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CAN RATIONAL-EMOTIVE BEHAVIOR

THERAPY (REBT) AND ACCEPTANCE ANDCOMMITMENT THERAPY (ACT) RESOLVE

THEIR DIFFERENCES AND BE INTEGRATED?

Albert EllisAlbert Ellis Institute, New York

ABSTRACT: Rational-Emotive Behavior Therapy (REBT) is a pioneeringform of Cognitive Behavior Therapy (CBT). Acceptance and CommitmentTherapy (ACT) is part of the new wave of CBTs. In this article, I discuss thepapers of Ciarrochi, Robb, and Godsell, and of Ciarrochi and Robb, who pro-pose that REBT and ACT can be quite suitably integrated, and the paper ofSteven Hayes, the originator of ACT and of Relational Frame Theory, who is

skeptical about the feasibility of Ciarrochi, Robb, and Godsells proposals. Myown view is that ACT and REBT significantly overlap in their theory andpractice and that they can be successfully integrated if both therapies makesome changes.

KEY WORDS: acceptance and commitment therapy; cognitive behaviortherapy; psychotherapy; rational-emotive behavior therapy.

In two papers in this issue, Ciarrochi, Robb, and Goodsell andCiarrochi and Robb have nicely shown how Rational-Emotive Behav-ior Therapy (REBT) and Acceptance and Commitment Therapy (ACT)have several distinct differences as well as similarities and how thesetwo new cognitive behavior therapies (CBTs) might successfully beintegrated. In a thoughtful paper discussing Ciarrochi, Robb, andGodsells suggestion, Steven Hayes (2005) summarizes the outcomestudies of ACT and is concerned about the effects of REBT and CBTsfocusing on the content of dysfunctional beliefs and the role of

logicalempirical challenges to beliefs.

Author correspondence to Albert Ellis, Ph.D., Albert Ellis Institute, 45 East 65th Street, NewYork, NY 10021, USA; e-mail: [email protected].

Journal of Rational-Emotive & Cognitive-Behavior Therapy, Vol. 23, No. 2, Summer 2005 (2005)

DOI: 10.1007/s10942-005-0008-8

Published Online: August 6, 2005

153 2005 Springer Science+Business Media, Inc.

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Let me now comment on these three papers and give my views onintegrating ACT with REBT and CBT. However, just as I was aboutto finish my comments, Guilford Press sent me the manuscript of a

new book edited by Steven Hayes, Victoria Follette, and MarshaLinehan, Mindfulness, Acceptance, and Relationship: Expanding theCognitive Behavioral Tradition (2005). I was asked to review thisbook and possibly endorse it and I shall favorably do so.

The book contains 13 chapters by many outstanding cognitivebehavior therapists who have also recently added to conventionalCBT, just as Hayes and his associates have done, and have citedsome innovative theories and techniques of their own. Some of thechapters are by the editors, Hayes, Linehan, and Follette; and otherchapters are by well-known CBT practitioners, including Zindel Se-gal, John Teasdale, Robert Kohlenberg, T.D. Borkovec, G. TerenceWilson, and G. Alan Marlatt.

These authors and their collaborators all largely favor Hayes ACTand his Relational Frame Theory (RFT), but they also add some ori-ginal theoretical concepts and cognitive behavioral techniques. Theyall believe that their innovative methods can definitely be integratedwith ACT and RFT without much difficulty. I agree with themas

does Steven Hayes.The interesting question is: Since most of the innovative therapies

in his edited book, Mindfulness, Acceptance, and Relationship, in-clude much less metacognition, which is at the basis of mindfulness,and distinctly less emphasis on acceptance than REBT has done foryears, I wonder why Steve favors integrating the CBT therapies inthis book with ACT but is much more unwilling to consider integrat-ing it and REBT. Let us see!

I shall first make the important point that REBT has distinct dif-ferences with Becks (1976) cognitive therapy (CT) and with conven-tional CBT, and that Hayes often mentions REBT in the same breathwith these other two forms of treatment. Formerly, all REBT wassimilar to Becks cognitive therapy and many other cognitive behav-ior treatments. Thus, they all mostly followed the ABCs of REBT.

