Rational Emotive
therapy,” to avoid the philosophical questions
Behavior Therapy (REBT)
Daniel David
Babes-Bolyai University, Romania and Icahn School of
Medicine at Mount Sinai, U.S.A.
Rational emotive behavior therapy (REBT) was
the first form of cognitive behavioral therapy
(CBT) founded by the American psycholo-
gist Albert Ellis (1913–2007). In 1957 Ellis
published his seminal article “Rational psy-
chotherapy and individual psychology,” which
set the foundation for what he called rational
therapy (RT). According to RT, if we want to
change various dysfunctional psychological
outcomes (e.g., depressed mood), we have
to change their main cognitive determinant,
namely irrational beliefs. Although this idea
can be found in philosophy and/or other med-
ical/psychological approaches before Ellis, he
articulated this view in a scientifically testable
paradigm. Thus, Ellis is generally considered
one of the main originators of the “cognitive
revolution” in clinical psychology, paralleling
the “cognitive revolution” in psychology in
general. Indeed, his book Reason and Emotion
in Psychotherapy (Ellis, 1962) legitimized the
cognitive paradigm shift in the clinical field.
Although RT targeted mainly emotional
consequences and used a large variety of emo-
tive/metaphorical techniques, it was perceived
by many as ignoring feelings. To correct this
misperception, in 1961 Ellis changed the name
of RT to rational emotive therapy (RET). How-
ever, although RET used a wide spectrum of
behavioral techniques, it was interpreted by
many professionals as being “too cognitive”
and ignoring the behavioral tradition. To
correct this misrepresentation, in 1993 Ellis
changed the name of RET to rational emotive
behavior therapy (REBT). In a personal com-
munication in 2005, Ellis said that he would
The Encyclopedia of Clinical Psychology, First Edition. Edited by Robin L. Cautin and Scott O. Lilienfeld.
© 2015 John Wiley & Sons, Inc. Published 2015 by John Wiley & Sons, Inc.
DOI: 10.1002/9781118625392.wbecp077
prefer the name “cognitive affective behavior
surrounding the term “rational.” Indeed, many
professionals did not contemplate the REBT
definition of “rational,” but understood it
within various philosophical traditions. This
was often detrimental to the scientific status
of REBT because instead of resources being
focused on the development of the scientific
level of REBT, it was often “wounded” in the
many philosophical debates. However, Ellis
never changed the name of REBT again, as he
passed away in 2007. After 2007, the Albert
Ellis Institute, the world center for REBT,
started publicly and professionally to promote
REBT as rational emotive and cognitive behav-
ior therapy (REBT/CBT), partially to address
Ellis’s intention and to better connect REBT to
the current CBT tradition that REBT initiated.
Theory
The theory of REBT is based on the ABC
model (see for details David, Lynn, & Ellis,
2010; Walen, DiGiuseppe, & Dryden, 1992).
Being a scientific approach, the original ABC
model of REBT has evolved from its initial
form. According to current REBT theory, the
impact of various activating life events (e.g.,
the death of a close relative—“the practical
problem”; A) on various psychological conse-
quences (e.g., feelings, behavioral, cognitive,
psychophysiological reactions; C) is mediated
by information processing (cognitions/beliefs;
B). Once generated, a C can become a new A,
being further processed (reappraisal), thereby
generating secondary or meta-consequences.
An A can therefore be a physical life event (e.g.,
death of a close relative) and/or a private one
(e.g., a depressed mood). Arguably, the ABC
model is the general paradigm of all cognitive
behavioral therapies. However, various CBTs
differ in the type of information processing on
which they focus.
2 RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)
REBT focuses on specific cognitions, namely
rational and irrational beliefs. Rational beliefs
are logically, empirically, and/or pragmat-
ically supported, and generate functional
consequences (e.g., functional feelings, adap-
tive behaviors, healthy psychophysiological
reactions). Irrational beliefs are illogical,
