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One pathway to cognitive behaviour therapy integration: introducing assimilative integrative rational emotive behaviour therapy

Published online by Cambridge University Press:  13 April 2020

Najwan Saaed Al-Roubaiy Open the ORCID record for Najwan Saaed Al-Roubaiy [Opens in a new window]
Najwan Saaed Al-Roubaiy*
Affiliation:
Psychology Department, American Center for Psychiatry and Neurology, United Arab Emirates
*
*Corresponding author, UK HCPC registered clinical psychologist. Email: [email protected]
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Abstract

In this paper, rational emotive behaviour therapy (REBT) is presented as the most comprehensive cognitive behavioural therapy (CBT) to date, with over-arching influence on most of the other therapies that came after it. However, despite REBT’s comprehensiveness and the limitations inherent in other CBT approaches, REBT has its limitations. Limitations in REBT theory are explored and an argument is made in favour of rectifying these limitations by incorporating other approaches into REBT (namely cognitive therapy and compassion-focused therapy) to create a more complete integrative psychotherapy model. It is then argued that psychotherapy integration is the future of CBT mainly due to the fact that it reflects how most therapists practise, and due to its utilization of the common factors theory. Finally, the integrative model – which I call Assimilative Integrative Rational Emotive Behaviour Therapy – is presented and demonstrated using a clinical case example.

Key learning aims

  1. (1) To understand the limitations of cognitive therapy and third-wave CBT approaches.

  2. (2) To appreciate the comprehensiveness and over-arching influence of REBT.

  3. (3) To understand the limitations of REBT despite its comprehensiveness.

  4. (4) To consider rectifying the limitations in REBT by incorporating other models into it.

  5. (5) To appreciate the complementary nature of CFT when integrated into other models.

  6. (6) To understand the value and relevance of psychotherapy integration.

  7. (7) To consider AI-REBT as one possible pathway to psychotherapy integration in CBT.

Keywords

cognitive therapycommon factorscompassion-focused therapyintegrative psychotherapyrational emotive behaviour therapytheoretical limitations
Type
Practice Article
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e7
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Further reading

Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York, USA: International University Press.Google Scholar
Carvalho, S., Martins, C. P., Almeida, H. S., & Silva, F. (2017). The evolution of cognitive behavioural therapy – the third generation and its effectiveness. European Psychiatry, 41, 773–774.CrossRefGoogle Scholar
DiGiuseppe, R. A., Doyle, K. A., Dryden, W., & Backx, W. (2014). A Practitioner’s Guide to Rational-Emotive Behavior Therapy (3rd edn). New York, USA: Oxford University Press.Google Scholar
Gilbert, P. (2010). Compassion Focused Therapy: Distinctive Features. New York, USA: Routledge/Taylor & Francis Group.CrossRefGoogle Scholar