They all held that when Activating Events or Adversities (A) occurto people and they experience emotional-behavioral disturbances as

Consequences (C), their Beliefs (B) lead to or cause C and thereforethey would better change them to rational or preferential insteadof irrational and absolutistic Beliefs (Ellis, 1957, 1962). When peo-ple believe (B), I wish I performed well, and they are not success-ful, they usually have the healthy or helpful feelings of sorrow,

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disappointment, and frustration and continue trying to succeed.When, however, they believe (B) I have to perform well and I amworthless when I dont, they often make themselves disturbedthat

is, experience anxiety, depression, and worthlessness.REBT and CBT both say that people have thechoice about disturb-

ing themselves and they can change unhealthy Beliefs to healthyones and undisturb themselves. In the original A, B, Cs of REBT,what happens to people at A (their environment) is important, since

A B = C. So both A and B affect C (emotional-behavioral Conse-quences); and since peoples Beliefs (Bs) and their temperaments arebiologically as well as environmentally learned and conditioned, theydisturb themselves as a result of their heredity and their environ-ment. So they can lessen their disturbances by changing either A orB. Because A (their environment) is often unchangeable, people canstill lessen their disturbances and increase their happiness by engag-ing in Disputing (D) their Irrational Beliefs (IBs) and making themmore preferential or flexible and less absolutistic and rigid.

Emotional and behavioral dysfunctioning, the original REBT the-ory said, were largelynot completelycorrelated with peoples abso-lutistic, rigid, inflexible, unrealistic, perfectionistic, grandiose

insistences instead of their flexible preferences.This original ABC version of REBT has been largely incorporated

into Aaron Becks (1976) CT and many of the other cognitive behaviortherapies (CBTs). But it was soon added to in important ways inREBT. First, I began emphasizing that Beliefs (Bs) were not merelycognitive, but also included emotions and behaviors. Thus, the BeliefI must perform well or else I am worthless! includes a forceful,strong emotional element (I am determined that I must perform

well!) and also includes a powerful action tendency (Id better pushmyself to perform well, to ward off feelings of worthlessness!).

Similarly, REBT holds that emotions are not merely feeling statesbut also include important cognitive and behavior aspects; and thatbehaviors are not merely actions but also include thinking and emo-tional factors (Ellis, 1962). According to this expanded theory ofREBT, human disturbances do not merely follow from (or arecaused by) Irrational Beliefs (IBs) but follow from a combination of

dysfunctional thoughtsfeelingsbehaviors. Yes, all three workingintegrally together.If this is so, then REBT practitioners had better show their clients

that they can thinkfeelact themselves into unhealthy Consequences(Cs) when unfortunate Adversities (A) occur in their lives or they can

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to a considerable degree constructively choose to thinkfeelact ratio-nally or functionally and experience healthy negative feelings (e.g.,sadness or regret) and healthy negative actions (e.g., sensible attempts

to withdraw from Adversities). As a result of this theorizing, REBT hasbeen a constructivist therapy for many years and includes in its prac-tice a good many different kinds of thinking, feeling, and behaviormethods, which integratively interact with one another and counter-at-tack peoples dysfunctioning. In this respect, it is rather different fromBecks CT and from many of the other CBTs. Therefore, I have changedits name from the original RT and RET to REBT.

As Ciarrochi, Robb, and Godsell (2005) have noted, REBT still ac-tive-directively and quite consciously Disputes (D) clients IBs realis-tically and logically, but it also heavily stresses functional Disputing:If you continue to believe the shoulds and musts that you now hold,where will this kind of thinkingfeelingaction get you? Will it leadto your achieving more of your goals and values-or less?

Although REBT still is similar to Becks CT in several respects, itis radically different in that it is much more philosophic. As a recentdiscussion between me and Padesky and Beck (Ellis, 2004b; Padesky& Beck, 2004) shows, Beck emphasizes empirical formulations and

information processing in CT, while I strongly emphasize profoundand fundamental philosophical changewhich includes a philosophyof feeling and of behaving functionally (Ellis, 2001a, b, 2003, 2004a).

In particular, REBT especially includes clients (and therapists)acceptance and commitment, and has been doing so years before ACTwas formulated by Hayes and his collaborators (Hayes, Stroshal,&Wilson, 1999). In fact, Jacobson (1992), who used to be an almostexclusive behavior therapist, gives me credit for adding acceptance to

the field of therapy in my seminal book, Reason and Emotion in Psy-chotherapy (1962), and Marsha Linehan did a study of REBT withMarvin Goldfried in the 1970s and may have been influenced by itwhen she formulated Dialectical Behavior Therapy for clients withborderline personality (Linehan, 1993). Many of the other recentinnovators in CBT have also been influenced by REBTs acceptanceand commitment philosophy.

Let me briefly summarize the main REBT techniques of commit-

ment that are taught at the Albert Ellis Institute and recommendedto all therapists who want to practice modern-day REBT. I still theo-rize that people mainly (not exclusively) disturb themselves by takingtheir normal preferences for success and approval and destructivelyescalate them into absolutistic shoulds and musts.


