REBT: Rational Emotive Behavior Therapy for Treating Addicts

Last Updated: October 6, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

Every person suffering from addiction is a unique case, and each person needs to be treated in a manner that is specific to their case. That is why so many therapies can be used when treating addiction, among which is rational emotive behavior therapy (REBT).

This therapeutic method aims to target addiction problems from the foundation — the thought processes that cause issues. This article will discuss REBT, the techniques used, its efficacy, and how therapists can use it to treat substance addiction.

What Is Rational Emotive Behavior Therapy?

Rational emotive behavior therapy is a type of therapy that centers around helping the individual identify irrational beliefs or thoughts that they hold that are the root causes of behavioral problems. REBT, sometimes referred to simply as rational emotive therapy, was developed by Albert Ellis, a psychologist, in the 50s.

For instance, if a person has the irrational belief “If I don’t get the job, I am worthless,” the effects before hearing back from the employers will take a toll on them. If they happen not to get the job, it will have significant consequences on their emotions and self-esteem. Rational emotive therapy focuses on dissolving irrational beliefs so that those consequences do not occur.

Some irrational beliefs that cause problems for addicts have been well studied and are referred to as core irrational beliefs.

These Include the Following:

Demands

These are the primary irrational beliefs seen in people. Demands are when a person considers something to be an absolute and something that must occur no matter what.

Demands Can Be Viewed as a Grouping of Several Individual Beliefs, Which Are:

  • Demand for love and approval, which the person expects from anyone who they consider meaningful
  • Demand for success or achievement, which the person expects in any enterprise that they hold dear
  • Demand for comfort, in which the person expects no hurdles, discomforts, or frustrations in life and the things they do
  • Demandingness (or absolutism), which extends this inflexible belief to anything else. It can be easily seen in thoughts marked by words like “must” and “have to”

Awfulization

This is the belief that certain things have no outcome other than to be 100% bad if they do not go as planned or expected. For instance, missing a plane is an unpleasant thing to happen. Still, for someone to awfulize it, they are elevating it to become a catastrophic, irredeemable event that is way beyond its actual effect.

Low Frustration Tolerance

It is the belief that certain things are absolutely intolerable when they occur, despite that not being the case. An example could be someone who orders food from a delivery service, but it does not come on time. They will find that they “cannot stand it,” although it is not too serious an inconvenience to deal with.

Angry man sitting at workplace throws documents.

Three Basic Musts

Tying in closely to the concept of Demands as an irrational belief are the “Three Basic Musts.” In REBT therapy they can be viewed as the core of all irrational beliefs. These can be read like vocalizations of the demands.

They Are Written Out Below:

  1. I must do well and get the approval of others; otherwise, I am no good.
  2. Others must treat me kindly and the way I want them to. Otherwise, they aren’t good people, and they deserve to be punished.
  3. I must always get what I want when I want it. Also, I must never get what I don’t want. If I don’t get what I want, I can’t stand it.

For people who fail to get the first Must, the consequence tends to be anxiety, depression, or shame, as it ties into the demands they place on themselves. For the second Must, if they feel they aren’t treated fairly, it can lead to aggressive behavior towards others. When they don’t get what they want, such as in the third Must, they react with self-pity, or they begin to procrastinate.

ABC of REBT

When developing this therapy, Albert Ellis came up with a model known as the ABC model. The ABC of REBT was a model designed to help individuals change the irrational thoughts they can identify.

The ABC of REBT eventually developed into the ABCDE model, which is discussed in more detail below.

A: Activating Event

The activating event is what can be considered as the triggering event for an individual’s negative thoughts. It is the first step of the REBT ABC model. The activating event can be almost anything, such as a breakup, losing a loved one, or losing a job.

B: Beliefs

In REBT ABC model, the product of the activating event is the belief that develops as a result of it. These thoughts tend to lead to self-degradation, low self-esteem, anger towards others, and many other mental states. It can include the belief that one must be successful no matter what or that one must be loved by everyone.

C: (Emotional and Behavioral) Consequences

The beliefs that arise from the activating event also have consequences, either emotional or behavioral. Substance abuse and addiction fall into this category, as well as significant changes in eating, self-harm or directing negative emotions towards friends and family.

Woman sitting at the window crying.

D: Disputing Irrational Beliefs

This is the first step in the model that targets treating the irrational beliefs that have arisen. This step aims to prevent the emotional and behavioral consequences from taking hold to the degree that can be intensely damaging. At this point, the therapy aims to have the individual identify their negative beliefs and dispute them with facts that disprove those beliefs.

E: Effective New Thinking and Behaviors

Once the individual has disputed these beliefs, they can then replace them with entirely new methods of thinking, which are more rational and positive. These new behaviors can help improve the person’s life in multiple aspects, including their relationships, mood, and general happiness with life.

