Standard Structure for an REBT Therapy Session

Standard Structure for an REBT Therapy Session: 

Standard Structure for an REBT Therapy Session The A>B>C>D>E approach

Part One: 

Part One Ask the client for a problem: What is the ‘A’? What is the ‘C’? What is the client’s goal? Example of depressed woman expelled from her political party by an opposing faction.

Part Two: 

Part Two Problem assessment: Assess the ‘C’: Is she really depressed, or merely sad or disappointed? Distinguish depression from sadness (Standard Handout, page 21). Show the link between IBs and depression, and the link between RBs and sadness.

Part 2 – Assessment continued: 

Part 2 – Assessment continued Asses the ‘A’: What is the ‘critical A’? Use ‘inference chaining’…or the ‘vertical arrow’ technique… So you were expelled, and why was that a problem for you? And what did that mean? Keep looking for a link to a demand or another irrational belief…

Part 3 - Teaching…: 

Part 3 - Teaching… Teach the B>C connection: Ten expelled politicos, all same??? Flower story… See pages 22-23 of Workbook For ‘Money example’…PTO…

The Money Example: 

The Money Example Imagine I have rB: “I’d prefer it if I always had a minimum of £50.00… Change to “I must have a min of 50 Keep demand…Got the 50… But the demand could still cause future problems. How?

Link iBs to C: 

Link iBs to C Make sure the client understands the B>C connection… Ask the client to clarify their own iBs in relation to their upset.. Example of politico… “He should not have treated me that way; it’s awful that he did; and my life is worthless without my political role…”

Part Four – Disputing iBs: 

Part Four – Disputing iBs Tom Miller’s approach: The sentence that causes the emotional upset: A = Something happens (internally or ext); B = Belief: “This event (whatever it is) shouldn't have happened, it's awful that it did, I can't stand it, and somebody around here needs to be condemned and damned as rotten and worthless. Let's see, is it me, is it you or is it the way the world works?” C = Overly upset emotion (like anger, anxiety, depression, etc).

Part Five – Debating/disputing: 

Part Five – Debating/disputing Tom Miller’s approach: Dispute ‘awfulizing’ first (why?) Albert Ellis’s definition of ‘awful’… Use the ‘Body scale’… (Handout 6, page 25) PTO for intro to Body Scale…

PowerPoint Presentation: 

Fig 2: A basic scale of badness: (or embryonic body scale) Degree of badness (%) Description of symptom/scenario 100% The worst case scenario (as bad as could be!) 50% The mid point 1% The smallest degree of badness If you had such a scale, you could then slot your current problem – e.g. a serioud loss or failure - into the table at the appropriate point, and that might help you to be more realistic about your situation, which would reduce the level of emotional arousal you are causing in yourself with your exaggerated assessment of the degree of badness of your problem.

Tom Miller’s Body Scale: 

Tom Miller’s Body Scale The Body Scale can be found on page 25 of the Workbook. Explain how I have used this in the past… Reconstruct example of my expelled politico…

LFT and Condemning and Damning: 

LFT and Condemning and Damning Then two derivatives of the ‘awful’… Low Frustration Tolerance; Condemning and damning (of self, other people and/or the world). How did I deal with these derivatives with my politico…? LFT straightforward… PTO for Big I re condemning…

The Big I – little i model: 

The Big I – little i model

Part Four - 4: 

Part Four - 4 Disputing ‘demandingness’: Should, must, have to, ought to, got to, need to… Use the ‘X’ and ‘Y’ model shown on Page 27 of your Workbook… PTO…for slide of model…

The X and Y model…: 

The X and Y model…

New ‘E’ as Homework…: 

New ‘E’ as Homework… The second statement from Tom Miller makes a good homework disputation: This event (whatever it is) must be happening, it’s about (blank)% bad that it is, and I can stand a (blank)% bad situation. (Mitzi)… Or use Jim’s standard disputation: It isn’t awful, terrible or horrible… (Handout, earlier, page 15)…

Jim’s 12 Stage Process: 

Jim’s 12 Stage Process Take a look at Jim’s 12 stage session structure on page 28… Talk it through…

Final reflection…: 

Final reflection… 7. Spend 5 to 10 minutes on questions and comments about the ABC Structure of sessions…

Real life example on video…: 

Real life example on video… Let us now take a look at Dr Albert Ellis running a counselling session with Rosanne, whose husband committed suicide in front of her, ten years earlier… The briefing document to set up this activity can be found on page 29. Read and digest the document. 10 mins… Any questions? Also read the 13 stage structure of this session, on page 30 of the Workbook. Focus on Steps 1-4,plus 6. Ignore the rest. (5 mins)…

Ellis video…: 

Ellis video… I will now present this video in three or four segments, so I don’t overload your Working Memory… Pay close attention to the 5 questions (from the end of page 29) about Ellis’s performance, and try to answer them as the session unfolds… There will be pauses for reflection / discussion between segments…

Final reflection on Ellis’s video…: 

Final reflection on Ellis’s video… 12. At the end of the 30 minutes (or so of the video), split the group into two, and ask them to: # reflect upon what they have witnessed; # form conclusions; # consider how they might, at some point, make use of any of these ideas from REBT; # prepare a flipchart sheet on their summation of their thinking. (Possibilities including considering the strengths and weaknesses of this approach; or ‘what we learned’).

Final presentations…: 

Final presentations… Both groups take turns to come to the front and present what they have on their flip chart paper… (Results, conclusions, etc)…

My final wrap-up…: 

My final wrap-up… 13. I will take the two presentations into account, and try to provide some additional pointers, insights, developmental feedback, etc.