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Why do they do so? Because that is their biosocial nature.As Alfred Korzybski (1933) brilliantly pointed out, people often sen-

sibly generalize (I failed a few times and I may easily fail again)

and they frequently exaggeratedly overgeneralize (Therefore I am afailure). Korzybski (1933) wisely noted that just about all the peopleon earth are both sane and unsane. He held, as does Steven Hayes(Hayes et al., 1999), that they are disturbed because they are lan-guage-creating animals, and their using language and symbols (asother animals do not do), helps them resort to both generalizationand overgeneralization. So in Korzybskis form of psychotherapy, gen-eral semantics, they are specifically shown how they create inaccu-rate overgeneralizations, mistake a map for a territory, and can betaught to prevent themselves from thinkingfeelingacting in thatdisturbing way. REBT, among other techniques, favors generalsemantics methods (Ellis, 1962, 2001b) and agrees that just about allpeople are often irrational and unsaneincluding therapists (Ellis,1976)!

Prophylactically and therapeutically, REBT strongly and cogni-tivelyemotionallybehaviorally promotes three major forms of accep-tance. It hypothesizes that when people overtly or implicitly hold

unrealistic and inflexible demands, they frequently create threedestructive forms of nonacceptance: (1) Since I have failed to per-form well and be approved by significant others as I absolutely must,it is not good and I am also no good, worthless. People put downtheir behaviors and their total selves; and they create, as Korzybskisaid, the is of identity, which leads to self-downing. (2) Since otherpeople dont treat me kindly and fairly, as they absolutely must not,they are rotten people who deserve to be punished. Clients (and oth-

ers) then make themselves hostile and antisocial. (3) Since the worldand conditions in my community are frequently bad and frustrating,as they absolutely must not be, my life has unnecessary hassles andmisfortunes, and that is awful and terrible, and almost totally bad.People, with this nonaccepting philosophy, create awfulizing and lowfrustration tolerance.

Based on this theory of clients (and other peoples) self-chosen non-acceptance, REBT postulates that self-rating (I am good or bad),

other-rating (You are good or bad) do not create all human distur-bance, but very possibly create most of it.Contemporary (or latter day) REBT, unlike Becks CT and most of

the other CBTs, uses every possibly means of helping clients to think-inglyemotionallyactively solidly make three major acceptances: (1)

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unconditional self-acceptance (USA). This means that you fully acceptyourself whether or not you succeed at important tasks and whetheror not you are approved by significant people. (2) Unconditional other-

acceptance (UOA). This means that you fully accept (though not nec-essarily like) all other humanssimilar to Alfred Adlers (1964) socialinterestwhether or not they act fairly and competently. (3) Youunconditionally accept life (ULA). This means that you fully acceptlife whether or not it is fortunate or unfortunate and do your best todiscover and enjoy its personally selected satisfactions and pleasures(Ellis, 2001a, b, 2002, 2003, 2004a; Ellis and Harper, 1997).

One more important aspect of REBT is today emphasized. I discov-ered soon after I created REBT that clients (and other people) notonly destructively demand that they succeed in important tasks, betreated rightly by others, and live under what they consider asgood conditions. To make matters worse, they also, when they up-set themselves with their demandingness, berate themselves for mak-ing themselves anxious, depressed, and raging. They insist, I mustnot be anxious and depressed!and thereby make themselves moreanxious and depressed. They also insist, Others must not be dis-turbed!and thereby make themselves more hostile to others. They

also insist, I must not have low frustration tolerance (LFT)! andthereby have low frustration tolerance for their LFT. Not always, ofcourse; but quite frequently. REBT therefore goes out of its way toshow them these destructive secondary disturbances; and, of course,to fully accept themselves and others with their self-upsetting. Theythen achieve a thoroughgoing thinkingfeelingacting philosophy ofacceptance (Ellis, 2001b, 2002, 2003, 2004a).

REBT also stresses (but not demands) commitment to therapy if

you desire lastingly change. I have been saying for many years,There are many insights that REBT can give you, but three aremost notable: (1) You do not only get disturbed by people and events.

You also frequently disturb yourselfabout them. So much of your dis-turbance results from your self-upsetting. (2) You usually began dis-turbing yourself in your early childhood. But you remain anxious,depressed, and raging today because you keep inventing your strongand persistent shoulds, oughts, and musts to which you habituated

yourself in your earlier life. (3) Today, your destructive thinkingfeel-ingacting propensities and habits are usually so engrained thatthere is probably no way but continual work and practiceyes, stea-dy work and practiceto minimize and to alleviate them. Tough!but you may well have to often put on your thinkingfeelingdoing


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caps for the rest of your life (Ellis, 1962, 2002). No rest for the weary!Then you look for many creative enjoyments! (Ellis, 1962, 1994).

