Rational Emotive Behavior Therapy: What It Is and How It Works

Rational emotive behavior therapy (REBT) is a form of clinical psychotherapy that aims to resolve emotional and behavioral problems. This type of therapy can help treat anxiety, depression, and substance use disorders.

Below, we’ll take a closer look at what REBT is, how it works, and its effectiveness at treating mental health conditions.

What Is Rational Emotive Behavior Therapy (REBT)?

Rational emotive behavior therapy, also known as REBT, is a type of clinical psychotherapy developed by Albert Ellis in the 1950s. REBT was originally developed as an alternative to what was then known as psychotherapy, which focused almost entirely on verbal dialogue, with very little emphasis on changing thought and behavior patterns.

Ellis used the teachings of the Stoic philosophers of ancient Greece and Rome to guide his development of REBT. Ellis was especially inspired by the Epictetus quote, “Men are disturbed not by things, but by the views they take of them,” which in many ways summarizes the rational emotive behavior therapy approach.

The REBT framework boils down to a few closely related theoretical underpinnings:

• Humans have both innately rational, helpful, and constructive tendencies and irrational, unhelpful, and self-defeating tendencies.
• People consciously and unconsciously construct emotional and behavioral difficulties as a result of these tendencies.
• With education and training, we can overcome these tendencies to change our thought patterns and behaviors.

Rational emotive behavior therapy focuses on cognitive thoughts rather than the unconscious mind, which made it different from most clinical therapy approaches at the time Ellis invented it. REBT posits that humans do not get upset by unfortunate circumstances but rather how they construct their views of these circumstances.

What Conditions Can REBT Help Treat?

Rational emotive behavior therapy has been used to successfully treat a large number of mental health conditions, including:

• Anxiety disorders, including generalized anxiety disorder, social anxiety disorder, specific phobias, and panic disorder: REBT helps identify and change irrational beliefs that contribute to many forms of anxiety.
• Depression: REBT challenges irrational, negative beliefs and helps patients replace those with rational and constructive beliefs.
• Anger management issues: REBT helps individuals identify and change irrational, negative beliefs contributing to anger and develop healthier anger management tools.
• Stress: REBT helps identify and change irrational, negative beliefs that cause stress or minimize the effectiveness of stress management techniques.
• Substance abuse disorders and behavioral addictions: REBT helps patients recognize and change negative thoughts contributing to addiction or increasing the likelihood of relapse.
• Eating disorders: REBT helps patients address and correct distorted beliefs about body image, food, and self-worth.
• Low self-esteem: REBT helps challenge and change self-defeating beliefs about one’s self-worth and abilities.
• Obsessive-compulsive disorder (OCD): REBT is a complementary treatment for OCD that addresses irrational beliefs and thought patterns that worsen OCD symptoms.

“The direct yet empathetic style helps patients confront toxic beliefs and develop healthier patterns of thinking that provide symptom relief across various mental health conditions. REBT gives patients the tools to manage their minds in an active, constructive way,” says psychiatric mental health nurse practitioner (PMHNP) Valerie Puffenberger.

The ABCs of REBT

Rational emotive behavior therapy patients learn to apply the premises of REBT through the ABCDEF model of psychological disturbance and change.

• A – Adversity: The patient experiences an adverse event.
• B – Beliefs about adversity: The patient has irrational beliefs about the adversity they face.
• C – Emotional consequences: The patient experiences negative emotions as a result of their irrational beliefs about the adverse event.
• D – Disputations to challenge beliefs about adversity: With the help of a therapist, the patient disputes the irrational/negative beliefs they have about the adverse event.
• E – Effective new rational beliefs: The patient comes up with new, rational, and more productive beliefs about the adverse event.
• F – New feelings: The patient experiences better emotions as a result of the rational beliefs they now hold about the adverse event.

Although a therapist trained in REBT is useful at all stages of the ABCDEF model, they are particularly important during the D and E stages. The therapist will often directly question, challenge, or try to disprove the patient’s beliefs during the D phase and is often the driving force behind the disputations. During the E phase, the therapist will often provide suggestions or use techniques to guide the patient toward positive, helpful beliefs.

