Pioneered by Albert Ellis in the 1950s, rational emotive behavior therapy (REBT) looks at identifying irrational beliefs and thought patterns that may be the cause of emotional or behavioral issues. Ellis' work on REBT layer became the foundation for cognitive behavioral therapy, which is used to help with various types of mental health disorders and substance use problems.

What is rational emotive behavior therapy?

Rational emotive behavior therapy (REBT) is a type of psychotherapy used in the treatment of mental health disorders; pioneered by Albert Ellis in the 1950s. It was through researching REBT that lead Aaron T. Beck to the development of cognitive behavioral therapy (CBT).

REBT dictates that it is not events themselves that cause negative behaviors and emotions. Rather, it is people’s irrational beliefs about the events that lead to emotional and behavioral disturbances.[1] 

REBT involves the identification of irrational beliefs and negative thought patterns that cause behavioral problems. Then, together with a therapist, patients can develop strategies that enable them to replace these thoughts with rational thought patterns. 

REBT is focused on aiding people in eschewing irrational thoughts and coping with their emotions, thoughts, and behavioral problems in a healthy manner.

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REBT treatment components

Central to REBT, is the concept of an ABC framework, which helps explain that while we are prone to blaming outside events for our issues, it is actually our interpretation of these events that cause us angst.

The acronym ABC stands for:[1]

  • A – activating event or adversity – the external event that occurs in our environment
  • B – beliefs – our irrational beliefs about the external event
  • C – consequences – our emotional response to our beliefs

During REBT, your therapist will enable you to apply the ABC model to your daily life. For example, if you are feeling depressed due to a family conflict, your therapist will work with you to identify the activating event (A) for your depressive feelings. They would then help you identify the beliefs causing the offending feelings (B), before assisting you in changing your response (C) to those beliefs.

Example: you didn’t get into your college of choice (A), you feel your prospects have been irreparably harmed B) and thus, you’re experiencing feelings of worthlessness (C).

In the above scenario, REBT would focus on helping shift your perspective from feeling prospects have been damaged. Instead, focus on how many possibilities the future holds and how many alternate routes there are to achieve your goals, and how ultimately no singular event can render a person worthless.

What conditions is REBT used to treat?

REBT is used to treat several conditions including:[2]

Research asserts that sport is culturally encouraging of irrational beliefs in professional athletes.[1] As such, REBT can aid in the psychosocial development of athletes, improving mental health outcomes over the course of their careers.[1]

REBT in addiction treatment

Behavioral therapies, including REBT, have been shown to provide numerous benefits in the treatment of addiction. REBT can help identify, manage and replace the negative thought patterns which act as triggers for substance using, drinking alcohol, or other addictive disorders.[3]

REBT is offered in addiction centers across the country, along with other evidence-based addiction therapies. If you or a loved one suffers from substance abuse or addiction, an addiction center could prove invaluable to recovery.

Effectiveness of REBT

Since the late 1980s and early 90s, REBT was investigated in numerous randomized controlled trials and proved effective for a variety of conditions. These include obsessive-compulsive disorder (OCD), social phobia, depression, psychotic symptoms, parental distress, disruptive behavior, and in the management of side effects resulting from breast cancer treatment.[4]

A 2017 review analyzed 50 years’ worth of research on REBT and concluded that REBT aided people in reshaping their irrational thoughts about external events.[4]

Another study, assessing the impact of REBT on clinical social workers, found REBT to be effective in the treatment of depression in patients.[5] REBT contributed to a 47.9% decrease in the number of visits of patients following a year’s worth of treatment.[5]

A 2017 study found that REBT was successful in reducing anger in schizophrenia sufferers, whilst a separate 2019 study held that REBT was effective in reducing junior high school students’ anxiety in facing examinations.[6]

As underscored by the range of studies mentioned above, REBT can be used to improve all areas of a patient’s life. It can increase self-awareness by teaching patients to overcome self-defeating thoughts and replace them with positive, uplifting thoughts rooted in reality.[1]

Things to consider

REBT can feel like an intimidating undertaking. Confronting personal demons and verbalizing negative thought patterns is a challenging process. It feels counter-intuitive to consider ingrained beliefs as unhealthy and the process of supplanting these long-held beliefs with new ones can seem even more difficult.

Whilst you’ll have to get comfortable feeling uncomfortable initially, REBT can be extremely beneficial in understanding and reframing negative thoughts.

Where to find REBT treatment

Your first port of call is your doctor or other medical professional. Ask for recommendations of therapists or other qualified mental health professionals in your area offering REBT.

Alternatively, websites such as Talkspace or BetterHelp may be useful in locating someone offering REBT.

It is recommended to shop around for therapists, ensuring you find one that is the right fit for you. Feeling comfortable, secure, and confident that your therapist is meeting your therapeutic goals is well within your rights. 

Many therapists offer an introductory session, in which patients can discuss their goals and both parties can establish whether they are a good fit for one another.

Does health insurance cover REBT?

Under the Affordable Care Act, all plans purchased through the health insurance marketplace cover mental health services, such as therapy. This is irrespective of whether they are state or federally managed and includes family plans, small business plans, and individual plans.

If you have health insurance through your work, it’s possible it includes coverage for therapy. 

Insurance companies recognize the increased societal awareness and importance of good mental health, and this is reflected in many policies offered. However, they will require a mental health diagnosis before paying on any claims, which can be uncomfortable for people.

Medicaid and Medicare both cover essential health benefits, including therapeutic services in many instances. Check the terms of your personal plan to verify what, if any, additional costs you would have to pay to access the therapeutic treatment of your choice.