From what I have just said, it should be reasonably obvious that

the critics of REBT, including Steve Hayes (2005) often wrongly per-ceive it as almost obsessed with irrational and illogical Beliefs. Somesloppy followers of REBT and some practitioners of forms of CBTmay be in that camp. But hardly up-to-date REBTers. They fre-quently show clients how to find and Dispute (D) their IBs and to ar-rive at Effective New Philosophies (E), otherwise known as RationalCoping Beliefs. Fine. That, as many empirical studies and an im-mense amount of clinical evidence have shown, is enormously effec-tive in helping people (Lyons & Woods, 1991). REBT can frequentlybe effective in from 1 to 10 sessions. It also works with practically allkinds of severe personality disorders, and with people with psychoticdisorders. Of course, REBT doesnt significantly help all disturbedpeople; but it does remarkably well with most of themif their thera-pists induce them to commit themselves to working at it. It thereforerequires a dedicated, committed therapist who uses good relatingskillsjust as ACT does.

However! competent REBT practitioners do much more than teach

people how to find and Dispute their destructive thinking. They alsotry to persuade their clients, in several cognitive, emotional, andbehavioral ways, to consciously take and profoundly imbibe a philoso-

phy of both acceptance and commitment. They strongly present theseimportant therapeutic goals to their clients. To accomplish this, theyfrequently take on several roles and can serve as teachers, preachers,propagandists, persuaders, and encouragers. As far as I can see, ACTpractitioners do something similar. For example, they often teach

Mindfulness to clients; give them metaphors, analogies and fables,stories, puzzles, and other presentations just as REBT practitionersdo; and even, though they deny using direct cognitive methods, usemore active-directive teaching than many other therapistssuch asRogerian, Reichian, and Gestalt therapists.

REBT also stresses teaching clients to focus on their goals and val-uesas pointed by several reviewers. And it uses evaluationwhichis a cognitive technique that involves languagenot only to assess

whether a therapeutic method works; but it also explores clientsevaluations of their goals and their demands about these goals. Thus,clients usually have the goal of succeeding in an important endeavor,and their rational evaluation is something like, I really wish to suc-ceed and gain approval. That would be good. But their irrational

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evaluation of this goal may be, I must succeed or else it is terribleand Im worthless! Their irrational or musturbatory evaluations areradically different from their functional evaluations of their goals. So

REBT practitioners point out this difference, and show clients howone kind of goal evaluation is helpful and another kind of goal evalu-ation is unrealistic and unhelpful. In this way, REBT is probablymore focused on evaluation of goals than is ACT.

Hayes (2005) cites several studies where, without addressing the

content of dysfunctional thinking, ACT gets excellent therapeutic re-sults. What he seems to mean is that ACT doesnt directly addressthe clients dysfunctional Beliefs, such as, Because I failed at thisimportant project, that is awful and my failing makes me an incom-

petent person, a failure. But in several ways, it indirectly contradictsthem. It shows, by stories, metaphors, coping statements, in vivodesensitization, and other cognitive behavioral techniques that yourtherapist accepts you with your failings; that your friends and lovedones do so, too; that many people dont consider you a total failure;that people who fail (like Lincoln for example) can finally succeed;that you can accept yourself no matter how many times you fail; thatit isnt the end of the world to fail; that you can relax and not focus

on your failures; that you can enjoy many other things, etc.In other words, ACT both explicitly and implicitly presents several

philosophies of acceptance that help you to believe that failing doesntmake you a worm and is not catastrophic and awful.

Now the interesting thing is that REBT uses a number of cogni-tive, emotive, and behavioral techniques that ACT also uses to helpchange your self-downing and awfulizing outlooks, but it consciouslyteaches them directly and indirectly with everyday language and

with stories and metaphors. It analyzes the language of clients (asKorzybskis general semantics does) and does so quite openly anddidactically; but it also uses realistic and logical Disputing of yourIBs.

Why does REBT logically and realistically Dispute your dysfunc-tional ideas, feelings, and actions? Because REBT (and some otherCBTs) have found, in contradiction to ACT, that Disputing the con-tent of what you think not only works, but works remarkably well in

most (though hardly all) cases. It is effective, very often, in from 1 to10 sessions. What is more, active Disputing of IBs is effective in self-help form, through books, handouts, cassettes, lectures, workshops,intensives, courses, etc. REBT direct teaching has helped millions ofpeople prophylactically and therapeutically.


