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The Role of Rational Emotive Behavior Therapy in Addiction Treatment

Rational emotive behavior therapy (REBT) is a popular short-term psychotherapy treatment that helps patients identify self-defeating thoughts and feelings. This form of therapy also focuses on the present time and helps people identify how unhealthy thoughts and beliefs can create emotional distress, leading to harmful actions and behaviors. It’s a psychotherapy treatment designed to treat self-sabotage, a common practice among those with substance use disorders.

What’s Rational Emotive Behavior Therapy?

Initially introduced by Albert Ellis in the 1950s, REBT helps identify irrational beliefs and negative thought patterns that can lead to emotional or behavioral issues. Once these patterns are identified, patients work with therapists to develop critical strategies to replace them with more rational patterns. 

REBT is helpful for different types of issues, but it can be constructive for people struggling with:

  • Depression and anxiety
  • Addictive behaviors 
  • Phobias
  • Procrastination
  • Eating disorders
  • Aggression
  • Sleep problems 

How REBT Works for Recovery

This form of therapy is grounded in the belief that people generally want to do well in life. It uses three core principles – called the ABCs – of REBT to illustrate its point. The ABC model implies that: 

  • A for Activating the event or situation triggers the adverse reaction or response, such as a phobia. 
  • B for Beliefs or irrational thoughts that someone might have about a specific situation or circumstance. 
  • C for Consequences of these beliefs, such as distressing emotions or unhealthy actions. 

REBT uses these core principles alongside three different techniques to assess the symptoms and promote recovery. A therapist might use one or a combination of the following methods:

Problem-solving techniques. Strategies that help address the activation event or core principle (A), including:

  • Improving problem-solving skills
  • Working on social skills
  • Practicing assertiveness
  • Develop conflict-resolution skills 
  • Working on decision-making skills

Cognitive restructuring techniques. These strategies help change irrational beliefs or core principles (B), such as:

  • Rationalizing techniques
  • Practicing visualization
  • Trying reframing
  • Disputing irrational beliefs or thoughts
  • Being exposed to the feared situation

Coping techniques. Strategies used to manage the emotional consequences better or activating the core principle (C), such as:

  • Hypnosis
  • Meditation
  • Relaxation 


Some experts believe REBT is the framework for cognitive-behavioral therapy. While CBT and REBT have similar principles, they still have many differences. Both approaches help you accept and change irrational thoughts. But, REBT places more emphasis on the acceptance principle. 

REBT is also unique because it uses different approaches like humor as a therapeutic approach to help people make situations or events look less severe. This approach allows people to see these events from a different perspective. Besides, REBT makes it a point to address secondary symptoms like becoming anxious about experiencing anxiety. 

What to Expect from Treatment

In essence, REBT looks very much like a traditional psychotherapy session. There’s a talk therapy element paired with other techniques. Each step is still designed to recognize the irrational patterns and eventually change these behaviors. 

Identify Irrational Thought Patterns

The first step is to identify the irrational thoughts, feelings, and beliefs leading to emotional distress. These beliefs are usually present themselves as absolutes, for example, “I must,” or “I cannot.” Common irrational thoughts include:

  • Feeling irrationally upset over someone else’s mistakes or misconduct
  • Believing that one must be 100% competent in everything to be worthwhile
  • Feelings that one has no control over one’s happiness
  • Assuming that one would be happier if one avoids life’s difficulties

Eventually, holding to these beliefs can lead to disappointment, regret, and severe anxiety that interferes with life. 

Challenge Irrational Beliefs

After identifying the underlying feelings and beliefs, it’s time to challenge them. Therapists dispute these beliefs using direct and sometimes uncomfortable methods. Ellis’s core principles also suggested that therapists needed to be honest, blunt, and honest to push people toward changing their beliefs and behaviors. 

However, this is a highly controversial practice as there’s questioning how far therapists take their bluntness. Also, not everyone responds to this form of encouragement, so it’s essential to work with a comprehensive therapist to adapt accordingly.

Change Behavior

At last, it’s time to start changing the behavior. However, this might be the most daunting and challenging part. Patients use different techniques to change their behavior, such as journaling, meditation, and guided imagery to help them move away from their unhealthy beliefs. 

Is It Effective?

Overall, REBT is accepted as an effective form of therapy for different conditions. A complete review of 84 published articles on REBT concluded that it’s a valid treatment for obsessive-compulsive disorders, social anxiety, depression, as well as disruptive behaviors. 

Another small study looked at the benefits of regular sessions for long-term depression. After a year in the study, participants made fewer trips to their primary care doctor, and prescription medications also decreased. 

The goal of REBT is to help people achieve unconditional self-acceptance. Still, people respond differently to different types of therapy. What works for one person may not work for others. For these reasons, research studies are not always accurate on their effectiveness. 

Getting Help

Overall, REBT can help address self-sabotaging behaviors in some individuals. If you or someone you know struggles with addiction, phobias, or other behavioral disorders, consider talking to a therapist about rational emotive behavior therapy. 

REBT is also similar to cognitive-behavioral therapy, so many people try REBT and believe it too harsh. They might transition to a different yet identical approach to treatment like CBT. No matter what, consider talking to a mental health professional about your struggles to find the best treatment for your needs. 


Rovira Aler, C., Fuentes Leiva, M. I., Fernández Bonet, X., Almeda Ortega, J., Cunillera Puertolas, O., & Edo Izquierdo, S. (2016). Effectiveness of Rational Emotive Behaviour Therapy in Clinical Social Work: Impact on Frequency of Visits and Use of Psychopharmacological Treatment. International Journal of Integrated Care, 16(6), A6. DOI

Drug-Free Housing for Substance Abusers Leaving Detox Linked to Fewer Relapses – 02/27/2012. (2021). Retrieved 12 March 2021

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