REBT: Rational Emotive Behavior Therapy and the ABCDE Model

About this tool

REBT, short for rational emotive behavior therapy, is a form of psychotherapy developed by the American psychologist Albert Ellis from 1955 onward, and it is the earliest of the cognitive behavioral therapies. Its central claim is old and simple: people are disturbed less by events than by the rigid beliefs they hold about those events. Ellis took the idea from the Stoic philosopher Epictetus and built a practical method on it: identify the belief that sits between a situation and your reaction, argue with it until it gives way, and replace it with something flexible you can actually hold. He called the approach rational therapy at first, renamed it rational emotive therapy in 1961, and settled on rational emotive behavior therapy in 1993.

The working model is the ABC model, which Ellis introduced and which later CBT inherited. A is the activating event: what happened, or what you expect to happen. C is the consequence: the emotion you felt and what you did. B is the belief about A, and the whole point of REBT is that B, not A, produces C. Two people lose the same job; one feels sad and starts applying elsewhere, the other feels worthless and stays in bed. Same event, different belief. REBT extends the model to ABCDE. D is disputing: questioning the belief on logical, empirical and pragmatic grounds. E is the effective new belief, and the new emotion that follows from it.

Ellis argued that most emotional disturbance runs through four belief processes. Demandingness is the core one: absolute musts, shoulds and have-tos aimed at yourself, at other people or at life. The other three grow from it. Awfulizing turns a bad outcome into a catastrophe, completely bad with nothing worse imaginable. Low frustration tolerance is the conviction that you cannot stand discomfort, that it is unbearable rather than hard. Global rating, or depreciation, judges a whole person or the whole of life from one event: I failed, therefore I am a failure. These are evaluative stances rather than cognitive distortions in Beck's sense, and the demand is always the one to find first.

Each has a rational counterpart, and the worksheet below asks you to write one. A rigid demand becomes a flexible preference: I would strongly prefer to pass, and I do not have to. Awfulizing becomes a realistic appraisal: this is bad, perhaps very bad, and not the end of the world. Low frustration tolerance becomes high frustration tolerance: this is hard to bear, I can bear it, and it is worth bearing. Global rating becomes unconditional acceptance of yourself, of others and of life, which Ellis considered the philosophical heart of the approach. You can judge your acts and your results. You cannot sensibly give a whole, changing human being a single grade.

Unconditional self-acceptance is where REBT departs from most popular psychology. Ellis was suspicious of self-esteem: if your worth rises when you succeed, it has to fall when you fail, which makes self-esteem a setup for anxiety on good days and depression on bad ones. His alternative was to drop the rating altogether, accept yourself as a fallible human being who does good and bad things, and spend the saved energy on changing what you can.

Disputing works on three grounds. Logical: does it follow that because I want this, I must have it? Empirical: where is the evidence that the universe runs on my musts, or that I literally cannot survive discomfort? Pragmatic: where does holding this belief get me? REBT also separates unhealthy negative emotions, which follow from demands, from healthy ones, which follow from preferences: anxiety becomes concern, depression becomes sadness, rage becomes annoyance, guilt becomes remorse. The aim is never to feel nothing about a loss; it is to feel the fitting amount.

REBT is one of the cognitive behavioral therapies, so the question of REBT versus CBT is really a comparison with Aaron Beck's cognitive therapy, which started a few years later and became the dominant form. The difference is method. Beck treats a negative thought as a hypothesis to test: gather evidence for and against, run a behavioral experiment, let the data settle it. Ellis treats the underlying demand as a philosophy to dispute: attack the must directly, on logical and pragmatic grounds, and aim at what he called an elegant solution, a change in basic outlook rather than a correction to one prediction. Most CBT therapists now borrow from both. A thought record is Beck's tool; the ABCDE worksheet on this page is Ellis's.

The evidence for REBT is real, and also older and thinner than the evidence for CBT as a whole. Meta-analyses by Lyons and Woods in 1991 and by Engels and colleagues in 1993 found REBT more effective than no treatment and comparable to other active therapies. A 2018 systematic review and meta-analysis led by Daniel David, covering fifty years of trials, reached a similar conclusion: medium effects across a range of problems, REBT about as effective as other CBT variants and better than control conditions, with many included trials small or dated. Where a strongly evidenced protocol exists for a condition, such as CBT for panic disorder or OCD, that protocol is the better starting point. For everyday anger, procrastination, performance anxiety and self-criticism, the ABCDE method is well supported and unusually portable.

REBT suits people who like an argument and are willing to question what they believe, not only what they predict. It suits less well anyone who hears disputing as being told their feelings are wrong, a common misreading: the feelings are never irrational in REBT, only the demand behind them. Three mistakes recur on this worksheet. Writing the event in the belief box, which keeps you arguing with reality instead of with yourself. Disputing a surface thought without finding the must beneath it, so the disputing has no target. And writing a rational belief you do not believe, a slogan rather than a conviction.

A worksheet is a way to learn the method, not a course of therapy. If the same demand keeps resurfacing, if your reactions are harming your work or relationships, or if you notice despair, panic or thoughts of harming yourself, work through this with a licensed therapist. The Psychology.com directory lets you search by specialty, including cognitive behavioral therapy, at no cost. The ABC Model Worksheet on this site covers the first three letters in a gentler format, and the Cognitive Restructuring Worksheet and List of Cognitive Distortions give Beck's side of the same work.

Reviewed by Michael Callans, MSW
Checked the ABCDE structure, the four irrational belief processes and their rational counterparts, and the REBT versus Beck distinction against Ellis and Dryden.

References

1. Ellis A. Reason and Emotion in Psychotherapy. Lyle Stuart; 1962.
2. Ellis A, Dryden W. The Practice of Rational Emotive Behavior Therapy. 2nd ed. Springer Publishing; 2007.
3. DiGiuseppe RA, Doyle KA, Dryden W, Backx W. A Practitioner's Guide to Rational-Emotive Behavior Therapy. 3rd ed. Oxford University Press; 2014.
4. David D, Cotet C, Matu S, Mogoase C, Stefan S. 50 years of rational-emotive and cognitive-behavioral therapy: a systematic review and meta-analysis. Journal of Clinical Psychology. 2018;74(3):304-318.
5. Lyons LC, Woods PJ. The efficacy of rational-emotive therapy: a quantitative review of the outcome research. Clinical Psychology Review. 1991;11(4):357-369.

REBT (Rational Emotive Behavior Therapy) FAQ