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Hayes (2005) states that ACT, theoretically and philosophically, isa contextual behavioral therapy which seeks rapid changes in the

function of cognition and emotion, rather than what RFT suggests

would be the more difficult and error-prone task of changing theircontent. That is quite different from traditional CBT, and the data sofar seem to bear this out.

Hayes may be largely right about the advantages of ACT over tra-ditional CBT; but as I indicated at the beginning of this article, tradi-tional CBT is far from being the same as REBT. So let me now showhow his statement does not understand what REBT today is.

(1) In many ways REBT is a contextual behavior therapy. It clearly

holds that peoples Beliefs about Adverse events often (not always)

help create disturbed Consequences (thoughts, feelings, and ac-

tions) because they interact to do so. The REBT ABC theory clearly

says that A B = C. So the environmental context is definitely ta-

ken into account. Thus, if you fail one test (at A) you may conclude

(at B), Its only one failing and I probably will succeed the next

time. You will probably therefore have the healthy emotional Con-

sequence (C) of disappointment about your performance. But if you

fail several tests in a row (A) you often (not always) will have the

unhealthy behavioral Consequence (C) of anxiety and depression

because you tell yourself (B), Ill never succeed and am a total fail-

ure. Both Rational and Irrational Beliefs occurof coursein

some context, which influences them.

(2) ACT, notes Hayes (2005) seeks rapid changes in the functions of

cognition and emotion, rather than what RFT suggests would be

the more difficult and error prone task of changing their content.

Fine. But REBT analyzes two different functions of cognitions:

First, a helpful function, I dont like this failing. I wish that I usu-

ally succeed, but I can stand it if I dont and still be reasonably

happy. Second, an unhelpful content, Because I hate failing, I

absolutely must not fail and am a worthless person if I do! By

showing clients how different are these two functions of cognitions,

it helps them keep the first and reduce the second.

The error-prone liability of REBTs analyzing the content ofunhelpful cognitions sometimes arises when clients think, Since my

therapist has shown me that my thoughts are irrational and unhelp-ful, I must not have them and its awful if I do! This, as Hayes hasnoted (Hayes et al., 1999), is an error that REBT disputing mayencourage. Yes, it may, but it usually doesnt. Moreover, REBTers

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are keenly aware of this possible musturbatory error, usually quick-ly find it, and help their clients Dispute their musts about theirmusts and surrender them to preferences.

Hayes and I often tell clients the same parable in this respect: Aking didnt want his daughter to marry a prince who had passed allthe tests he had been given that made him eligible to marry her. Sohe said to his wise men, Find a test that the prince can not pass oroff goes your heads! After much anxious planning, the kings wisemen found a test that the prince could not passnamely, Dontthink of a pink elephant for twenty minutes. Because, of course, intrying desperately to not think of a pink elephant, the prince had tothink of one and therefore failed the test.

I deliberately tell my clients this parable, to show them that if theywere the prince and told themselves, I absolutely mustnt have anymust! that Irrational Belief will paradoxically add to their mustabout thinking about an elephant. So absolutistic musts and mustsabout musts are, paradoxically, destructive. REBT therefore warnsclients about them and thereby doubly Disputes the content of dys-functional musts. (Incidentally, as I also show my clients, if theprince wants to pass the test and marry the princess, he could delib-

erately think of a white elephant and use other distraction tech-niques in order to pass it.)

This parable, I think, really shows that clients can irrationallymusturbate about any therapy technique, no matter how good it usu-ally is. Thus, they can take the ACT and the REBT technique ofacceptance, and tell themselves, I absolutely must follow the philoso-phy of acceptance, otherwise I am no damned good! They thereforereinforce their nonacceptance. Since ACT doesnt consciously look for,

find, and actively Dispute clients dysfunctional musts about theirown therapeutic efforts, I would say that it omits one of the mostuseful therapeutic methods.

REBT also points out that in using some distraction techniquesthat Hayes at times recommends, some clients do not see the errorof their thinking and therefore change it. Thus, when they usemindfulness training, they dispassionately observe their thinking,think about it, see that it easily leads them into needless worry

and obsession, and therefore decide that it is dysfunctional and de-cide to let go of it or change it to more functional thinking and do-ing. Just as they consciously and unconsciously plague themselveswith musts, they now consciously and/or unconsciously let go ofthese musts. Acceptance includes implicit and explicit philosophic


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change, such as, I no longer have to give into and follow my wor-risome thoughts. I am able to let go of them.

