession |
You try to convince yourself that you are happy with your possessions (although you are not) | You are honest with yourself if you are not happy with your possessions, rather than defensively trying to convince yourself that you are happy with them when you are not | |
You think about how to acquire the desired possession regardless of its usefulness | You think about how to obtain the desired possession because you desire it for healthy reasons | |
You think about how to deprive the other person of the desired possession | You can allow the other person to have and enjoy the desired possession without denigrating that person or the possession You think about what the other has and lacks and what you have and lack | |
You think about how to spoil or destroy the other’s desired possession You think about all the other things the other has that you don’t have | ||
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Dryden, W. (2019). Rational Emotive Behavior Therapy: Assessment, Conceptualisation and Intervention. In: Bernard, M.E., Dryden, W. (eds) Advances in REBT. Springer, Cham. https://doi.org/10.1007/978-3-319-93118-0_8
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