nonempirical, and/or nonpragmatic, and
generate dysfunctional consequences (e.g.,
dysfunctional feelings, maladaptive behaviors,
and unhealthy psychophysiological reactions).
Regarding functional and dysfunctional
feelings (i.e., “the emotional problem”), REBT
theory assumes two competing models (for
details, see David, 2003; David, Montgomery,
Macavei, & Bovbjerg, 2005). The first model is
a classic one, assuming that dysfunctional neg-
ative feelings (e.g., depressed mood, anxiety,
guilt, anger) differ from corresponding func-
tional negative feelings (e.g., sadness, concern,
remorse, annoyance) mainly in intensity. The
second model is an original one, assuming that
differences between functional and dysfunc-
tional feelings, be they positive or negative,
are mainly qualitative (without eliminating the
quantitative components). Data are accumulat-
ing for both models but the problem remains
unanswered.
At its core, REBT theory is mainly a moti-
vational one (David, 2003) that can be seen as
part of the appraisal paradigm (Smith et al.,
1993) in the standard emotional theories of
general psychology. Therefore, REBT is focused
on particular cognitions, appraisal/evaluative
or “hot” cognitions (i.e., rational and irrational
beliefs) that are strongly involved in the gener-
ation of our feelings. In a broad sense, REBT
admits that “B” can also include descriptions
(e.g., “It is a crowded auditorium”) and infer-
ences (e.g., “I will fail to speak in front of this
auditorium”) (e.g., “cold” cognitions; David,
2003). These can be represented in our cogni-
tive system by production rules (i.e., “if A then
do C”) and thus, generate mainly behaviors at
“C.” The relations between “cold” and “hot”
cognitions seem to be bidirectional. Indeed,
rational and irrational beliefs seem to influence
the functionality of descriptions/inferences.
However, REBT argues that if cold cognitions
are not further appraised by rational and/or
irrational beliefs in terms of motivational rel-
evance, they do not generate feelings (David
et al., 2010).
Therefore, when we face various activating
events, we come with our own desires (moti-
vational relevance). If we had no desires, we
would not experience feelings. Our desires
(i.e., primary appraisals) can be formulated
irrationally or rationally.
An irrational formulation of our desires
comprises three factors: demandingness
(inflexible/absolutistic thinking), motivational
relevance, and nonacceptance (e.g., “I must
succeed, I do my best to succeed, and I can-
not conceive not succeeding”). If activating
events fit our irrationally formulated desires
(motivational congruence), we will experience
dysfunctional positive feelings; they are dys-
functional because they reinforce the irrational
beliefs that generated them. If activating events
do not fit our irrationally formulated desires
(motivational incongruence), a second wave of
information processing follows (i.e., irrational
secondary appraisal): (a) frustration intoler-
ance; (b) awfulizing/catastrophizing; and/or
(c) global evaluation. Frustration intolerance
(e.g., “I cannot stand it”) means that we cannot
tolerate our rigid desires not being fulfilled
(meaning that either we and/or the situation
should disappear). Awfulizing/catastrophizing
(e.g., “It is awful”) means that our rigidly
formulated desires not being fulfilled is the
worst thing that could happen (or more than
100% bad). Global evaluation means that if
your rigid desires are not fulfilled, we, others,
and/or life are totally bad (e.g., “I am bad, you
are bad, and/or life is bad”).
The rational formulation of our desires
comprises three factors: flexible preference,
motivational relevance, and acceptance (e.g., “I
would prefer to succeed and I will do my best
to succeed, but I can accept that sometimes
things do not happen the way I want them to
happen”). If activating events fit rationally for-
mulated desires (motivational congruence), we
 RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)
experience functional positive feelings. If acti-
vating events do not fit rationally formulated
desires (motivational incongruence), a sec-
ond wave of informational processing follows
