Rational Emotive Behavioral Therapy

Client Examples for Diagnosis:(1) A Filipino immigrant who has been referred to the mental health center following statements he made indicating hopelessness and suicidal intent and (2) A women who has been physically disabled since an automobile accident in her early teens and expresses feelings of loneliness and bitterness. She will arrive in a wheelchair, escorted by a personal aide.

It was Albert Ellis who first founded Rational emotive behavioral therapy (REBT), an approach that assumes the client has control over the thinking processes and self talk. REBT “rests on the premise that thinking, evaluating, analyzing, questioning, doing, practicing, and redeciding are at the basis of behavioral change,” (Corey & Corey, 137). Those who align themselves with the REBT approach believe that as individuals we are all born with the capacity for positive, constructive thinking, however, clients who suffer from disturbances, such as depression, often do so as a result of the automatic repetition of irrational and dysfunctional thoughts. The REBT therapist would employ the directive, cognitive approach of Rational-Emotive Behavior Therapy to “exhort, frustrate, and command…..” clients in order “to get them to analyze their thoughts and learn to rationally restructure their belief systems,” (Okun & Kantrowitz, p. 137).
With respect to the two client examples provided, the therapist must remember that: every client is different, therefore it is imperative that a professional take the time to seek the necessary information, understand and recognize their clients’ beliefs, values, morals, background, and chosen lifestyle to ensure the usage of appropriate therapeutic approach. Furthermore, in accordance with the American Counseling Association’s Code of Ethics, section A.4.b., “Counselors are aware of their own values, attitudes, beliefs, and behaviors and avoid imposing values that are inconsistent with counseling goals. Counselors respect the diversity of clients, trainees, and research participants,” (Corey et. al, Codes of ethics for the helping professions, 11). As the REBT approach suggests, dysfunctional thinking is often formed during childhood as a result of the repeated use of irrational and illogical beliefs (Corey & Corey, 2007). Furthermore, REBT therapists believe that it is not a specific event or set of events that causes the emotional disturbance, but the repeated thinking and perception of the event that is at the root of this issue. In preparing for to meet with this client, it would be unethical to suppose the events, issues, or perceptions they have previously struggled with and therefore the therapist must wait to meet with them in order to explore this further with the client.
It is possible that a variety of issues are plaguing these clients. For the Filipino client, it could be that he is struggling to assimilate with Western society, misses the family that he left behind, has been unable to find work or housing, or a wide range of other issues not related to his immigration to the United States and again, it would be unethical to “assume” his difficulties prior to his session. In this case however, it would be suggested that the therapist become knowledgeable of the characteristics a Filipino male as his values, beliefs, and culture would certainly be different that of his or her own. However, once meeting with the client, the REBT therapist would be able to explore the root cause of his emotional disturbance and the dysfunctional thinking processes related to it, without any prior assumptions. Once the irrational thoughts were discovered, the therapist would directly explain to the Filipino client that his self-talk was irrational, self-defeating, rooted in feelings of self-pity, and needed to be changed. After this was explored, the therapist would assign the client homework, in an effort to recondition his dysfunctional thought processes.
In reference to the disabled client, it would also be unethical to assume the root causes of her emotional disturbances, i.e. loneliness and bitterness. While it is likely that her issues are as a reaction to her accident, it could just as likely be related to natural occurrences such as the death of a parent, divorce, or a child leaving for college and again an initial meeting to explore these issues would be advised prior to devising a course of treatment. Once meeting with the client, and assuming that she is experiencing these feeling in relation to her disability, the therapist, would utilize the REBT approach as she did with the Filipino client by disputing the irrational beliefs by “helping clients detect the beliefs, debating with them about whether their beliefs are true or logical, and helping them discriminate between rational and irrational beliefs,” (Capuzzi & Gross, 278). For the disabled client, it is possible that she has maintained feelings of self-pity and bitterness since the time of the accident, focusing on her limitations, rather than her abilities. It would then be necessary to present this issue to the client, evaluate how this thinking process has effected her and aid her in reconditioning her automatic self-talk to a more positive outlook, thus improving her overall mental health and experience.
It is however important to note that while the REBT approach is directive and at times appears abrasive, that the therapist must remain compassionate, friendly and optimistic with the client (Capuzzi & Gross, 2007). “REBT proposes that humans are happiest when they have goals and purposes that give meaning to their lives,” (p.271) and therefore their goals are to foster a positive relationship with the client in order to influence this dynamic change in thinking.
Stephanie Lowrance-Henckel
References
Capuzzi, D. & Gross, D.R. (2007). Counseling and psychotherapy: Theories and interventions. Pearson Education: Upper Saddle River, New Jersey.
Corey, M. S. & Corey, G. (2007). Becoming a helper (5th ed.). Thomson Brooks/Cole. Belmont, CA.
Corey, G., Corey, M. S., & Callanan, P. (2007). Codes of ethics for the helping professions (7th ed.). [Bundled]. Belmont, CA: Thomson Brooks/Cole.
Okun, B. F. & Kantrowitz, R. E. (2008). Effective helping: Interviewing and counseling techniques (7th ed.) Thomson Brooks/Cole. Belmont, CA.