Rational emotive behavior therapy - Wikipedia

Rational Emotive Behavior Therapy (REBT), previously called rational therapy and rational emotive therapy, is a comprehensive, active-directive, philosophically and empirically based psychotherapy which focuses on resolving emotional and behavioral problems and disturbances and enabling people to lead happier and more fulfilling lives. REBT was created and developed by the Americanpsychotherapist and psychologist Albert Ellis who was inspired by many of the teachings of Asian, Greek, Roman, and modern philosophers. REBT is one form of Cognitive Behavior Therapy (CBT) and was first expounded by Ellis in the mid-1950s; development continued until his death in 2007.

Rational Emotive Behavior Therapy (REBT) is both a psychotherapeutic system of theory and practices and a school of thought established by Albert Ellis. Originally called rational therapy, its appellation was revised to rational emotive therapy in 1959, then to its current appellation in 1992. REBT was one of the first of the cognitive behavior therapies, as it was predicated in articles Ellis first published in 1956, nearly a decade before Aaron Beck first set forth his cognitive therapy.

Precursors of certain fundamental aspects of REBT have been identified in various ancient philosophical traditions, particularly Stoicism. For example, Ellis' first major publication on rational therapy describes the philosophical basis of REBT as the principle that a person is rarely affected emotionally by outside things but rather by ‘his perceptions, attitudes, or internalized sentences about outside things and events.'

Cognitive Behavioral Therapy - Wikipedia

Cognitive Behavioral Therapy (CBT) is a psychotherapeutic approach which addresses dysfunctional emotions, maladaptive behaviors and cognitive processes, and contents through a number of goal-oriented, explicit systematic procedures. The name refers to behavior therapy, cognitive therapy, and to therapy based upon a combination of basic behavioral and cognitive principles and research. Most therapists working with patients dealing with anxiety and depression use a blend of cognitive and behavioral therapy. This technique acknowledges that there may be behaviors that cannot be controlled through rational thought. CBT is "problem focused" (undertaken for specific problems) and "action oriented" (therapist tries to assist the client in selecting specific strategies to help address those problems).

CBT is thought to be effective for the treatment of a variety of conditions, including mood, anxiety, personality, eating, substance abuse, tic, and psychotic disorders. Many CBT treatment programs for specific disorders have been evaluated for efficacy; the health-care trend of evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments.

CBT was primarily developed through an integration of behavior therapy (the term "behavior modification" appears to have been first used by Edward Thorndike with cognitive psychology research, first by Donald Meichenbaum and several other authors with the label of cognitive behavior modification in the late 1970s. This tradition thereafter merged with earlier work of a few clinicians, labeled as Cognitive Therapy (CT), developed by Aaron Beck, and Rational Emotive Therapy[ (RET) developed by Albert Ellis. While rooted in rather different theories, these two traditions have been characterized by a constant reference to experimental research to test hypotheses, both at clinical and basic level. Common features of CBT procedures are the focus on the "here and now", a directive or guidance role of the therapist, a structuring of the psychotherapy sessions and path, and on alleviating both symptoms and patients' vulnerability.

The premise of mainstream cognitive behavioral therapy is that changing maladaptive thinking leads to change in affect and in behavior, but recent variants emphasize changes in one's relationship to maladaptive thinking rather than changes in thinking itself. Therapists or computer-based programs use CBT techniques to help individuals challenge their patterns and beliefs and replace "errors in thinking such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing" with "more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior" or to take a more open, mindful, and aware posture toward them so as to diminish their impact. Mainstream CBT helps individuals replace "maladaptive… coping skills, cognitions, emotions and behaviors with more adaptive ones", by challenging an individual's way of thinking and the way that he/she reacts to certain habits or behaviors, but there is still controversy about the degree to which these traditional cognitive elements account for the effects seen with CBT over and above the earlier behavioral elements such as exposure and skills training.

Modern forms of CBT include a number of diverse but related techniques such as exposure therapy, stress inoculation training, cognitive processing therapy, cognitive therapy, relaxation training, Dialectical Behavior Therapy (DBT), and Acceptance and Commitment Therapy (ACT).

