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Rational Emotive Behavioural Therapy (REBT) in Addiction Treatment

    We’re incredibly fortunate that in modern times, people who exhibit addictive behaviours are offered a wide selection of treatment options, ranging from holistic therapies to 12-step programs.

    It wasn’t always this way, however. Flashback to 70 years ago and the world was a different place – addictions and other mental health conditions were met with stigma, and treatment options were scarce.

    To help people overcome mental health challenges and unhealthy behaviours, psychiatrists pioneered a new wave of treatment: a concept rooted in psychotherapy.

    Rational Emotive Behaviour Therapy (REBT) [1] was developed by psychologist Albert Ellis in 1955, preceding Cognitive Behavioural Therapy (CBT) by several years.

    Despite this, many people believe that REBT is a direct extension of CBT, whereas in reality these two therapies tackle different issues. Whereas REBT focuses on how harmful beliefs shape people’s actions, CBT tackles cognitive distortions or thought patterns.

    Ellis proposed that mental illnesses form when we hold negative beliefs about an event, rather than the event itself. In essence, the way we feel is a result of the way we think.

    For example, many people hold the irrational belief that they must perform perfectly in every aspect of their lives to be valued and successful.

    We’re not talking about perfectionism here, but rather the belief that every small and normal setback equates to worthlessness.

    The emotionally healthy response to this thought process would be to realise that life is full of minor setbacks and that this doesn’t define our future.

    However, thinking this way is easier said than done, and many people need a helping hand through evidence-based therapies.

    Through his observations, Ellis concluded that it was people’s irrational thinking that led to negative feelings and an impact on their quality of life. REBT was his campaign to help people alter their irrational beliefs about themselves, the world, and those around them.

    Start engaging with Rational Emotive Behavioural Therapy at your ideal drug and alcohol rehab by giving us a call on 0800 326 5559

    What are the Key Concepts of Rational Emotive Behaviour Therapy?

    A man in therapy

    This form of psychotherapy has three key beliefs at the heart of its methodology.

    Each concept is used by REBT counsellors [2] to help patients reframe their thoughts, whether they are suffering from a substance addiction or another mental health disorder.

    These concepts are:

    • In life, negative events are likely to occur at some stage, whether this is not meeting a particular goal or suffering a minor injury. Rather than letting this affect our quality of life, we must realise that negative events are normal, and aren’t a sign that our lives are taking a downward spiral. Life is often positive, but there are times when it is not, and these will pass.
    • As human beings working our way through life, we are all worthy of self-acceptance, and there’s no rational reason behind feelings of shame. Just because things might not be going our way, it doesn’t mean we cannot celebrate small achievements and feel gratitude for what we have.
    • This concept applies to the other people in your life, too. Just because you are worthy of self-acceptance, this doesn’t mean that others aren’t deserving of the same appreciation. Even when their behaviour doesn’t align with our personal values, it’s important to remain empathetic.

    While REBT emphasises illogical beliefs and the self-destructive behaviours they cause, it highlights that we can halt this cycle of negativity. The core tenet of REBT is that psychotherapy can help people change the way they think and foster healthier beliefs.

    REBT exercises encourage patients to use reason when approaching problem-solving, making it more likely that they’ll replace negative behaviours with positive coping mechanisms.

    In this way, rational emotive therapy can tackle the urge to use addictive substances such as drugs and alcohol.

    To learn more about the key concepts of Rational Emotive Behavioural Therapy, give our team a call on 0800 326 5559

    Using REBT to Treat Addiction

    Men talking during 1-1 therapy

    For many victims of Substance Use Disorder (SUD) [3], the cycle of addiction is perpetuated by irrational thinking and negative thought patterns.

    As direct sufferers know all too well, anxiety and depression are common feelings associated with substance abuse.

    Oftentimes, those struggling with addiction started using substances to self-medicate the symptoms of their co-occurring disorders.

    Even if they aren’t battling a mental illness that preceded their substance abuse, difficult feelings can manifest further down the line

    During active addiction, many people experience feelings of shame and guilt made worse by the public stigma surrounding SUD.

    As such, it makes sense that REBT proves to be an effective treatment method for substance abuse, helping people get to the root cause of their behaviour.

    While other treatment strategies help people deal with the symptoms of their SUD, such as withdrawal, REBT helps prevent relapse by changing the foundations of someone’s thought processes.

    Unlike quick-fire addiction therapies like Motivational Interviewing [4] which are completed in a few sessions, REBT is a long-term affair. This is because therapists take the time needed to identify their patient’s unique underlying beliefs, and then replace them over time.

    When REBT is modified to treat those with addiction, sessions hone in on identifying relapse triggers. Usually performed in one-to-one settings rather than group therapy, the individual and their therapist work together to identify irrational beliefs.

