Good Practice in Rational Emotive Behaviour Therapy

Windy Dryden is in clinical and consultative practice and is an international authority on Single-Session Therapy and Rational Emotive Behaviour Therapy. He has worked in psychotherapy for more than 45 years and is the author or editor of over 275 books.

• Part 1: General Good Practice in REBT 1. Explore briefly your clients’ expectations of REBT and their previous experiences of therapy 2. Develop the therapeutic relationship in REBT through the work 3. Set and keep to a therapeutic agenda 4. Obtain a problem list 5. Generally, be active and directive 6. Intervene in your clients’ problems without knowing the ‘big picture’ first 7. Deal with clients’ present problems without getting caught up in their past 8. Help your clients to express themselves through the REBT’s ABC framework 9. Listen actively 10. Ensure that your clients answer the questions you have asked 11. Interrupt clients when they ramble or talk too much 12. Be clear and concise in what you say to clients 13. Obtain feedback from your clients 14. Confront your clients, but do so with tact, respect, warmth and care 15. Work collaboratively with your clients 16. Adopt and maintain a problem-orientated focus with your clients 17. Keep your clients on track 18. Explain REBT terminology to your clients and check their understanding of your explanations 19. Develop a shared vocabulary with your clients 20. Use B-C language yourself while teaching B-C thinking to your clients 21. Socialise your clients into REBT in the first or early sessions of therapy 22. Teach the ABC framework in a clear way 23. Use Socratic dialogue and didactic explanations to teach REBT concepts to clients who will benefit the most from each 24. Be repetitive in teaching REBT concepts 25. Explain the purpose of an intervention before making it Part 2: Good Assessment Practice in REBT 26. Help your clients to be specific when they are vague in describing their problems 27. When clients want to talk at length about their feelings, explain REBT’s attitude-based model of change 28. Ask for a specific example of the client’s nominated problem 29. Check that a rigid/extreme attitude is your client's problem 30. Help clients to make imprecise emotional Cs precise 31. Explain why disturbed feelings are unhealthy/unhelpful and why non-disturbed feelings are healthy/helpful 32. Treat frustration as an A rather than a C, but be prepared to be flexible 33. Learn when to be specific about an emotional C and when to generalise from it 34. Use your clients’ behavioural Cs to identify their emotional Cs 35. Pinpoint the client’s adversity at A 36. Examine attitudes at B rather than question the validity of adversities at A 37. Pursue clinically significant inferences at A instead of theoretical inferences 38. Realise that your clients’ target emotions have changed 39. When doing inference chaining, notice when your clients have provided you with a C instead of an inference and respond accordingly 40. Clarify the ‘it’ 41. Use theory-driven questions in assessing rigid and extreme attitudes and their flexible and non-extreme attitude alternatives 42. Do not assume that your clients hold all four rigid/extreme attitudes 43. Distinguish between absolute and preferential shoulds 44. Refrain from constructing a general version of your clients’ situation-specific rigid/extreme attitude unless you have evidence to do so 45. Express self-devaluation in your clients’ words 46. Clearly determine whether ego or discomfort disturbance is the primary problem 47. Look for a meta-emotional problem 48. Do not assume that a meta-emotional problem is always present 49.Decide with clients whether or not to work on their meta-emotional problem first Part 3: Good Goal-Setting Practice in REBT 50. Distinguish between the two stages of goal-setting 51. Achieve a balance between your clients’ short- and long-term goals 52. Negotiate goals that help to strengthen your clients’ flexible and non-extreme attitudes 53. Agree goals with clients that are within their control 54. Encourage your clients to state their goals in positive terms 55. Focus on outcome goals instead of process goals 56. Focus on emotional goals before practical goals 57. Help your clients understand that intellectual insight into flexible and non-extreme attitudes is necessary but not sufficient for meaningful change to occur 58. Help your clients understand that feeling neutral about negative events is not healthy 59. Help your clients understand that improved problem management can be attained rather than cure 60. Agree goals with your clients that are realistic and ambitious 61. Elicit from your clients a commitment to change Part 4: Good Practice in Examining Attitudes in REBT 62. Prepare your clients for examining their attitudes 63. Examine attitudes creatively, not mechanically 64. Examine a rigid/flexible attitude and the relevant extreme/non-extreme attitude 65. Use didactic and Socratic examination of attitudes appropriately 66. Focus on the type of argument that is more helpful to your clients than the other types 67. Help your clients to put flexible/non-extreme attitude into their own words 68. Help your clients to examine attitudes rather than argue about them 69. Take care to examine attitudes rather than inferences Part 5: Good Practice in Negotiating and Reviewing Homework Tasks in REBT 70. Negotiate and review homework tasks 71. Make the homework task therapeutically potent 72. Take your clients through the specifics of negotiating homework tasks 73. Encourage your clients to use force and energy in executing their homework tasks 74. Use multimodal methods of change 75. Check whether your clients have the skills to execute homework tasks 76. Encourage your clients to do homework tasks, not to ‘try’ to do them 77. Take time negotiating homework tasks 78. Remember to review homework tasks 79. Respond to clients’ differing experiences with homework tasks 80. Capitalise on successful homework completion Part 6: Good Practice in Dealing with Clients’ Doubts, Reservations and Objections to REBT 81. Elicit and respond to your clients’ doubts, reservations and objections (DROs) to REBT 82. Deal with your clients’ doubts, reservations and objections (DROs) to giving up rigid attitudes and acquiring flexible attitudes 83. Deal with your clients’ doubts, reservations and objections (DROs) to giving up awfulising attitudes and acquiring non-awfulising attitudes 84. Deal with your clients’ doubts, reservations and objections (DROs) to giving up attitudes of unbearability and acquiring attitudes of bearability 85. Deal with your clients’ doubts, reservations and objections (DROs) to giving up devaluation attitudes and acquiring unconditional acceptance attitudes 86. Explore and deal with your clients’ doubts, reservations and objections (DROs) to giving up their unhealthy negative emotions and experiencing healthy negative emotions instead Part 7: Good Practice in the Working-Through Phase of REBT 87. Help your clients to become self-therapists in the working-through phase of REBT 88. Discuss with your clients that change is non-linear 89. Explain to your clients cognitive-emotive dissonance reactions to the change process 90. Discuss with your clients attitude change vs. non-attitude change 91. Distinguish between your clients’ pseudo-flexibility and non-extremeness and a genuinely flexible and non-extreme outlook 92. Help your clients to generalise their learning to other problematic situations in their lives 93. Help your clients to look for core rigid/extreme attitudes 94. Help your clients understand how they perpetuate their core rigid/extreme attitudes 95. Teach relapse prevention 96. Encourage self-actualisation when your clients indicate it as a goal 97. Do not sacredise endings Part 8: Good Practice in Self-Maintenance as an REBT Therapist 98. Look after yourself 99. Do not disturb yourself about your clients’ disturbances 100. Do not sacredise REBT 101. Practise what you preach