References

Al-Roubaiy, N. S. (2012). An REBT conceptualisation of Iraqi refugee exile-related stressors. The Rational Emotive Behaviour Therapist, 15, 39–51.Google Scholar
Al-Roubaiy, N. S., Owen-Pugh, V., & Wheeler, S. (2013). The experience of exile-related stress among Iraqi refugee men in Sweden and its implications for counselling and psychotherapy: a qualitative study. Counselling Psychology Review, 28, 53–67.Google Scholar
Al-Roubaiy, N. S., Owen-Pugh, V., & Wheeler, S. (2017). Iraqi refugee men’s experiences of psychotherapy: clinical implications and the proposal of a pluralistic model. British Journal of Guidance & Counselling, 45, 463–472.CrossRefGoogle Scholar
Arean, P. A. & Kraemer, H. C. (2013). High Quality Psychotherapy Research: From Conception to Piloting to National Trials. New York, USA: Oxford University Press.CrossRefGoogle Scholar
Barlow, D. H. (1991a). Disorders of emotion. Psychological Inquiry, 2, 58–71.CrossRefGoogle Scholar
Barlow, D. H. (1991b). Disorders of emotions: clarification, elaboration, and future directions. Psychological Inquiry, 2, 97–105.CrossRefGoogle Scholar
Beaumont, E., & Hollins Martin, C. J. (2015). A narrative review exploring the effectiveness of compassion-focused therapy. Counselling Psychology Review, 30, 21–32.Google Scholar
Beck, A. T. (1963). Thinking and depression I: Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9, 324–333.CrossRefGoogle ScholarPubMed
Beck, A. T. (1964). Thinking and depression II: Theory and therapy. Archives of General Psychiatry, 10, 56–71.CrossRefGoogle ScholarPubMed
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York, USA: International University Press.Google Scholar
Bennett-Levy, J., Butler, G., Fennell, M., Hackman, A., Mueller, M., & Westbrook, D. (eds). (2004). Cognitive Behaviour Therapy: Science and Practice Series. Oxford Guide to Behavioural Experiments in Cognitive Therapy. Oxford, UK: Oxford University Press.CrossRefGoogle Scholar
Beutler, L. E. (2009). Making science matter in clinical practice: redefining psychotherapy. Clinical Psychology: Science and Practice, 16, 301–317.Google Scholar
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review, 26, 17–31.CrossRefGoogle ScholarPubMed
Carvalho, S., Martins, C. P., Almeida, H. S., & Silva, F. (2017). The evolution of cognitive behavioural therapy – the third generation and its effectiveness. European Psychiatry, 41, 773–774.CrossRefGoogle Scholar
Castonguay, L. G., Newman, M. G., Borkovec, T. D., Holtforth, M. G., & Maramba, G. G. (2005). Cognitive-behavioral assimilative integration. In Norcross, J. C. & Goldfried, M. R. (eds), Handbook of Psychotherapy Integration (2nd edn, pp. 241–260). New York, USA: Oxford University Press.CrossRefGoogle Scholar
Castonguay, L. G., Christopher Muran, J., Angus, L., Hayes, J. A., Ladanay, N., & Anderson, T. (2010). Bringing Psychotherapy Research to Life: Understanding Change Through the Work of Leading Clinical Researchers. Washington, DC, USA: American Psychological Association.CrossRefGoogle Scholar
Chambless, D. & Ollendick, T. (2001). Empirically supported psychological interventions: controversies and evidence. Annual Review of Psychology, 52, 685–716.CrossRefGoogle ScholarPubMed
Chapman, L. (2012). Evidence-based practice, talking therapies, and the new taylorism. Psychotherapy and Politics International, 10, 33–44.CrossRefGoogle Scholar
Churchill, R., Moore, T. H. M., Furukawa, T. A., Caldwell, D. M., Davies, P., Jones, H., Shinohara, K., Imai, H., Lewis, G., & Hunot, V. (2013). Third wave cognitive and behavioural therapies versus treatment as usual for depression. Cochrane Database of Systematic Reviews, 10, article no. CD008705.Google Scholar
Clark, D. M. (2001). A cognitive perspective on social phobia. In Crozier, W. R. and Alden, L. E. (eds), International Handbook of Social Anxiety: Concepts, Research, and Interventions Relating to the Self and Shyness (1st edn, pp. 405–430). New York, USA: Wiley.Google Scholar
Clément, C., Lin, J., & Stangier, U. (2019). Efficacy of behavioral experiments in cognitive therapy for social anxiety disorder: study protocol for a randomized controlled trial. Trials, 20, 748.CrossRefGoogle ScholarPubMed
Cooper, M., & McLeod, J. (2007): A pluralistic framework for counselling and psychotherapy: implications for research. Counselling and Psychotherapy Research: Linking Research with Practice, 7, 135–143.CrossRefGoogle Scholar
