Assessing the effectiveness of rational emotive behavioural therapy

23 Mar 2015

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Rational emotive behavioural therapy (REBT) is the practice of reducing the emotions such as anger, depression, and anxiety to their respective counterparts of annoyance, sadness, and concern according to Lipsky, Kassinov, and Miller (1980). The aim of REBT practitioners is to reduce the intensity, and frequency, as well as the duration of overly negative emotions, to a more manageable level.

Earlier studies that tested the effectiveness of the REBT model when applied to depression do show a decrease in both less than rational beliefs and other outcomes that can support the REBT theory of change according to the discoveries of Lipsky et al. (1980). They fashioned a study to address some shortcomings in the REBT theory, namely the lack of supportive data for it. Taking their subjects from a mental health centre population, they tested the REBT theories of rational role reversal and rationalemotive imagery, comparing them to an alternate treatment. They hypothesized that the subjects would experience a better result in the REBT conditions than the alternative treatment.

The subjects chosen for the study were 50 adults between the ages of 21 and 60 years. Each of the 50 subjects met with a therapist for a 45 minute session once a week for a total of 12, being subjected to both the REBT treatment and the alternative treatment. The following results of this study confirmed the hypothesis that the REBT method would cause the subjects to retain the principles and concepts that were presented. Lipsky et al. also discovered that it heavily supported the effectiveness of REBT as a treatment method for adult mental health centre patients.

However, the evidence supporting the theory's use against depression is still limited in several ways claims Macavei (2005). The earliest irrational beliefs that were measured did not have discriminant validity, and did not focus on the cognitive side of the theory. Because of this, correlations with other negative effects were expected to throw some doubt on the results. Macavei also confirms that these studies did not include an ordinary sadness group, making pinpointing effects of depression difficult, and furthermore these studies did not have a recovered group, making the task of determining if it was a casual or non-casual factor in depression difficult. Some limitations were investigated in other studies, leading to results that supported the hypothesis that clinically depressed people and individuals under the risk of becoming depressed have more irrational beliefs than the control groups (McDermut, Haaga, & Bilek, 1997; Solomon, Arnow, Gotlib, & Wind, 2003).

The aim of the study completed by Macavei (2005) was to further clarify the REBT theory of depression. To accomplish this, they compared a clinically depressed group, a dysphoric group, and a control group on less than rational beliefs. Participating in Macavei's study were 51 people, in the age group of 15 to 62. The first step was a two-hour evaluation interview, where they evaluated the symptoms arising from depression, then on another day they underwent a 30 minute psychiatric evaluation. Following these evaluations the subjects that met all the criteria's came back for a one hour session.

The results of the study confirmed the findings of McDermut et al. (1997) as well as Solomon et al. (2003). According to Macavei, the findings provide new arguments in support of the REBT theory of depression; "clinical depression is accompanied by irrationality" (Macavei, 2005). In addition, less than rational beliefs show a trend of being associated with the symptoms of depression, even under subclinical levels. The individual testing of the types of irrational beliefs offers empirical evidence that leads to the conclusion that self-downing and awfulizing beliefs are different from clinical depression and subclinical dysphoria.

Tiba and Szentagotai (2005) writes that a basic assumption of the REBT theory is that less than rational beliefs lead to positive as well as negative dysfunctional emotions. They claim that there is a lack of empirical data investigating the positive dysfunctional emotions and how they relate to the different types of less than rational beliefs in individuals. Their question was "Do dysfunctional positive emotions really exist?"

The theory of REBT claims there are two manners of positive emotions: dysfunctional and functional. The word "dysfunctional" according to Tiba and Szentagotai (2005) means something that doesn't help the subject achieve a goal. Through studying the dysfunctional elements of positive emotions Tiba and Szentagotai (2005) believes that a step can be made in understanding the cognitive factors like absolutistic evaluations in emotions and disturbances that are commonly undetected, but prevent an individual from reaching their set goals.

35 people participated in the study done by Tiba and Szentagotai (2005), aged between 18 and 26 years. All the subjects were tasked with recalling positive events under two conditions. The first condition instructed them to recall a past event where they had reached an important goal and to write a description of the event and the reaction, called the post-goal attainment situation. The second condition was done an hour later, where they were told to recall a past event where they knew they would reach an important goal and again to write a description of the event and reactions before finishing the questionnaire, the pre-goal attainment situation.

The REBT theory according to Tiba and Szentagotai (2005) considers a positive relation between demandingness and the positive dysfunctional emotions when it relates to positive events. The results of the study indicate that individuals that are demanding are more likely to experience positive emotions after reaching their pre-goal, as well as post-goal emotions if they expect to succeed at a goal. Some of these positive emotions could be considered functional in some events, while at the same time dysfunctional in others. Tiba and Szentagotai (2005) came to the conclusion that demandingness, dysfunctional inferences, levels of positivity and arousal made a difference when it came to this.

Bond and Dryden (2000) completed a study with the aim of finding experimental evidence that could be used to judge the scientific merit of an element of the REBT theory, specifically the principal idea that rational and irrational beliefs affect psychological events. They chose 96 subjects, ranging from the ages of 19 to 27, who believed they would be participating in a stress management project. The study itself had the subjects rate the degree of agreement to 14 inferences, seven that were presented in a functional style, and seven in a dysfunctional one.

The study did confirm the hypothesis presented by Bond and Dryden (2000) in that the functionality of inferences were affected by both types of beliefs, but contrary to the established REBT theory the findings implied that "REBT and secondary beliefs had the same magnitude of effect on the functionality of inferences" (Bond and Dryden, 2000). Bond and Dryden confirm that the experiment doesn't support the distinguishing proposition of REBT, which are the demands and preferences, or "must" and "prefer", mechanism which REBT considers to affect the functionality of inference. Instead the findings support the fact that secondary beliefs are far more influential to this key element.

The conclusion found in Bond and Dryden (2000), as well as investigation of other similar studies, leads us to believe that it may be possible that demands and preferences are important elements to the less than rational and rational beliefs, but that the REBT terminology of "must" and "prefer" don't properly encapsulate the meanings of the concept. They note that the hypothesis follows the need in REBT to teach the subjects the meaning behind the terms, but that it decreases a scientific studies internal validity due to the fact that the meanings are taught to the subjects. Bond and Dryden further suggest that the REBT theory hypotheses are required to be tested using the representative terms, which they attempted, resulting in findings that were not supportive of the theory behind REBT.

The findings put forward by these studies generally confirm that there is some degree of success in REBT methods compared to other alternative means. The element that throws some doubt on the REBT theory is the lack of proper terminology to distinctly describe it to subjects, as to retain the internal validity of the empirical studies. There is also a high variation in results depending on what the study is addressing in terms of REBT, for example depression or stress, but these differences in results may also be due to the decade in which the studies were performed. The newer studies show results that confirm some elements of REBT while disproving others, while the older studies generally support the REBT theory, but are criticised for limited evidence and doubtful internal validity.

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