(rational secondary appraisal): (a) frustration
tolerance; (b) badness; and/or (c) uncon-
ditional acceptance, generating functional
negative consequences. Frustration tolerance
means that one assumes the tolerance of not
having one’s flexible preferences met, even if it
is unpleasant; moreover, positive aspects can
be found in other life events. Non-awfulizing
(noncatastrophizing) refers to a nuanced nega-
tive evaluation (e.g., in terms of badness) of not
having our flexible preferences met; recogniz-
ing the badness of the situation may even allow
us to look for positive experiences elsewhere.
Unconditional acceptance is REBT’s specific
antidote to global evaluation (self-esteem).
More precisely, we do not globally evaluate
ourselves (positively or negatively), but we
accept ourselves unconditionally and evaluate
only specific and discrete aspects of the self
(e.g., what we are doing, thinking, feeling);
the same idea applies to the evaluation of
others and of life. REBT’s acceptance construct
(involved in rational formulation of desires
and in unconditional acceptance) was a pre-
cursor of the “third wave CBTs’” acceptance
construct, which was further developed by this
movement on its own.
Rational and irrational appraisals processes
can involve various contents. They can refer
to oneself (e.g., “I must succeed”), others (e.g.,
“You must succeed”), and/or life (e.g., “Life
must be fair”). Moreover, they can be general
(e.g., “People must appreciate me”) and/or
domain (e.g., affiliation, academic, comfort)
or situation-bounded (e.g., “My wife must
appreciate me”). The rational and/or irrational
profile can be homogeneous (e.g., a general
level of rationality and/or irrationality) and/or
heterogeneous, depending on the content (e.g.,
rational in some domains, irrational in others).
The specific combinations of various rational
and irrational processes and their content
(i.e., rational and irrational beliefs) generate a
core theme relating to specific consequences.
3
For example, “depressed mood” seems to
involve a core theme of “loss” and specific
irrational appraisal components relating to
demandingness (irrational primary appraisal)
and self-downing (irrational secondary
appraisal). Its functional counterpart involves
the same theme of “loss,” but preference (ratio-
nal primary appraisal) and unconditional
self/acceptance (rational secondary appraisal)
as specific appraisal components. This line of
research is still under scientific scrutiny, but
several models have been proposed and tested.
REBT theory in the form of the ABC model
is based on the classic stress-diathesis model.
Therefore, irrational beliefs are seen as cognitive
vulnerability factors whereas rational beliefs
are considered “sanogenic” (health-inducing)
mechanisms. Thus, irrational beliefs are not
necessarily associated with dysfunctional con-
sequences; they become associated with dys-
functional consequences only if they are primed
by various activating events.
Rational and irrational beliefs develop
during ontogenesis, and both genetic and
environmental (e.g., parenting) factors have
important contributions. Ellis argued that
the genetic contribution is strong, even evo-
lutionarily influenced, but this idea is still
a subject of scientific scrutiny in genetic
and neuroscience-based research paradigms
(David et al., 2010).
General core rational and irrational beliefs
are coded in our cognitive system as schemas
and/or propositional networks. In specific
situations they bias the perception of the
activating events and thus generate specific
rational and irrational beliefs, often in the
form of automatic thoughts. They are called
automatic thoughts because they come to our
mind effortlessly and are specifically related
to various activating events. Once generated,
these thoughts reinforce and maintain the core
beliefs. The same model seems to work for
descriptions and inferences as well.
In an expanded version of the ABC model
(David, 2003), it was proposed that some of the
information processing between “A” and “C”
could be implicit (i.e., unconscious information
4 RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)