    Then they’ll explore why these thoughts are harmful and how they can drive substance use.

    Lastly, they’ll look at how to replace these with rational beliefs and positive behaviour.

    The therapeutic method of challenging irrational beliefs [5] is called “Disputation” – taking a step back to dispute our thoughts.

    Depending on their patient’s unique situation, REBT therapists may choose to implement cognitive disputation or imaginal disputation, which are easier concepts to grasp than their names suggest.

    During cognitive disputation, therapists ask their patients questions that challenge the logic of the way they think. This often requires people to face up to their fears or challenge the way they feel about addictive substances [6], events, people, or themselves.

    While this can be an upsetting experience, it’s worthwhile in the long run as it allows for immense self-expansion and healing.

    The alternative method, imaginal disputation, is more suited to patients who can easily imagine how situations might play out. REBT therapists encourage patients to use mental imagery as a way of re-imagining difficult situations.

    These might include the temptation to use drugs, relapse triggering social situations, or arguing with a loved one. By envisaging different ways the scenario might play out, patients can learn to respond in healthy ways that maintain their sobriety.

    Find out more about how Rational Emotive Behavioural Therapy will help you overcome addiction by talking to our experts on 0800 326 5559

    The ABC Model in Addiction Treatment

    A meeting with a therapist

    During their therapeutic programme, counsellors use what’s known in REBT language as the ABC model.

    This three-step process explains to individuals in recovery that while they might blame external events for their substance misuse, it’s their interpretation of such events that keeps the cycle of addiction going.

    The ABC model starts with (A)ctivating event, also described as adversity. This event is something that triggers us to form unhealthy beliefs, whether this is about ourselves or those around us.

    An activating event kindles the development of a negative thought to help us cope with what’s happened, whether this is a minor inconvenience or something serious.

    The second component is irrational (B)elief or the negative thought process formed after the activating event.

    For example, in response to drinking alcohol after a long period of sobriety [7], someone might think “I’m worthless, and quitting drinking for good is something I’m destined to fail at”. This kind of cognitive distortion is known as awfulizing and is our brain’s shoddy attempt at helping us cope with stress.

    The “C” stands for (C)onsequences and delves into how harmful belief systems stand in the way of recovery. In most cases, irrational beliefs have a range of emotional and behavioural consequences.

    Some of these are immediately obvious, such as turning back to drugs or alcohol, and others may fester beneath the surface, such as guilt and shame.

    These three components are the ABC model at its simplest, but REBT therapists can extend it by adding a “D” and an “E”.

    Adding to the acronym (now ABCDE), means that once a therapist and their patient have identified behaviour patterns, they can go about changing them.

    The fourth component is something mentioned earlier, (D)isputes or arguments. As briefly covered, the next step after recognising the consequences of our irrational thoughts is to challenge these beliefs.

    During this phase, therapists help their patients come up with contrary internal dialogue that they can use to combat negative thoughts [8].

    And lastly, we have the final (and most uplifting) part of the acronym, “E” for New (E)ffect. After a course of REBT sessions, patients will start to see the positive effects that come with holding more rational beliefs.

    This could come in many different forms, from renewed self-confidence or reduced anxiety to a greater awareness of the nature of their addiction. Hopefully, these healthier coping skills will make relapse far less likely to occur.

    Discover just how effective Rational Emotive Behavioural Therapy can be at your ideal drug and alcohol rehab – give our team a call today on 0800 326 5559

    REBT in Action

    A cognitive therapy session

    To gain real insight into how REBT operates in addiction treatment programs, it’s important to take a look at some examples of the ABCDE model in action.

    We’ve used a scenario that can happen for those trapped in the cycle of addiction but also applies to those prone to anxiety and overthinking.

    In this case, the Activating Event is when an individual has been turned down for a job that they really wanted.

    Having recently got their life back on track following the effects of substance abuse, this position meant a lot to them. So in this scenario, the activating event is a situation rather than a person (although the individual in question might blame those who conducted their interview).

    Second is the Belief that forms – this individual has jumped to the conclusion that “if I failed to get the job this time, I’ll continue meeting rejection time and time again”.

    This unhelpful dialogue may spiral into “Clearly I can’t get a job, so therefore I’m not good at anything, I’m worthless”.

    The Consequence of this is that the individual resumes their problematic alcohol use. They’re attempting to make the shame and anxiety go away and have suffered a relapse: falling back on unhealthy coping mechanisms [9].

    Fortunately, this individual is seeing an REBT therapist who helps them move beyond the irrational belief of self-hatred.

    During their sessions, they’ll discuss why these beliefs are irrational and negative; they are a type of cognitive distortion and should be treated as such. Armed with this knowledge, the individual can try implementing the next part of the model: disputation and new effect.