Creswell, J., Pacilio, L., Lindsay, E., & Brown, K. (2014). Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology, 4, 1–12.CrossRefGoogle Scholar
David, D. & Hofmann, S. G. (2013). Another error of Descartes? Implications for the ‘third wave’ cognitive-behavioral therapy. Journal of Cognitive and Behavioral Psychotherapies, 13, 115–124.Google Scholar
David, D., Lynn, S. J., & Ellis, A. (2010). Rational and Irrational Beliefs: Research, Theory, and Clinical Practice. New York, USA: Oxford University Press.Google Scholar
David, D., Szentagotai, A., Eva, K., & Macavei, B. (2005). A synopsis of rational-emotive behavior therapy (REBT); fundamental and applied research. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 23, 175–221.CrossRefGoogle Scholar
DiGiuseppe, R. A., Doyle, K. A., Dryden, W., & Backx, W. (2014). A Practitioner’s Guide to Rational-Emotive Behavior Therapy (3rd edn). New York, USA: Oxford University Press.Google Scholar
Dobkin, P. L., Irving, J. A., & Amar, S. (2012). For whom may participation in a mindfulness-based stress reduction program be contraindicated? Mindfulness, 3, 44–50.CrossRefGoogle Scholar
Dobson, D. & Dobson, K. S. (2009). Evidence-Based Practice of Cognitive-Behavioral Therapy. New York, USA: Guilford Press.Google Scholar
Dryden, W., & Mytton, J. (1999). Four Approaches to Counselling and Psychotherapy. London, UK: Routledge.Google Scholar
Dryden, W., & Sill, A. (2006). Historical aspects of mindfulness and self-acceptance in psychotherapy. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 24, 3–28.CrossRefGoogle Scholar
Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (eds) (2010). The Heart and Soul of Change: Delivering What Works in Therapy. Washington, DC, USA: American Psychological Association.CrossRefGoogle Scholar
Eifert, G. H., and Forsyth, J. P. (2005). Acceptance and Commitment Therapy for Anxiety Disorders: A Practitioner’s Treatment Guide to Using Mindfulness, Acceptance, and Values-Based Behavior Change Strategies. Oakland, CA, USA: New Harbinger Publications.Google Scholar
Ellis, A. (1958). Rational psychotherapy. Journal of General Psychology, 59, 35–49.CrossRefGoogle ScholarPubMed
Ellis, A. (1962). Reason and Emotion in Psychotherapy. New York, USA: Lyle Stuart.Google Scholar
Ellis, A. (1989). Comments on my critics. In Bernard, M. E. (ed), Inside Rational Emotive Therapy: A Critical Appraisal of the Theory and Therapy of Albert Ellis (pp. 199–233). San Diego, CA, USA: Academic Press.Google Scholar
Ellis, A. (1994). Reason and Emotion in Psychotherapy: A Comprehensive Method of Treating Human Disturbances. New York, USA: Carol Publishing.Google Scholar
Ellis, A. (2001). Reasons why rational emotive behavior therapy is relatively neglected in the professional and scientific literature. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 19, 67–74.CrossRefGoogle Scholar
Ellis, A. (2003). How to deal with your most difficult client – you. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21, 203–213.CrossRefGoogle Scholar
Ellis, A. (2004a). The Road to Tolerance: The Philosophy of Rational Emotive Behavior Therapy. Amherst, New York, USA: Prometheus Books.Google Scholar
Ellis, A. (2004b). How my theory and practice of psychotherapy has influenced and changed other psychotherapies. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 22, 79–83.CrossRefGoogle Scholar
Ellis, A. (2004c). Why rational emotive behavior therapy is the most comprehensive and effective form of behavior therapy. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 22, 85–92.CrossRefGoogle Scholar
Ellis, A. (2005). Can rational-emotive behavior therapy (REBT) and acceptance and commitment therapy (ACT) resolve their differences and be integrated? Journal of Rational-Emotive & Cognitive-Behavior Therapy, 23, 153–168.CrossRefGoogle Scholar
Ellis, A. (2006). Rational emotive behavior therapy and the mindfulness based stress reduction training of Jon Kabat-Zinn. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 24, 63–78.CrossRefGoogle Scholar
Ellis, A., & Dryden, W. (1997). The Practice of Rational Emotive Behavior Therapy (2nd edn). New York, USA: Springer Publishing Company.Google Scholar
Engels, G. I., Garnefski, N., & Diekstra, R. F. W. (1993). Efficacy of rational-emotive therapy: a quantitative analysis. Journal of Consulting and Clinical Psychology, 61, 1083–1090.CrossRefGoogle ScholarPubMed