B
Conscious information processing

Automatic thoughts Automatic thoughts

Specific Specific rational

descriptions and irrational
and inferences beliefs

Biases Biases
A C
Activating events Consequences
General core General core
descriptions Feelings (e.g., fear, anxiety)
rational and
Life events and inferences Behavior (e.g., avoidance)
irrational beliefs
Private events Psychophysiology (e.g.,
arousal)

Unconscious information processing/cognitive unconscious

Classical conditioning
Implicit expectancies/automatic associations
Automatized conscious processes

Life history and genetics

Figure 1 The expanded ABC model in the general REBT theory. In the restricted form of the ABC model, it
includes only the specific and general rational and irrational beliefs from the “B” component.

processing/cognitive unconscious), either exam distress is partially mediated by response

structurally—it cannot be conscious and
functions unconsciously (e.g., classical con-
ditioning, implicit expectancies)—and/or
functionally—it can be conscious, but often
functions unconsciously (e.g., automatiza-
tion of conscious beliefs). In this framework,
classic rational and/irrational beliefs do not
immediately mediate the impact of “A” on
“C,” but can amplify a “C,” once generated by
unconscious information processing, through
further appraisal.
The current REBT theory in the form of
the expanded ABC model is represented in
Figure 1.
Hundreds of studies have tested the REBT
theory in the form of the ABC model (for a
review, see David et al., 2010). Most of them
confirmed the main aspects of the theory
(e.g., offered support for the “primacy” of
demandingness among irrational beliefs),
some invalidated various hypotheses (e.g., they
found that the impact of irrational beliefs on
expectancies), whereas others are still under
scientific scrutiny (e.g., the “qualitative” versus
“quantitative” distinction between functional
and dysfunctional feelings). A main limitation
of studies testing REBT theory is that many
researchers misunderstood the underlying
theory. For example, some researchers con-
ceptualized rational beliefs as low levels of
irrational beliefs, which is a misunderstanding
of the theory. According to REBT theory, func-
tional consequences are generated not by low
levels of irrational beliefs, but by high levels of
rational beliefs. Low levels of irrational beliefs
could also mean a lack of rational beliefs (no
motivational relevance). Therefore, current
research also focuses on elaborating better
measures of rational and irrational beliefs
(both explicit and implicit measures).
Practice
The practice of REBT (i.e., individual, small,
and/or large groups, family/couple) is based
 RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)
on REBT theory in the form of the ABC
model (Walen et al., 1992). It refers to human
optimization (in various fields), health promo-
tion and prevention of clinical problems, and
the treatment of mental disorders and other
clinical conditions. REBT practice is immersed
in the general psychotherapy and clinical field,
which provides the “common factors” of REBT
practice (e.g., clinical assessment, clinical
conceptualization, therapeutic relationship).
Based on the ABC model, REBT uses three
classes of techniques. To deal with problems
at A, REBT uses a large spectrum of “prac-
tical problem-solving techniques” such as
assertiveness training, social skills training,
decision making, conflict resolution, specific,
and problem-solving techniques. To deal
directly with clinical problems at C, REBT uses
a large spectrum of “symptomatic techniques,”
such as relaxation, hypnosis, meditation (e.g.,
REBT-based mindfulness), and other coping
strategies that aim to change the C without
explicitly targeting underlying cognitions (B).
To change dysfunctional consequences into
functional consequences, REBT uses “cog-
nitive restructuring” (e.g., cognitive change,
cognitive disputation, reframing) techniques
aiming to turn irrational beliefs into rational
beliefs (first specific and then general beliefs).
REBT uses a large variety of cognitive restruc-
turing techniques: (a) logical; (b) empirical;
(c) pragmatic; (d) emotive/metaphorical (e.g.,
metaphors, stories, poems, humor, songs,
meditation/mindfulness-based REBT, etc.);
(e) spiritual; and (f) behavioral (fundamental
to change not only conscious beliefs, but also
implicit processes/unconscious information
processing). Moreover, beyond these core
REBT cognitive restructuring techniques,
REBT endorses the use of any safe technique
borrowed from other psychotherapy schools.
These techniques, however, are separated from
their original theories, being used in a new
“cognitive framework.” REBT thus proves
eclectic at the practical level (not at the theory
level) and serves as a platform for a possible
psychotherapy integration.
5
Classic (i.e., elegant, preferential) REBT
argues that in clinical practice we should start
by solving emotional problems (e.g., anger)
and then move on to the practical problems
(e.g., communication with your wife). Once
we change dysfunctional consequences (e.g.,
anger) into functional consequences (e.g.,
annoyance) by changing the underlying irra-
tional beliefs (e.g., “My wife must do what
I want and respect me, otherwise she is bad
and I cannot stand it”) into rational beliefs,
we are more productive when focusing on the
practical problems (e.g., learning communi-
cation skills). This is what Ellis called “getting
and staying better,” a profound philosophical
change.
General (i.e., inelegant) REBT, which fits
general CBT practice according to Ellis, allows
various strategies to reduce dysfunctional
consequences. For example, we can start
with the practical problem (e.g., learning
communication skills), and thus reduce the
dysfunctional consequences (e.g., anger); how-
ever, Ellis would argue that, in this case, our
clients would still have the cognitive vulner-
ability (e.g., irrational beliefs). Alternatively,
we could start by restructuring dysfunctional
descriptions/inferences (e.g., “My wife does
not respect me”) and then move to changing
irrational beliefs. However, the client may
not be sufficiently motivated to make this
philosophical shift if he is already feeling
better.
These strategies are what Ellis called “feeling
better.” If getting and staying better also involve
feeling better, feeling better does not necessarily
involve getting and staying better.
Typically, the REBT intervention is focused
on the “present problems,” conceptualized by
the ABC model. However, if necessary in the
therapeutic process, REBT can engage a “his-
torical understanding” of the present problems
(e.g., how irrational beliefs were developed in
the client’s life history) and/or even a “here
and now” approach (e.g., how irrational beliefs
are expressed during the therapy process, in
relation to the therapist). This is similar, as a
technique, to the well-known “dynamic” of
6 RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)

