EDUCATIONAL ISSUES

SUBMITTED BY :
PRARTHITA BISWAS-V058
OPTIONAL PAPER_REBT_02
Suggest that clients record and review
their therapy sessions
• Key point
Encourage your clients to record and review therapy sessions as a way of
facilitating their learning of rational principles.
The main advantage of clients tape recording their sessions is that such
recordings provide them with the opportunity to hear themselves
express irrational beliefs that they may have denied having. Tape
recordings also give clients an opportunity to hear and appreciate,
perhaps more fully than they did during therapy sessions, the points that
you as their therapist were making to them .When clients listen to a
recording of a therapy session they are often in a better frame of mind
than when they are talking about their problems in the session.
Educate clients in the model and process of REBT and help
them understand your respective roles within that process
• Preparing clients for psychotherapy has been shown to have a beneficial
effect on the outcome of therapy . When you prepare your clients to
understand REBT and the roles that you and they have to play in the process,
they will make more effective use of therapy. Such preparation can be done
before clients come to therapy or early in the therapeutic process.
• It is crucial to elicit client feedback on whatever material you present. First, it
communicates to your clients that you are taking them seriously as active
partners in the therapeutic process. Second, the questions clients raise during
feedback often provide useful clues to how you as a therapist may have to
change your normal style to accommodate their idiosyncratic and healthy
preferences about therapy. You may need to stress these changes when
explaining your therapeutic style to some clients.
Explain what you are doing and why you
are doing it
• It is important for you to explain, at fairly regular intervals, not only
what you are doing, but why you are doing it. If you can explain to
your clients the rationale for an intervention before you make it and if
your clients can indicate that it makes sense to them, this is a good
way of gaining their cooperation. This is particularly useful if you plan
to make interventions that may otherwise be perceived as strange or
even aversive by your clients.
• There are exceptions to this practice and these concern times when it
is important for your client to have an experience and when a prior
explanation of the intervention would detract from the impact of that
experience.
Pay attention to clients’ non-verbal and
paraverbal behaviour
• REBT sessions are quite verbal in nature and practitioners of other therapeutic schools are
struck by the amount that REBT therapists talk in comparison to themselves. Despite this fact,
effective REBT therapists are concise in their communications and do not talk for the sake of it
(quality of talk is valued over quantity of talk). This emphasis on words does not mean that
good REBT therapists neglect their clients’ non-verbal or paraverbal behaviour. Being sensitive
to such client behaviour will help you gauge their reactions, particularly to any teaching points
you might make.
• In ordinary social conversation people often non-verbally or paraverbally indicate agreement
or understanding, when in fact they may disagree with or not understand what is being
communicated by the other person. This same principle also applies in the practice of REBT.
You should not only look out for overt signs that your clients disagree with or do not
understand what you are saying, but also be aware of signs that their subtle non-verbal and
paraverbal cues contradict their stated agreement and understanding. Thus, certain clients
may state that they agree with you but fidget quite a lot with their hands, which may be an
indication of their true response.
Repeatedly teach your clients the principle
of emotional responsibility
• Key point
Teach your clients the principle of emotional responsibility. Remind them
of this principle without annoying them and encourage them to discover
it for themselves both in their own experience and in the experiences of
others.
We often find it helpful to work out a physical sign with clients which
indicates to them that they are using A–C language rather than B–C
language. For example, one sign that is particularly useful is when we pat
ourselves on the head. This draws our clients’ attention to the fact that
they are neglecting the role that their mind plays in their emotional
responses.
Teach the full distinction between rational
beliefs and irrational beliefs
• REBT is very clear about what constitutes an irrational belief. Generally
speaking an irrational belief is rigid, extreme, self- and other-defeating,
illogical and inconsistent with reality. It can take the form of a dogmatic
must, awfulizing, low frustration tolerance and depreciation of self, others
and/or life conditions. An important part of helping your clients to
challenge such beliefs is to teach them the distinction between these
irrational beliefs and their rational alternatives. These rational beliefs are
flexible, non-extreme, logical, consistent with reality and more productive
with respect to self-enhancement and the development of healthy
interpersonal relationships. Rational beliefs generally take the form of non-
dogmatic desires, an evaluation of a negative event as being bad, high
frustration tolerance and acceptance of self, others and/or life conditions
Teach your clients to distinguish between
healthy and unhealthy negative emotions
• REBT is the only theoretical perspective in psychotherapy that keenly
discriminates between healthy and unhealthy negative emotions,
although there is not strong empirical evidence to support this
distinction. This distinction acts as a starting point for how clients
would like to feel as an emotional goal. As most of you will be aware,
according to REBT theory, unhealthy negative emotions (e.g. anxiety,
depression, guilt, anger) stem from irrational beliefs, while healthy
negative emotions (e.g. concern, sadness, remorse, annoyance) occur
when people hold rational beliefs about adversities at A. As an REBT
therapist, you will see those unhealthy negative emotions listed
above as preventing your clients living emotionally.
Teach your clients the importance of dealing with emotional
disturbance before they learn new skills or change their
environment
• Your clients will often come to therapy experiencing dysfunctional
emotions. Some will find it difficult to understand that before they can
learn new skills or change aversive activating events they will need to
change the irrational beliefs that are at the core of their disturbed
emotions. Others will grasp this point but may forget it later in therapy.
It is therefore important that you use a number of analogies to show
your clients the continuing importance of working to change their
irrational beliefs before working at other levels of change. One of the
best ways that we have found to communicate this point so that clients
learn and apply it is to show them that when they make themselves
emotionally disturbed they give themselves an additional problem.
Teach your clients about the cognitive consequences
of irrational beliefs and the effects that bringing
irrational beliefs to situations have on their
interpretations at A
• In REBT theory, the relationship between activating events (including
interpretations of these events), beliefs, emotions and behaviours is
exceedingly complex. Albert Ellis (1991) has argued that people bring
their irrational beliefs to the interpretations they make of activating
events and that these beliefs not only have emotional and
behavioural consequences, but also have cognitive consequences
which serve as A’s in further ABC episodes. We have found it very
useful to teach clients these important points in ways that they can
readily understand.
Teach relapse prevention
• Key point
Teach your clients that they need to work to identify
internal and external triggers to potential relapse. Help
them to prevent such relapse by encouraging them to
expose themselves to these triggers in imagery and in
vivo. Doing so will show them that they can apply their
rational coping skills should they encounter their
vulnerability factors
Teach your clients the principles of REBT
self-therapy
The central task as an REBT therapist is:
• To introduce the concept of self-help into therapy.
• Systematically to help your clients to acquire REBT self-help skills. You
can best do this in a structured way. Thus, you can formally and
deliberately teach your clients such REBT skills as:
• Using a variety of self-help forms.
• Identifying clinically relevant aspects of negative activating events.
• Discriminating keenly between their rational beliefs and their irrational
beliefs.
• Challenging and changing in a vigorous manner their irrational beliefs.