Feixas, G., & Botella, L. (2004). Psychotherapy integration: reflections and contributions from a constructivist epistemology. Journal of Psychotherapy Integration, 14, 192–222.CrossRefGoogle Scholar
Fox, K. C. R., Nijeboer, S., Dixon, M. L., Floman, J. L., Ellamil, M., Rumak, S.P., Sedlmeier, P., & Christoff, K. (2014). Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neuroscience and Biobehavioral Reviews, 43, 48–73.CrossRefGoogle ScholarPubMed
Gilbert, P. (2009). An introduction to compassion focused therapy. Advances in Psychiatric Treatment, 15, 199–208.CrossRefGoogle Scholar
Gilbert, P. (2010). Compassion Focused Therapy: Distinctive Features. New York, USA: Routledge/Taylor & Francis Group.CrossRefGoogle Scholar
Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53, 6–41.CrossRefGoogle ScholarPubMed
Gilbert, P., & Irons, C. (2005). Focused therapies and compassionate mind training for shame and self-attacking. In Gilbert, P. (ed), Compassion: Conceptualisations, Research and Use in Psychotherapy (pp. 263–325). New York, USA: Routledge.CrossRefGoogle Scholar
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13, 353–379.CrossRefGoogle Scholar
Goss, K. (2014). The development and application of compassion-focused therapy for eating disorders (CFT-E). British Journal of Clinical Psychology, 53, 62–77.CrossRefGoogle Scholar
Goyal, M., Singh, S., Sibinga, E. M. S., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., & Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine, 174, 357–368.CrossRefGoogle ScholarPubMed
Gross, J. J. (1998). Antecedent- and response-focused emotion regulation: Divergent consequences for experience, expression, and physiology. Journal of Personality and Social Psychology, 74, 224–237.CrossRefGoogle ScholarPubMed
Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: the acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106, 95–103.CrossRefGoogle ScholarPubMed
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavior therapy. Behavior Therapy, 35, 639–665.CrossRefGoogle Scholar
Hayes, S. C. (2005). Get Out of Your Life and Into Your Life: The New Acceptance and Commitment Therapy. Oakland, CA, USA: New Harbinger Publications.Google Scholar
Hayes, S. C., & Hofmann, S. G. (2017). The third wave of cognitive behavioral therapy and the rise of process-based care. World Psychiatry, 16, 245–246.CrossRefGoogle ScholarPubMed
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behaviour Research and Therapy, 44, 1–25.CrossRefGoogle ScholarPubMed
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York, USA: Guilford Press.Google Scholar
Hofmann, S. G., & Asmundson, G. J. G. (2008). Acceptance and mindfulness-based therapy: new wave or old hat? Clinical Psychology Review, 28, 1–16.CrossRefGoogle ScholarPubMed
Hubble, M., Duncan, B. L., & Miller, S. D. (1999). The Heart and Soul of Change: What Works in Therapy. Washington, DC, USA: American Psychological Association.CrossRefGoogle Scholar
Hunot, V., Moore, T. H. M., Caldwell, D. M., Furukawa, T. A., Davies, P., Jones, H., Honyashiki, M., Chen, P., Lewis, G., & Churchill, R. (2013). ‘Third wave’ cognitive and behavioural therapies versus other psychological therapies for depression. Cochrane Database of Systematic Reviews, 10, article no. CD008704.Google Scholar
Hyland, T. (2016). The limits of mindfulness: emerging issues for education. British Journal of Educational Studies, 64, 97–117.CrossRefGoogle Scholar
Hyland, P., Maguire, R., Shevlin, M., & Boduszek, D. (2014). Rational beliefs as cognitive protective factors against posttraumatic stress symptoms. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 32, 297–312.CrossRefGoogle Scholar
Imel, Z., & Wampold, B. (2008). The importance of treatment and the science of common factors in psychotherapy. In Brown, S. D. & Lent, R. W. (eds), Handbook of Counseling Psychology (4th edn, pp. 249–262). Hoboken, New Jersey, USA: John Wiley and Sons.Google Scholar
Jones-Smith, E. (2016). Theories of Counseling and Psychotherapy: An Integrative Approach (2nd edn). Los Angeles, USA: Sage.Google Scholar
Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of the Body and the Mind to Face Stress, Pain and Illness. New York, USA: Dell.Google Scholar
Kabat-Zinn, J. (1994). Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New York, USA: Hyperion.Google Scholar
Kolts, R. L. (2012). The Compassionate-Mind Guide to Managing Your Anger. New York, USA: New Harbinger.Google Scholar
Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: an early systematic review. Psychological Medicine, 45, 927–945.CrossRefGoogle Scholar