Here and now Present problems

C B B C

A A

B A

History

Figure 2 A “dynamic” process of ABCs in REBT.

dynamic therapies, although the content and
the objectives are completely different. Thus,
the dynamic element of REBT, of moving from
one component to another, is similar to Malan’s
model of dynamic therapies and can facilitate
the therapeutic process in some clinical cases
(Figure 2).
From its creation, REBT has been an
“evidence-oriented therapy.” Therefore, sev-
eral efficacy (how REBT works in controlled
conditions—to understand internal validity)
and effectiveness studies (how REBT works in
real clinical practice—to understand external
validity) have been conducted to test REBT.
However, initial REBT studies were criti-
cized (a) for using mainly transdiagnostic
categories rather than DSM categories and
(b) for using an effectiveness approach (e.g.,
populations and practices as they appear in
real clinical practice) rather than an efficacy
approach (e.g., randomization, homogeneous
symptomatology, rigorous manualization).
Subsequently, REBT studies started to exam-
ine DSM categories and rigorous controlled
designs in testing outcomes (at posttest and
follow-up) (e.g., David, Szentagotai, Lupu, &
Cosman, 2008), mechanisms of change (e.g.,
Szentagotai, David, Lupu, & Cosman, 2008),
and cost-effectiveness (Sava, Yates, Lupu, Szen-
tagotai, & David, 2009) for various mental
disorders (e.g., major depressive disorder).
Moreover, REBT was tested in rigorous clin-
ical trials for medical-related disorders (e.g.,
cancer-related symptoms; Montgomery et al.,
2009).
Several large-scale meta-analyses that sum-
marized REBT clinical trials showed that REBT
works for a large spectrum of disorders both
in adults (Engels, Garnefski, & Diekstra, 1993;
Lyons & Woods, 1991) and children (e.g.,
Gonzales et al., 2004). Additionally, numerous
clinical trials published under the generic label
of CBT, supporting its efficacy/effectiveness,
draw upon REBT strategies (e.g., Montgomery
et al., 2009). Despite this optimistic image of
the impact of REBT in clinical practice, less
is known about the use of REBT for human
optimization and health promotion compared
with the use of REBT in the clinical field.
Ironically, REBT was once criticized for using
transdiagnostic rather than DSM categories
and effectiveness rather than efficacy studies.
 RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)
Today, transdiagnostic categories and effective-
ness studies are “hot topics” in the clinical field.
Thus, a large part of the old REBT research
should be reevaluated given its promising
external validity.
Limitations
First, REBT has all the limitations of a scientific
approach to mental health. Thus, REBT has
not clarified the causal mechanisms involved
in mental disorders. Future research is needed
here. Even when the processes are reasonably
well known, REBT does not have the tech-
niques to change them in all patients. Further
research is needed for new innovative tech-
niques and for better technology assimilation
in the classical REBT (e.g., robotics and virtual
reality techniques; internet/computer-based
REBT).
Second, REBT has been adversely affected
by severe misrepresentations in the scientific
literature and thus its scientific potential is
not fully realized. For example, REBT has
sometimes been pictured as very active and
directive (even harsh), but this depiction is
incorrect. Depending on the client and his
or her problems, in the context of a sound
therapeutic relationship, REBT can be very
active and directive but also very metaphorical.
Finally, REBT theory and techniques have
often been wrongly portrayed as simplistic, by
arguing that a few rational and irrational beliefs
cannot explain the large variation of mental
disorders; instead, we need specific cognitive