Here’s a hypothetical example of an individual (Sara) using REBT’s ABC model:

• A – Adversity: Sara is laid off from her job due to company downsizing and experiences anxiety and depression as a result.
• B – Beliefs about adversity: Sara holds negative and irrational beliefs like, “I will never find another job” and, “If I don’t get another job soon, I am a complete failure.”
• C – Emotional consequences: As a result of these beliefs, Sara feels unmotivated, sad, and on edge. She becomes more reclusive and turns to alcohol to soothe her emotional pain.
• D – Disputations to challenge beliefs about adversity: Sara seeks out a therapist, and together, they begin to dispute the beliefs she has about herself. Together, they find evidence for why her initial beliefs were irrational.
• E – Effective new rational beliefs: Sara now holds beliefs like, “I will find a new job eventually. I just have to keep trying and have an open mind,” and, “My worth isn’t based on my job. I am not a failure just because I am out of work.”
• F – New feelings: Sara feels empowered, motivated, and hopeful about the future. She begins to see friends and family more often and reduces her alcohol consumption.

The Guiding Principles of Rational Emotive Behavior Therapy

There are a number of guiding principles of rational emotive behavior therapy. The most important is that adversity is not what causes negative consequences and behaviors; it’s the irrational beliefs we hold about adversity that do.

These irrational beliefs are known as the “Three Basic Musts”:

• I must do good enough to get approval from other people or else I am a failure.
• Other people must always treat me with kindness and consideration.
• I must get what I desire when I desire it.

The Three Basic Musts cause disappointment and other negative emotions because they often go against what is real and rational: that we cannot expect the world or ourselves to be perfect.

Another critical principle is that we can change our thought patterns, behaviors, and life outcomes if we transform negative, irrational beliefs into positive, rational ones.

Rational emotive behavior therapy is also founded on principles of radical, unconditional acceptance of oneself, others, and life.

Unconditional self-acceptance (USA) teaches patients to recognize that they, like all humans, are not perfect. It’s natural to make mistakes and have limitations—and we should accept ourselves fully regardless of our flaws, imperfections, and mistakes.

Unconditional other-acceptance (UOA) teaches patients that everyone has flaws and imperfections and makes errors. So, we should accept others unconditionally and be more tolerant and compassionate.

Acceptance of life’s imperfections teaches patients that life is difficult and filled with challenges, setbacks, and adversity. But these are inherent parts of the human experience that we can either fight or accept.

The principles of unconditional acceptance guide therapists’ actions and words during an REBT session. The therapist will use empathy and a non-judgmental attitude. They avoid criticizing or condemning patients for their thoughts, emotions, and behaviors, instead offering understanding, support, and a safe space.

REBT therapists guide patients toward more self-accepting and forgiving attitudes and actively promote self-compassion by exposing irrational negative beliefs. They also promote tolerance and compassion toward others and greater acceptance of the adversity life brings.

REBT vs. CBT

Cognitive behavioral therapy (CBT) is one of the most common and effective forms of clinical therapy for a wide range of mental health conditions. REBT and CBT both aim to change a patient’s thought patterns and behaviors and share many similarities. However, the two types of therapy also are quite different in a number of ways.

The major similarities between REBT vs. CBT include:

• Cognitive focus
• The belief that changing thought patterns can change emotions and behaviors
• Highly structured and goal-oriented nature
• Time-limited
• Evidence-based and proven with decades of studies
• A collaborative therapeutic relationship
• Have homework assignments
• Use and training of behavioral techniques

The major differences between REBT vs. CBT include:

• REBT focuses on the unconditional acceptance of self, others, and life, while CBT does not have a strong philosophical component.
• CBT uses the ABC model, and REBT uses the ABCDEF framework.
• CBT is based on negative thoughts and emotions causing emotional distress, while REBT is based on irrational beliefs causing emotional distress.
• REBT routinely uses more philosophical and confrontational language than what is common in CBT.
• REBT therapists regularly directly challenge patient beliefs; CBT therapists rarely do.
• REBT therapists teach about the “Three Basic Musts” of irrational thinking, which are absent from CBT.