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York, USA: Guilford Press.Google Scholar
Lyons, L. C., & Woods, P. J. W. (1991). The efficacy of rational-emotive therapy: a quantitative review of the outcome research. Clinical Psychology Review, 11, 357–369.CrossRefGoogle Scholar
McFetridge, M.et al. (2017) Guideline for the treatment and planning of services for CPTSD in adults. UKPTS. Available at: http://www.ukpts.co.uk/guidance_11_2920929231.pdfGoogle Scholar
McMillan, D., & Lee, R. (2010). A systematic review of behavioral experiments vs. exposure alone in the treatment of anxiety disorders: a case of exposure while wearing the emperor’s new clothes? Clinical Psychology Review, 5, 467–478.CrossRefGoogle Scholar
Norcross, J. C. (2005). A primer on psychotherapy integration. In Norcross, J. C. & Goldfried, M. R. (eds), Handbook of Psychotherapy Integration (2nd edn, pp. 3–23). New York, USA: Oxford University Press.CrossRefGoogle Scholar
Öst, L. G. (2008). Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis. Behaviour Research and Therapy, 46, 296–321.CrossRefGoogle ScholarPubMed
Pompoli, A., Furukawa, T. A., Imai, H., Tajika, A., Efthimiou, O., & Salanti, G. (2016). Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. Cochrane Database of Systematic Reviews, 4, article no. CD011004.Google ScholarPubMed
Rogers, C. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 459–461.CrossRefGoogle ScholarPubMed
Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6, 412–415.CrossRefGoogle Scholar
Sedlmeier, P., Eberth, J., Schwarz, M., Zimmermann, D., Haarig, F., Jaeger, S., & Kunze, S. (2012). The psychological effects of meditation: a meta-analysis. Psychological Bulletin, 138, 1139–1171.CrossRefGoogle ScholarPubMed
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2001). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York, USA: Guilford.Google Scholar
Shapiro, D. (1992). Adverse effects of meditation: a preliminary investigation of long-term meditators. International Journal of Psychosomatics, 39, 62–67.Google ScholarPubMed
Stricker, G., & Gold, J. (2005). Assimilative psychodynamic psychotherapy. In Norcross, J. C. & Goldfried, M. R. (eds), Handbook of Psychotherapy Integration (2nd edn, pp. 221–240). New York, USA: Oxford University Press.CrossRefGoogle Scholar
Szentagotai, A., David, D., Lupu, V., & Cosman, D. (2008). Rational emotive behavior therapy versus cognitive therapy versus pharmacotherapy in the treatment of major depressive disorder: mechanisms of change analysis. Psychotherapy: Theory, Research, Practice, Training, 45, 523–538.CrossRefGoogle ScholarPubMed
Tasca, G. A., Sylvestre, J., Balfour, L., Chyurlia, L., Evans, J., Fortin-Langelier, B.et al. (2015). What clinicians want: findings from a psychotherapy practice research network survey. Psychotherapy, 52, 1–11.CrossRefGoogle ScholarPubMed
Tirch, D. (2012). The Compassionate-Mind Guide to Overcoming Anxiety. New York, USA: New Harbinger.Google Scholar
Tirch, D., Schoendorff, B., & Silberstein, L. R. (2014). The ACT Practitioner’s Guide to the Science of Compassion. New York, USA: New Harbinger.Google Scholar
Velten, E. (2007). Under the Influence: Reflections of Albert Ellis in the Work of Others. Tucson, AZ, USA: See Sharp Press.Google Scholar
Wachtel, P. L. (1997). Psychoanalysis, Behavior Therapy and the Relational World. Washington, USA: American Psychological Association.CrossRefGoogle Scholar
Wampold, B. E. (2001). The Great Psychotherapy Debate: Models, Methods, and Findings. New Jersey/London: Erlbaum.Google Scholar
Wampold, B. E., Mondin, G. W., Moody, M., Stich, F., Benson, K., & Ahn, H. (1997). A meta-analysis of outcome studies comparing bona fide psychotherapies: empirically all must have prizes. Psychological Bulletin, 122, 203–215.CrossRefGoogle Scholar
Westbrook, D., Kennerley, H., & Kirk, J. (2007). An Introduction to Cognitive Behaviour Therapy: Skills and Applications. London, UK: Sage.Google Scholar
Williams, J. M. G., Crane, C., Barnhofer, T., Brennan, K., Duggan, D. S., Fennell, M. J. V., … & Russell, I. T. (2014). Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial. Journal of Consulting and Clinical Psychology, 82, 275–286.CrossRefGoogle ScholarPubMed
Wilson, B. M., Mickes, L., Stolarz-Fantino, S., Evrard, M., & Fantino, E. (2015). Psychological Science, 26, 1567–1573.CrossRefGoogle Scholar
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