    When they next feel like a failure or feel bad about themselves, they’ll question their thought process.

    This will involve reminding themselves that everyone makes mistakes in life and that setbacks do not make us bad people. At the heart of this process is acknowledging that thoughts are simply thoughts, and are transient.

    From this, a new effect emerges; the individual replaces their negative thoughts with positive ones by accepting that we all make mistakes.

    Instead of turning to alcohol to cope with these feelings, they are now able to combat these feelings by themselves, and by using the tools learned in REBT.

    Find your way towards accessing all the benefits REBT by giving our team a call on 0800 326 5559

    What are the Benefits of REBT?

    A young woman in a therapy session

    As we’ve explored, SUD is a condition that’s exacerbated by irrational thinking, and we’ve examined how REBT operates to treat addiction [10] in rehab clinics.

    But how does this form of psychotherapy directly benefit people?

    Whether someone has a dual diagnosis or has suffered from emotional trauma, REBT has an array of benefits that, with the right practice, help people throughout their lives.

    1. Aiding Post-Acute Withdrawal Syndrome (PAWS)

    Post-acute withdrawal symptoms are those that linger for months or even years after someone has gone through detox.

    Depending on the substance the person was addicted to and their history of mental health, they often include anxiety, depression, and insomnia.

    REBT helps individuals suffering from PAWS by replacing unhealthy thoughts with positive thinking, helping them change their relationship with anxiety or low mood.

    A large part of this involves teaching acceptance, allowing clients to come to terms with their feelings and realise that they will come and go.

    2. Enhancing Productivity

    Unlike other more passive addiction treatments, REBT requires participants to put in active work, both in and outside of sessions.

    As an intensive, focused style of therapy, workshops won’t revolve around informal conversation and will instead spend time getting to the heart of the matter.

    Moreover, many REBT therapists assign homework and assignments, allowing their patients to try out the new behaviours they’ve explored during sessions.

    This might come in the form of ABCDE worksheets that the client fills out, or a similar journal activity.

    While this intensive format can put some people off trying REBT [11], it helps many individuals in recovery regain a sense of purpose and rebuild their productivity.

    Having to show up for their ongoing recovery, rather than simply taking medications, optimises the integrity of someone’s sobriety.

    Middle aged woman smiling

    3. Increasing Positivity in Addiction Recovery

    It’s no secret that negativity breeds negativity, and when this occurs as part of your internal dialogue, it can cause your mental health to dip quickly.

    By its very nature, REBT focuses on the positives in life, and reframing negative self-talk in a way that allows people to grow.

    Any type of recovery is hard, but those struggling with addiction have an especially hard time seeing the light at the end of the tunnel. As such, having a positive therapy such as REBT involved in your treatment will help you learn to smile in the face of adversity.

    4. Building a Trusting Relationship With Your Therapist

    As a long-term, one-to-one treatment, REBT allows participants to engage with the same therapist during each session. Over time, this therapist will come to know you well as you work through addiction-related struggles together and pick apart unhelpful beliefs.

    Because REBT is a behavioural therapy [12] that requires someone to be honest about their feelings, it can be very liberating to share this with someone.

    This famously intensive approach requires both the patient and their therapist to make a commitment and be fully present during sessions.

    This dynamic can often help patients learn to trust someone again, especially if they’ve dealt with trauma as part of their substance abuse journey. Learning to talk with someone openly about how our mind works can be an incredibly healing process and will help unburden you of harmful mental chatter.

    While some stages in the REBT process can feel confrontational, especially when your therapist challenges beliefs you’ve held for a while, they’ll make sure you feel comfortable throughout the process.

    After all, it can be impossible to recover when surrounded by people who do nothing but agree with everything we say.

    Get the help you need to leave addiction behind by calling our team on 0800 326 5559

    Reach Out to the Ok Rehab Team and Start Your Recovery Journey

    A woman talking on the phone with a ring on her hand

    Accessing a therapist who practices REBT could mark the turning point in your recovery, or help someone you love to overcome their addiction [13].

    However, the process of finding a counsellor who A) specialises in Rational Emotive Therapy, and B) has experience in addiction treatment can be hard to do alone.

    That’s why here at Ok Rehab, we’ve built an accessible helpline for you to call at any time for expert guidance. Our team of health professionals can help you find an REBT therapist in your local area with the correct experience and set of certifications.

    If your drug or alcohol addiction is severe, we can help you access a specialised rehab facility that provides REBT and various types of therapy.

    Whatever the cause of your distress, a sympathetic member of the Ok Rehab team is here to help, any time of the day or night.

    For general enquiries, simply call 0800 326 5559, or complete our contact form to hear back from a team member, usually within the hour.

    Together, we can facilitate your journey towards lifelong healing















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