Techniques Used

When trying to break down the irrational beliefs of the addict, some techniques can be used to target each step of the REBT ABC model. These can make it easier for the therapist to get the individual to change as needed.

For the activating event, the therapist may focus on what is known as problem-solving techniques.

These Include the Following:

  • Problem-solving skills
  • Conflict resolution
  • Decision-making skills
  • Social skills
  • Assertiveness

To go head-on against the B in the ABC of REBT are the techniques known as cognitive restructuring techniques. Though it sounds intimidating, these techniques exist to help alter the irrational beliefs that the client holds into a more positive form.

The Specific Methods Under This Group Include:

  • Utilizing humor and irony
  • Rationalizing techniques
  • Reframing
  • Guided visualization
  • Disputing negative thoughts

Coping techniques are carried out with a primary focus on helping the client cope with the behavioral and emotional consequences of their beliefs. These come into play when the person finds themselves unable to rationalize through their thoughts.

Asian psychologist talking to his client.

Coping techniques do not advance the client closer to recovery per se, but they improve the person’s wellbeing and make them more comfortable and easier to treat.

These Techniques Include:

  • Meditation
  • Hypnosis
  • Relaxation
  • Breathing exercises

What Does REBT Help With?

REBT is a psychological therapeutic technique that can help people with behavioral, psychological, or emotional problems.

Some of the Health Conditions That Rational Emotive Therapy Can Help With Include the Following:

  • Depression
  • Anxiety
  • Social anxiety disorder
  • Substance abuse
  • Obsessive-compulsive disorder
  • Phobias
  • Aggression
  • Sleep problems
  • Eating disorders

It can also be applied to non-medical settings, such as managing stress, sports psychology, and managing grief.

REBT Therapy For Addiction Treatment

Individuals with addiction have irrational thoughts that can easily be targeted by rational emotive behavior therapy.

Demandingness/absolutism is heavily present in the manner in which most of these people think. For instance, many addicts see their drug use as an absolute must for several reasons. It might be that they feel that if they don’t use the substance, they will fail at the things that are important to them or hurt themselves or others. This absolute thinking places them in a box of their own making, as they feel like they have no choice. Rational emotive therapy combats that by helping to dispute those thoughts in a logical and sustained manner.

One of the most worrying aspects of addiction for many addicts’ loved ones is their behavior. These irrational behaviors come about under the influence and due to little resistance from the person. It is not necessary to act on the things they feel, and this is one of the aspects that REBT therapy can bring out.

There have not been many studies examining the efficacy of this therapy in the treatment of addiction specifically. However, a 2009 study found that REBT could significantly reduce the level of addiction seen in several internet-addicted university students.

Effectiveness

While the efficacy of REBT therapy in treating addiction is yet to be widely covered in studies, its general efficacy across several conditions is better established.

This therapeutic method was tested in patients suffering from major depressive disorder, and it was shown to improve not only irrational beliefs but also dysfunctional attitudes and automatic thoughts.

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In sports psychology, athletes were found to have a decrease in irrational beliefs while increasing their self-motivation and self-efficacy, which were the targets for the study.

It was also shown to be a good tool towards improving the effectiveness of individuals in an organization, as a study in 2018 was able to show an improvement in job performance and satisfaction from nurses in Korea.

A study performed in both India and Iran was able to find that REBT was effective in reducing the intensity of pain in patients with cancer, which is an interesting application for this therapy.

CBT vs. REBT

CBT therapy is another therapy used to treat and modify behavior and thoughts in people with certain psychological conditions. However, while they might be similar at first glance, there are some differences between CBT vs. REBT.

  • Comparing CBT vs. REBT, rational emotive therapy treats irrational thought and its consequences, but CBT focuses on the consequence alone.
  • There is a concept known as unconditional self-acceptance in rational emotive behavior therapy. CBT might focus on amplifying the positive qualities of an individual to boost their self-esteem. Still, REBT will help the individual identify that they are an imperfect human like everyone else and help them love themselves like that.
  • REBT therapy identifies that some negative emotions are appropriate and does not attempt to stifle them all. For instance, grief at the loss of a loved one is negative yet appropriate. Anger is more frequently an inappropriate negative emotion.

Using Rational Emotive Therapy to Treat Addiction

Rational emotive behavior therapy is a method that can be used in the treatment of several psychological conditions, among which is addiction. It focuses on curing the irrational beliefs that lie behind specific problems.

For those who have had little success with more popular methods of treatment of addiction or are looking to get started, considering REBT is a step in the right direction.

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Page Sources

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  2. David, D., Cotet, C., Matu, S., Mogoase, C., & Stefan, S. (2018). 50 years of rational-emotive and cognitive-behavioral therapy: A systematic review and meta-analysis. Journal of clinical psychology, 74(3), 304–318. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836900/
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Published on: October 6th, 2021

Updated on: October 6th, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.