Dialectical Behavior Therapy - Wikipedia

Dialectical behavior therapy (DBT) is a form of psychotherapy that was originally developed by Marsha M. Linehan, a psychology researcher at the University of Washington, to treat people with Borderline Personality Disorder (BPD). DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. DBT may be the first therapy that has been experimentally demonstrated to be generally effective in treating BPD. A meta-analysis found that DBT reached moderate effects. Research indicates that DBT is also effective in treating patients who present varied symptoms and behaviors associated with spectrum mood disorders, including self-injury. Recent work suggests its effectiveness with sexual abuse survivors and chemical dependency.

Linehan observed "burn-out" in therapists after coping with non-motivated patients who repudiated cooperation in successful treatment. Her first core insight was to recognize that the chronically suicidal patients she studied had been raised in profoundly invalidating environments, and, therefore, required a climate of unconditional acceptance (not Carl Rogers’ positive humanist approach, but Thich Nhat Hanh’s metaphysically neutral one), in which to develop a successful therapeutic alliance. Her second insight involved the need for a commensurate commitment from patients, who needed to be willing to accept their dire level of emotional dysfunction.

DBT strives to have the patient view the therapist as an ally rather than an adversary in the treatment of psychological issues. Accordingly, the therapist aims to accept and validate the client’s feelings at any given time, while, nonetheless, informing the client that some feelings and behaviors are maladaptive, and showing them better alternatives.

Linehan and others combined a commitment to the core conditions of acceptance and change (ACT) through the Hegelian principle of dialectical progress (in which thesis + antithesis → synthesis) and assembled an array of skills for emotional self-regulation drawn from Western psychological traditions, such as cognitive behavioral therapy and an interpersonal variant, "assertiveness training", and Eastern meditative traditions, such as Buddhist mindfulness meditation. One of her contributions was to alter the adversarial nature of the therapist-client relationship in favor of an alliance based on intersubjective tough love.

All DBT can be said to involve two components:

  • Individual - The therapist and patient discuss issues that come up during the week (recorded on diary cards) and follow a treatment target hierarchy. Self-injurious and suicidal behaviors take first priority. Second in priority are behaviors which, while not directly harmful to self or others, interfere with the course of treatment. These behaviors are known as therapy-interfering behaviors. Third in priority are quality of life issues and working towards improving one's life generally. During the individual therapy, the therapist and patient work towards improving skill use. Often, a skills group is discussed and obstacles to acting skillfully are addressed.
  • Group - A group ordinarily meets once weekly for two to two-and-a-half hours and learns to use specific skills that are broken down into four skill modules: core mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.

Neither component is used by itself; the individual component is considered necessary to keep suicidal urges or uncontrolled emotional issues from disrupting group sessions, while the group sessions teach the skills unique to DBT, and also provide practice with regulating emotions and behavior in a social context.

Acceptance and Commitment Therapy - Wikipedia

Acceptance and Commitment Therapy (ACT, typically pronounced as the word "act") is a form of clinical behavior analysis (CBA) used in psychotherapy. It is an empirically-based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways with commitment and behavior-change strategies, to increase psychological flexibility. The approach was originally called comprehensive distancing. It was developed in the late 1980s by Steven C. Hayes, Kelly Wilson, and Kirk Strosahl.

ACT is developed within a pragmatic philosophy called functional contextualism. ACT is based on relational frame theory (RFT), a comprehensive theory of language and cognition that is an offshoot of behavior analysis. ACT differs from traditional cognitive behavioral therapy (CBT) in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to "just notice," accept, and embrace their private events, especially previously unwanted ones. ACT helps the individual get in contact with a transcendent sense of self known as "self-as-context"—the you that is always there observing and experiencing and yet distinct from one's thoughts, feelings, sensations, and memories. ACT aims to help the individual clarify their personal values and to take action on them, bringing more vitality and meaning to their life in the process, increasing their psychological flexibility.

While Western psychology has typically operated under the "healthy normality" assumption which states that by their nature, humans are psychologically healthy, ACT assumes, rather, that psychological processes of a normal human mind are often destructive. The core conception of ACT is that psychological suffering is usually caused by experiential avoidance, cognitive entanglement, and resulting psychological rigidity that leads to a failure to take needed behavioral steps in accord with core values. As a simple way to summarize the model, ACT views the core of many problems to be due to the concepts represented in the acronym, FEAR:

  • Fusion with your thoughts
  • Evaluation of experience
  • Avoidance of your experience
  • Reason-giving for your behavior

And the healthy alternative is to ACT:

  • Accept your reactions and be present
  • Choose a valued direction
  • Take action