Steven Hayes notes that ACT was more effective with halluci-

nated psychotic clients when compared to treatment as usual(TAU). I can well believe it was, because it used acceptance meth-ods to help these clients accept themselves with their hallucina-tionsmeaning, accept themselves without blame. This is exactlywhat REBT does with clients with psychosis. It assumes that theirhallucinations (and other bizarre behavior) are partly biologicallycaused and are not like the IBs of clients with neurosis. It thereforeoften does not try to change the hallucinationwhich may not stemfrom their making their preferential desires into demandsbut itstresses teaching hallucinating people USAunconditional self-acceptance. They may then retain or even increase their psychoticthoughts or perceptions, and still not damn themselves for havingthem. Good ACTbut also good REBT!

The same thing goes for people with addictions, severe personal-ity disorders, and practically all the difficult clients that seem tobe successfully treated with ACT. It is not absence of Disputing ofthe content of their dysfunctional beliefs that ACT used with them.

It is mainly ACTs helping them to fully accept themselves withtheir dysfunctional perceptions, emotions, and actions. This is pre-cisely what happens in REBT practice in addition to sometimesDisputing the content of their IBs. Hayes lightly acknowledgesREBTs very strong philosophy of unconditional acceptance. Butthen he implies that it is not a crucial REBT concept and practice.It damned well is!

Hayes, in answering Ciarrochi and Robb, says, It is not clear to me

why we must be attached to logicalempirical challenging. He forgetsthat REBT challenges IBs in cognitive, emotive, and behavioral ways,and that logicalempirical challenging is only one of these severalways. REBT also says that it is preferable to challenge IBsnot thatwemust.

Hayes doubts that REBT would target the thought, life is wonder-ful along with the thought, life is awful. How wrong he is! Boththoughts, according to REBT (and to Alfred Korzybski) are irrational

overgeneralizations, are unrealistic, and may easily be harmful topeople.Hayes is unaware of studies showing that REBT in a few hours is

effective. Actually, there are over 200 outcome studies of REBT, most

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of them 10 sessions or less, that show its effectiveness (DiGiuseppe,Terjasen, Rose, Doyle, & Vidalakis, 1998).

Hayes (2005) admits that changing the content of client thought is

not anathema to ACT or RFT. Indeed, ACT itself includes such ef-forts. Ah, indeed it does! ACT, as I noted above, consistently doesDisputing and reframing. But where REBT does so both directly andindirectly, ACT obsessively-compulsively sticks to using only indirectand presumably nonverbal methods of challenging dysfunctionalthoughts, feelings, and actions. As Hayes rightly says, since bothREBT and ACT methods often work, we can do empirical studies todiscover which work best and which have more disadvantages.

ACT also employs a good many verbal language methods and thenclaims that it does not really do so. I also think that it indirectly em-ploys the technique of Disputing IBs by helping clients to arrive atwhat REBT calls Effective New Philosophies (E).

Thus, when clients believe, I must succeed at work or love, or elseI am an incompetent, worthless person, REBT asks these Disputing(D) questions and actively-directively encourages these more func-tional answers of Effective New Philosophy (E):

(1) Realistic Disputing (D): Why must you succeed? Where is it writ-ten that you have to? Would a strong preference to succeed be bet-

ter than your must? Answer or Effective New Philosophy (E): I

clearly dont have to succeed, though it would be preferable. My

need to succeed is only written in my nutty head. Of course, a

strong preference to succeed would be more sensible than my

demanding that I do so.

(2) Logical Disputing (D): Does it logically follow that if I dont suc-

ceed, my failing will make me an incompetent, worthless person?

Does my failing make me be or become a total failure? Answer orEffective New Philosophy (E): No, failing makes me a person who

failed this time, not an incompetent or worthless person who will

always fail. No, I (and anyone else) cant become a total failure be-

cause I would then have to fail at everything all the time.

(3) Functional Disputing (D): Where will it get me if I think in this

unrealistic and illogical way? Answer or Effective New Philosophy

(E): It will get me nowhere, except anxious and self-downing. Dis-

puting: Will it help me or make me happier? Answer or Effective

New Philosophy (E): It damned well wont.

REBT employs this kind of Disputing to help clients see: (1) Thatthey create their thinking errors. (2) That they can choose to think


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differently if they fail and get rejected by otherscan choose to feelsorry and disappointed instead of anxious and depressed. (3) Thatthey can also similarly think dysfunctionally about many other fail-

ures, rejections, and adversities. (4) That their dysfunctional think-ing-feeling-behaving practically always follows when they turnhealthy preferences into dysfunctional demands. (5) That in the fu-ture they can continue to see their destructive cognitionsemotionsbehaviors and work hard at Disputing them until their common auto-matic thoughts habitually tend to be minimal and to be replaced byrational coping philosophies. So REBT hypothesizes that actively,determinedly, and persistently Disputing IBs is a hell of a good wayto minimize them, therapeutically and prophylactically. It consciouslyaims, by this and many other cognitiveemotionalbehavioral tech-niques, to help clients Feel Better, Get Better, and Stay Bet-terwhich is the title of one of my best-selling books (Ellis, 1994,2001a).