How Effective is REBT?

Studies dating back to the 1950s have proven that REBT is a highly effective form of clinical therapy for a number of mental health conditions. REBT has helped millions of patients improve their lives while minimizing the impacts of their self-destructive and irrational beliefs.

For example, one 10-year study of 349 patients at the Albert Ellis Institute found that patients reported significant improvements in their functioning after rational emotive behavior therapy. Another study compared 68 studies on the effectiveness of REBT and found that most patients saw medium to significant benefits from REBT.

How effective rational emotive behavior therapy will be for an individual will be determined by many factors, including:

• The condition being treated
• The severity of the condition being treated
• The individual client’s characteristics
• The quality and experience of the therapist
• The presence of any co-occurring mental health, medical, or substance use disorders

“REBT empowers people to take an active role in managing their thoughts and emotions, which instills self-efficacy,” says Puffenberger. “It focuses on the present instead of the past, enabling patients to move forward. By teaching patients to think flexibly and practically, they are able to overcome cognitive distortions.”

Here for Your Mental Health

Mental health conditions like anxiety, depression, and addiction can make life much more difficult, whether it’s you or your loved one who is suffering from them. Luckily, Legacy Healing Center is here to provide you with the help you need to take your life back.

We use a three-pronged approach to treating mental health conditions, which includes medication (if needed), evidence-based psychotherapy like REBT, and healthy peer support.

If you or a loved one is looking for mental health therapy, call 888-534-2295 today to speak with a treatment staff member at Legacy Healing Center.

Rational Emotive Behavior Therapy FAQs

How does rational emotive therapy differ from cognitive behavioral therapy?

Rational emotive therapy and cognitive behavioral therapy differ in a number of ways. CBT is focused on the idea that changing thoughts can cause changes in emotions, behaviors, and life outcomes, while REBT has a strong philosophical component that preaches universal acceptance of self, others, and life’s imperfections.

CBT uses an ABC model to describe relationships between events, thoughts, and emotions, while REBT uses an ABCDEF model to help patients replace irrational beliefs with rational ones. CBT believes that the source of emotional disturbances is negative thoughts and beliefs, while REBT believes that the source of emotional disturbances is irrational thoughts and beliefs.

Is rational emotive therapy effective?

Rational emotive behavior therapy is considered highly effective for treating a wide variety of mental health conditions, including anxiety, depression, substance use disorders, and many others. The efficacy of rationally emotive therapy has been shown by numerous studies conducted over a period of seven decades.

What are the techniques used in rational emotive therapy?

There are many techniques used in rational emotive behavior therapy, including:

• Disputation of irrational beliefs (D in the ABCDEF model)
• Socratic questioning
• Empirical arguments
• Logical analysis
• The replacement of irrational beliefs with rational ones
• Homework assignments
• Role-playing
• Behavioral techniques
• Unconditional self-acceptance and unconditional other-acceptance
• Humor
• Provocation techniques
• The ABCDEF model
• Relapse prevention

Who can benefit from rational emotive therapy?

Rational emotive therapy is beneficial to those who suffer from the following conditions and life challenges:

• Anxiety disorders
• Depression
• Anger management issues
• Substance abuse disorders and behavioral addictions
• Poor stress management skills
• Low self-esteem or self-worth
• Relationship problems
• Procrastination and time management problems
• Phobias and obsessions
• Eating disorders
• Grief and loss

About the Author

Jeffrey Juergens

Jeff Juergens is a leading author in the addiction and recovery field, dedicating the last seven years of his life to helping those struggling with substance use issues find the help that they need. Jeff's work has been used in rehabs across the country as tools to help patients achieve sobriety.

Read full bio

Medically Reviewed by

Dr. Edwin Gomez, M.D.

Edwin Gomez, M.D. joined the Legacy Healing Centers Medical Team in 2021. In addition to working at Legacy Healing Centers, Dr. Gomez operates a private practice and research here in the South Florida Area and the Florida Keys. Prior to joining Legacy Healing Center, he served as Medical Dire...

Read full bio