I often get asked by my clients what are the main differences between various schools of CBT as there a few to choose from.

What’s the difference?

There are several different types of so called Third Wave CBT approaches : Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), Rational Emotive Behaviour Therapy (REBT), Schema Therapy Mindfulness Based Cognitive Therapy (MBCT) and probably more are or will be emerging in the near future. 

In this blog, I will shed a light on two of them which are fairly close in their theoretical underpinnings and were developed around the same time.

According to Albert Ellis, the founder of REBT, the difference between Beckian CBT and REBT is that, “CBT does not attempt to modify the overall philosophy and assumptive world of clients through the use of disputation methods.” In other words, Ellis is saying that CBT does not look at the pros and cons of a client’s unhealthy or healthy negative beliefs via the disputation process.

REBT appears to take the position that behaviour and/or emotions are simply consequences of the patient’s core belief structure, which then leads to psychopathology, as proven by the studies of Ellis & Bernard, 1983.

Not better or worse, just a bit different

Ellis’ model deals with both the symptom treatment as well as advocating a philosophy of healthy living. His philosophy also does not shy away from disputing the worst-case scenarios from the start. By contrast, Beckian CBT model primarily focuses on symptom treatment and reality testing.

Ellis did not agree with Beck’s use of distraction techniques within CBT as he believed that this may cause low frustration tolerance. He described it as an “inelegant way of therapy”.

Based on my studies of Beck’s CBT I learned this school of therapy tends to be more investigative, scientific and evidence based. The main essence of CBT is the faulty thinking mechanism, which can be also called an unhealthy conscious process. That said, Ellis thought that the unconscious processes are more important. He also tends to look at the therapy in a more philosophical and directive way.

Is it a popularity contest?

It is self-evident that Beck’s CBT model took off more easily due to his scientific way of writing, symptom specific focus, and the main theme – depression. For these reasons, amongst others, Beck’s work attracted a wide audience, research, and clinical attention more so than Ellis’ model.

It is also important to point out that Ellis’ REBT distinguishes between distress and disturbance; however, such terms are interchangeable in main Beckian CBT books.

Solution focused therapies

Finally, I would like to highlight one of the main similarities of CBT and REBT, which is the fact that both therapies are not concerned by why patients have learned unhealthy beliefs, but why they are maintaining them. In other words, they do not focus on the background or reasons behind the problem, but mainly on the solution. 

Are you ready to change your direction? Or would you like more information about the subject of REBT, then I would love to hear from you.

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