And ACT? As far as I can see, its goals and purposes are quite sim-ilar to those of REBTto help clients clearly see that their usualways of thinking, feeling, and acting frequently are dysfunctional andthat therefore they had better fully acknowledge this and see pre-

cisely how they delude themselves and needlessly make themselvessuffer.

At the same time that they see how mistakenly and inefficientlythey behave, they had better not blame themselves for their self-defeating behaviors but totally accept themselves with their dysfunc-tions and then actively seek alternate, more functional ways of living.To do this, they had better actively commit themselves to using

ACTs potentially helpful methods. If these are some of ACTs main

goals and purposes, I can only say that they are quite similar to RE-BTswhich has tried to implement them for many years before ACTwas invented (Ellis, 1962).

Let me finally give my general impressions of ACT and RFT. I lar-gely favor what they say and dobut think that they have severalimportant omissions. ACT is definitely a form of cognitive behaviortherapy, with some unusual emphasis and techniques. It rightlyemphasizes the role of human language in disturbance and notes

that people most probably would not seriously disturb themselves ifthey had no language. This sounds accurate, except for psychotic andother biological-based disorders. Although regular and symbolic lan-guage has many great advantages, it also helps create emotional dis-turbances. Hayes (2005) says that ACT is the only behavior therapy

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with its own comprehensive research program into the nature of hu-man language and cognition. I agree with his point and congratulate

ACT devotees for doing this. They can teach REBT and all cognitive-

stressing therapists some important points.However, Hayes and his associates often imply that it is common

language itself that people use to upset themselves and that byavoiding it and by using metaphorical language, therapists reachpeople better. I doubt this. Yes, the kind of language used in ACTdefinitely can workand Hayes has listed several studies where itquickly works. But language itself doesnt seem to cause distur-bance while some kinds of internal languagewhich REBT special-izes in investigating, much more than ACT doeshave been shownin hundreds of studies to be significantly more prevalent in emotion-ally anguished than in nonanguished people. Before REBT was in-vented, personality inventories like the MMPI were shown to fairlyaccurately diagnose various kinds of psychological functioning, andthey still do. Some of these scales, like the famous Beck DepressionInventory, are part of the regular CBT movement that Hayes thinks

ACT is mightily different from. Other personality inventories, suchas the MMPI, show that the content of peoples dysfunctional Beliefs

are often highly correlated with their thinking, emotional, and behav-ioral disorders and can be usefully analyzed by therapists who useCBT and other forms of therapy. These personality inventories seemto have been used in several of the outcome studies of ACT and helpmake these studies more effective.

Why Hayes is allergic to consciously finding and Disputing dys-functional Beliefs in addition to his indirect ACT methods is stillsomething of a mystery to me. Yes, language helps people improperly

create disturbances. But language, in the form of consciously think-ing about thinking and thinking about thinking about thinking(meta-thinking), may be one of the most effective antidotes to emo-tional and behavioral disturbances (Ellis, 2001b, 2002). I think that

ACT indirectly uses powerful persuasive language similar to REBT.But instead of directly challenging clients to think differently by Dis-puting their IBs, it indirectly teaches them to adopt an Effective NewPhilosophy in a number of ways. Thus, it teaches clients to evaluate

how effective is their thinking, emoting, and behaving. It highlightsand explains why conventional thought is often dysfunctional. It pro-vides clients with what REBT calls rational coping statements. Itshows clients how to be more purposive. It encourages them to havea spiritual attitude meaning, to question their self-centeredness and


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have distinct social interest. It encourages flexible thinking, emoting,and acting.

Are these and other indirect methods of interrupting clients dys-

functional thinkingfeeling-and acting inefficient or bad? Not at all!Steven Hayes presents evidence that they work, and, as I say above,REBTalso uses practically all of them, and has done so for a numberof years (DiGiuseppe & Muran, 1992; Ellis, 1973, 1994). But REBTalso uses considerable active-directive Disputing of destructive Be-liefs, to which Steven Hayes is opposed. Because REBT does most ofwhat ACT does and because it vigorously Disputes disturbing IBs, too,I naturally think that it is more effective than ACT. But that remainsto be experimentally shown. Meanwhile, I definitely think, as Ciarro-chi, Robb, and Godsell nicely say in their papers (2005), that REBTcan productively be integrated with ACT. Lets try it and see!