models for each disorder. Again, this assertion
is incorrect. General and classic REBT recog-
nize the specific cognitions model of various
disorders, but classic REBT argues that, unless
these (more surface) specific cognitions—often
descriptions/inferences—are appraised by
rational and/or irrational beliefs, they do not
have an impact on mental disorders. Moreover,
REBT research is seeking new rational and
irrational beliefs involved in various disorders.
Therefore, the REBT reduction of pathogenic
and/or “sanogenic” mechanisms to a few core
cognitive processes is similar to the reduction
7
sought in neuroscience, where hundreds of
mental disorders are ideally related to a few
classes of neurotransmitters and their relations.
SEE ALSO: Behavior Therapies; Cognitive Thera-
pies; Ellis, Albert (1913–2007)
References
David, D. (2003). Rational emotive behavior
therapy (REBT): The view of a cognitive
psychologist. In W. Dryden (Ed.), Rational
emotive behaviour therapy: Theoretical
developments (pp. 130–159). New York:
Brunner-Routledge.
David, D., Lynn, S. J., & Ellis, A. (Eds.). (2010).
Rational and irrational beliefs in human
functioning and disturbance. London: Oxford
University Press.
David, D., Montgomery, G. H., Macavei, B., &
Bovbjerg, D. H. (2005). An empirical
investigation of Albert Ellis’s binary model of
distress. Journal of Clinical Psychology, 61,
499–516.
David, D., Szentagotai, A., Lupu, V., & Cosman, D.
(2008). Rational emotive behavior therapy,
cognitive therapy, and medication in the
treatment of major depressive disorder: A
randomized clinical trial, posttreatment
outcomes, and six-month follow-up. Journal of
Clinical Psychology, 64, 728–746.
Ellis, A. (1957). Rational psychotherapy and
individual psychology. Journal of Individual
Psychology, 13, 38–44.
Ellis, A. (1962). Reason and emotion in
psychotherapy. New York: Stuart.
Engels, G. I., Garnefski, N., & Diekstra, R. F. W.
(1993). Efficacy of rational-emotive therapy: A
quantitative analysis. Journal of Consulting and
Clinical Psychology, 61, 1083–1090.
Gonzalez, J. E., Nelson, J. R., Gutkin, T. B.,
Saunders, A., Galloway, A., & Shwery, C. S.
(2004). Rational emotive therapy with children
and adolescents: A meta-analysis. Journal of
Emotional and Behavioral Disorders, 12,
222–235.
Lyons, L. C., & Woods, P. J. (1991). The efficacy of
rational-emotive therapy: A quantitative review
of the outcome research. Clinical Psychology
Review, 11, 357–369.
Montgomery, G. H., Kangas, M., David, D.,
Hallquist, M. N., Green, S., Bovbjerg, D. H., &
Schnur, J. B. (2009). Fatigue during breast cancer
8 RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)
radiotherapy: An initial randomized study of
cognitive–behavioral therapy plus hypnosis.
Health Psychology, 28, 317–322.
Sava, F. A., Yates, B. T., Lupu, V., Szentagotai, A., &
David, D. (2009). Cost-effectiveness and
cost-utility of cognitive therapy, rational
emotive behavioral therapy, and fluoxetine
(prozac) in treating depression: A randomized
clinical trial. Journal of Clinical Psychology, 65,
36–52.
Smith, C. A., Haynes, K. N., Lazarus, R. S., & Pope,
L. K. (1993). In search of the “Hot” cognitions:
Attributions, appraisals, and their relation to
emotion. Journal of Personality and Social
Psychology, 65, 916–929.
Szentagotai, A., David, D., Lupu, V., & Cosman, D.
(2008). Rational emotive behavior therapy versus
cognitive therapy versus pharmacotherapy in the
treatment of major depressive disorder:
Mechanisms of change analysis. Psychotherapy:
Theory, Research, Practice, Training, 45, 523–538.
Walen, S., DiGiuseppe, R., & Dryden, W. (1992). A
practitioner’s guide to rational-emotive therapy.
London: Oxford University Press.
Further Reading
Velten, E. (2007). Under the influence: Reflections of
Albert Ellis in the work of others.Tucson, AZ: See
Sharp Press.