I was trained by Dr Al Raitt as an REBT Therapist, and Al had been taught by Dr Albert Ellis, in New York
City, so his system was very close to the original system. This is the approximate structure he taught me to apply to
each session with a client (though he might have recommended 11 stages!):
1a. If this is not the first session, then check up on how the client got on with
their between-session assignments (which are sometimes called Homework).
1b. Ask for a (new) problem, and formulate it in terms of an 'A' and a 'C' (or an Activating event and an emotional
Consequence).
2. Ask for a recent example of this problem arising
in the client's life.
3. Ask for the client's goal for dealing
with this problem.
4. Assess the 'A' to see what is it precisely
about the Activating event that is causing this think irrationally, and to have consequent disturbed emotions. (This
is called looking for the 'Critical A').
5. Assess the 'C',
to make sure it is indeed an overly upset emotion (like anger, anxiety or depression) and not a reasonable upset (like irritation,
concern or sadness).
6. Then teach the client the connection
between the 'B' and the 'C'; because the client probably has an A>C model of human disturbance. That is to say, the
client does not factor any kind of 'B's into their understanding of their disturbance.
7. Debate and dispute the client's obvious irrational beliefs, by teaching them about the distinction between rational
and irrational beliefs, and helping them to see the flaws in the irrational beliefs, such as "I must be loved and
approved by all significant others, otherwise life is not worth living!"
8. Link the client's irrational beliefs to their emotional consequences, and show them why it is important to change
the irrational beliefs in order to change their emotional consequences.
9. With the client's participation, develop a New Effective Philosophy for the client to apply in between-session
assignments and activities.
In New York City at that time (1998-99)
they were using a 12 stage session structure, very similar in most respects to this 9 stage structure. I went on to
develop my own structure, which got up to 16 stages at one point, and I then boiled it down again to 9 stages.
I experimented with this structure for about nine years. It is very unusual
to be able to apply it as it stands, because every client is different, and each client comes with their own agenda.
Inevitably, in the process of working democratically with the client, unique session structures emerge. Nevertheless,
this kind of structure, outlined above, is a very useful target for new REBT therapists to aim to apply to every session.
In practice, different bits of the structure may occur in a different order, and some bits may get more emphasis at some sessions
than at others. But it is helpful to have an "ideal structure" for which you are aiming.
Eventually, as I began to develop more into a CENT therapist, I began to use three
models at each session, as follows:
| The ABC Model (from REBT) | The WDEP Model (from Reality
Therapy) | The RCFF Model (from Impact Therapy) |
| Check Homework | W = What do you Want? | R
= Develop Rapport with the client. |
| Ask for a new problem in terms of an A and
a C, and the client's Goal. | D = What are you Doing to get what you want? | C = Establish a Contract with the client. |
| Assess the A and the
C | E = Help the client to Evaluate how well they are doing in pursuing their goal. | F = Focus on a specific problem to work on. |
| Teach, or review,
the B>C connection. | P = Help the client to formulate a new Plan. | F = Funnelling - which means trying to go deeper into the problem, rather than staying on the surface. |
| Debate, dispute the client's IB's, and help them to develop a new Effective philosophy. | | |
The model that emerged as the structure of each session would be a mixture of these three models, depending upon how my encounters with the client developed, organically.
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