Hayes (2005) concludes his article with Effectiveness, not just logic,is the issue. Agreed! He recommends that if defusing and direct expe-rience replace disputation and if believing in-context replaces belief,REBT and ACT may be integrated. Fine. REBT, unlike some otherCBTs, has always included defusion, direct experiencing, and believ-ing-in-context. But it also effectively includes empirical and logical dis-

putation of dysfunctional beliefs. Therefore, I hypothesize, it is morelikely to be both quickly and profoundly effective than ACT. Not onlycan it be integrated with ACT as it is practiced today, but I think that

ACT would benefit by adding some of the REBT forms of logical andempirical Disputing to its methods. Again, let us experiment and see.

REFERENCES

Adler, A. (1964). Social interest: A challenge to mankind. New York: Capricorn.Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York.Ciarrochi, J., Robb, H., & Godsell, C. (2005). Letting a little nonverbal air into

the room. Insights for Acceptance and Commitment Therapy. Part 1:Philosophical and theoretical underpinnings. Journal of Rational-Emo-tive and Cognitive-Behavior Therapy, 23.

Ciarrochi, J., & Robb, H. (2005). Letting a little nonverbal air into the room.Insights from Acceptance and Commitment Therapy. Part 2: Applications.

Journal of Rational-Emotive and Cognitive-Behavior Therapy, 23.DiGiuseppe, R. A., & Muran, J. C. (1992). The use of metaphor in rational-

emotive psychotherapy. Psychotherapy in Private Practice, 10, 151165.DiGiuseppe, R., Terjesen, M., Rose, R., Doyle, K., & Vidalakis, N. (1998).

Selective abstraction errors in reviewing REBT outcome studies: A reviewof reviews. Poster presented at the 106th Annual Convention of the

American Psychological Association, San Francisco, CA.

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Ellis, A. (1957). Outcome of employing three techniques of psychotherapy.Journal of Clinical Psychology, 13, 344350.

Ellis, A. (1962).Reason and emotion in psychotherapy. Secaucus, NJ: Citadel.Ellis, A. (1973). Humanistic psychotherapy: The rational-emotive approach.

New York: McGraw-Hill.Ellis, A. (1976). The biological basis of human irrationality. Journal of

Individual Psychology, 32, 145168. Reprinted, New York: Albert EllisInstitute.

Ellis, A. (1994).Reason and emotion in psychotherapy. New York: KensingtonPublishers. Revised and updated.

Ellis, A. (2001a). Feeling better, getting better, and staying better. Atascadero,CA: Impact Publishers.

Ellis, A. (2001b). Overcoming destructive beliefs, feelings, and behaviors.Amherst, NY: Prometheus Books.

Ellis, A. (2002). Overcoming resistance: A rational emotive behavior therapyintegrative approach. New York: Springer.

Ellis, A. (2003). Anger: Hot to live with and without it. New York: CitadelPress. (Rev).

Ellis, A. (2004a). Rational emotive behavior therapy: It works for meIt canwork for you. Amherst, NY: Prometheus Books.

Ellis, A. (2004b). Similarities and differences between rational emotivebehavior therapy and cognitive therapy. Journal of Cognitive Therapy,17, 225240.

Ellis, A., & Harper, R. A. (1997). A guide to rational living. North Hollywood,CA: Melvin Powers.Hayes, S. C. (2005). Stability and change in cognitive behavior therapy:

Considering the implications of ACT and REBT. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 23.

Hayes, S., Follette, V., & Linehan, M. (2005). Mindfulness, acceptance, andrelationship. Expanding the cognitive behavior tradition. New York:Guilford Press.

Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999).Acceptance and commitmenttherapy. New York: Guilford.

Jacobson, N. S. (1992). Behavioral couple therapy: A new beginning.BehaviorTherapy, 23, 491506.Korzybski, A. (1933). Science and sanity: An introduction to non-Aristotelian

systems and general semantics, Concord, CA: International Society ForGeneral Semantics.

Linehan, M. M. (1993). Cognitive behavioral treatment of borderline person-ality disorder. New York: Guilford.

Lyons, L. C., & Woods, P. J. (1991). The efficacy of rational-emotive therapy: Aquantitative review of the outcome research. Clinical Psychology Review,11, 357369.

Padesky, C. A., & Beck, A. T. (2004). Science and philosophy: Comparison ofcognitive therapy and rational emotive behavior therapy. Journal ofCognitive Therapy, 17, 211224.


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