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Contemporary Theories and Therapies

Rational Therapy

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Founder Albert Ellis, MD

Definition
 
Rational-Emotional therapy is built on the belief that how we emotionally respond at any moment depends on our interpretations--our views, our beliefs, our thoughts--of the situation. In other words, the things we think and say to ourselves, not what actually happens to us, cause our positive or negative emotions.
 
Description
 

Rational therapy holds that certain core irrational ideas, which have been clinically observed, are at the root of most neurotic disturbance. They are: (1) The idea that it is a dire necessity for adults to be loved by significant others for almost everything they do — instead of their concentrating on their own self-respect, on winning approval for practical purposes, and on loving rather than on being loved. (2) The idea that certain acts are awful or wicked, and that people who perform such acts should be severely damned — instead of the idea that certain acts are self-defeating or antisocial, and that people who perform such acts are behaving stupidly, ignorantly, or neurotically, and would be better helped to change. People’s poor behaviors do not make them rotten individuals. (3) The idea that it is horrible when things are not the way we like them to be — instead of the idea that it is too bad, that we would better try to change or control bad conditions so that they become more satisfactory, and, if that is not possible, we had better temporarily accept and gracefully lump their existence. (4) The idea that human misery is invariably externally caused and is forced on us by outside people and events — instead of the idea that neurosis is largely caused by the view that we take of unfortunate conditions. (5) The idea that if something is or may be dangerous or fearsome we should be terribly upset and endlessly obsess about it — instead of the idea that one would better frankly face it and render it non-dangerous and, when that is not possible, accept the inevitable. (6) The idea that it is easier to avoid than to face life difficulties and self-responsibilities instead of the idea that the so-called easy way is usually much harder in the long run. (7) The idea that we absolutely need something other or stronger or greater than ourselves on which to rely — instead of the idea that it is better to take the risks of thinking and acting less dependently. (8) The idea that we should be thoroughly competent, intelligent, and achieving in all possible respects — instead of the idea that we would better do rather than always need to do well and accept ourselves as a quite imperfect creature, who has general human limitations and specific fallibilities. (9) The idea that because something once strongly affected our life, it should indefinitely affect it — instead of the idea that we can learn from our past experiences but not be overly-attached to or prejudiced by them. (10) The idea that we must have certain and perfect control over things — instead of the idea that the world is full of probability and chance and that we can still enjoy life despite this. (11) The idea that human happiness can be achieved by inertia and inaction — instead of the idea that we tend to be happiest when we are vitally absorbed in creative pursuits, or when we are devoting ourselves to people or projects outside ourselves. (12) The idea that we have virtually no control over our emotions and that we cannot help feeling disturbed about things — instead of the idea that we have real control over our destructive emotions if we choose to work at changing the masturbatory hypotheses which we often employ to create them.

 

http://www.rebt.ws/albert_ellis_the_essence_of_rebt.htm

 

Therapeutic Goal

 

Organize information and establish priorities when formulating a therapeutic plan. Organize patient information in a readily retrievable format. Prioritize patient-related problems on a daily basis by degree of importance and urgency. Solve/intervene/address patient related and therapeutic problems on established order of priority in a timely fashion. Assess various therapeutic modalities (including non-drug modalities) and provide a rationale for the best therapeutic options and alternatives for a patient. Identify all rational therapeutic options for the specific clinical situation. Substantiate therapeutic recommendations with specific and appropriate literature references. Make appropriate therapeutic recommendations based on complete evaluation of all pertinent factors including (but not limited to) patient information and disease state, clinical status, allergies, comparative efficacy and toxicity of all rational therapeutic options. Provide primary and alternative recommendations. Initiate discussion of therapeutic recommendations with preceptor. Assess patient progress and follow appropriate monitoring parameters for drug therapy and disease states. Identify and assess key efficacy and toxicity monitoring parameters for drug therapy and disease states. Identify and follow appropriate monitoring parameters for daily assessment of the patient's clinical condition. Assess adequacy of each medication based on overall evaluation of efficacy and toxicity monitoring parameters. Determine the relative reliability of each method chosen to monitor drug therapy. Determine appropriate timing of each drug monitoring parameter in relation to dose, if necessary (i.e.. peak, trough, and steady-state). Provide timely and appropriate follow-up recommendations for optimal patient care.

 

http://sop.campbell.edu/~experiential/pepprogram/im2clerkship.htm

Engage client

1.        The first step is to build a relationship with the client. This can be achieved using the core conditions of empathy, warmth and respect.

2.        Watch for ‘secondary disturbances’ about coming for help: self-downing over having the problem or needing assistance; and anxiety about coming to the interview.

3.        Finally, possibly the best way to engage a client for REBT is to demonstrate to them at an early stage that change is possible and that REBT is able to assist them to achieve this goal.

Assess the problem, person, and situation

Assessment will vary from person to person, but following are some of the most common areas that will be assessed as part of an REBT intervention.

1.        Start with the client’s view of what is wrong for them.

2.        Check for any secondary disturbance: how does the client feel about having this problem?

3.        Carry out a general assessment: determine the presence of any related clinical disorders, obtain a personal and social history, assess the severity of the problem, note any relevant personality factors, and check for any non-psychological causative factors: physical conditions; medications; substance abuse; lifestyle/environmental factors.

Treatment Techniques

You must not have received chemotherapy or radiation within the past four weeks.

Any recent exposure to chemotherapy or radiation may sensitize your tumor to the drugs we test and cause inaccurate results. Thus, a four-week treatment-free period is required.

http://www.rationaltherapeutics.com/

 Rational-Emotional therapy is built on the belief that how we emotionally respond at any moment depends on our interpretations--our views, our beliefs, our thoughts--of the situation. In other words, the things we think and say to ourselves, not what actually happens to us, cause our positive or negative emotions.
 

Developing rational self-challenges to irrational self-talk is done by the client, either through discusions with the therapist or by writing a "rational self-analysis."  Rational self-analysis is very useful in alleviating undesireable emotions.
 
Clients can learn to analyze and change irrational self-talk in a variety of ways: instruction by their therapist; viewing videotapes and films; reading books and pamphlets; and attending workshops or seminars on rational therapy.
 
 
Source
The Practice of Social Work  Applications of Generalist and Advanced Content.  Charles H. Zastrow
 
Thomas Barnett