Transcription
Hello everybody. I am Dr. Steve Johnson and I want to welcome you today to this webinar. Um and um the topic will be REBT disputing and how to avoid common traps of disputing so that we do kind of a better job of of that and help our clients um even more. Okay.
So, um, at any time throughout this, um, throughout this, uh, webinar, if you have any questions, please feel free to, um, make, uh, comments and I will get to those as I am um, as I am able. Okay.
Um so let me begin um here with um with a PowerPoint so that you can watch this. One thing is that if you uh would like to get a copy of this PowerPoint, I'm more than happy to do that. All you need to do is email me at steve a johnson.phd steve aj johnson.phd at gmail.com and I would get that to you just as soon as I'm able. Also again if you have a comment a question feel free to post it in the comments section and I will definitely get to that as I am as I am able.
So introduction here for those of you who may not have been exposed much to REBT. Um and is that um what we do in REBT is a second-wave behavioral model. Um is that we try to identify dysfunctional beliefs. Sometimes we call them irrational or unhelpful and then we challenge those beliefs. the purpose being to help the client realize that they're not helpful or that they're dysfunctional. Uh we don't stop there. Then we try to replace them with more functional beliefs. And of course, this whole process is done collaboratively with the client. We are not dictating any of this. Um however as important as this process of disputing the unhelpful beliefs um is if it's not done skillfully um sometimes we can encounter some problems and disrupt the therapeutic alliance you know have clients feel judged or put down maybe gets confused whatsoever. So I'm going to explore some of the um disputing and why that matters. Some common mistakes that uh therapists often make not just new REBT therapists but sometimes we all slip into some bad habits and then what can we do to uh improve those.
So first is exactly what is disputing and I've already said it. This is a very active and structured process where we identify, challenge and replace dysfunctional beliefs because those beliefs tend to lead to u emotional distress, unhelpful emotions and dysfunctional uh behaviors that may sabotage us in reaching our our desired life goals in all kinds of domains of life. Um beliefs that would be dysfunctional and rigid would be I must absolutely succeed. You can see how rigid that is. Uh others must treat me fairly. Uh life has to be the way I want it to be and if it isn't it was absolutely horrible. So disputing those can be is a very important part and is at the core of psychological suffering. those um those dysfunctional beliefs can be at the core of psychological suffering. So we want to replace these and we do this um by we question them, replace them so that they're not likely to persist.
So what is the core of the disputing? This is where we, as I've said, we identify irrational beliefs. Sometimes I will refer to those as unhelpful. When I'm working with clients, I will often use the word unhelpful, but I'm using irrational because you will find that within the literature, these um irrational beliefs or unhelpful beliefs are very very rigid. They're not logical. They don't logically follow um from a situation or event. They're not realistic and they can actually be very self-defeating. As I said, they have a tendency to disrupt the attainment of desired life goals. So, um the process here, as I said, we're going to challenge the logic. We're going to uh challenge with evidence. We're going to challenge the usefulness of those beliefs. And once we've done that and the client realizes the dysfunctionality of those beliefs, then we replace them with rational beliefs. And within our EBT, we would say those rationables tend to be much more flexible, not so rigid. They're much more logical, realistic, and they support the attainment of our desired life goals in the different domains of life. This is a part of uh of restructuring. Restructuring has some other components to that. I won't be getting into that in this particular webinar, but if you go on my YouTube channel, psychotherapy education and training, I have videos ex uh on exactly how to go about doing the cognitive restructuring. And by doing that, we can begin to change our emotions and act by changing how we think, right? And if it's done well, they can lead to really profound and lasting shifts in how we view the self and others in life in the world and actually change our behaviors. So this is core to um the identity of REBT.
Um, another one common pitfall within REBT is despite the fact that disputing can be quite powerful, it isn't foolproof. And there are three common traps to avoid. And one of those is focusing solely on the negative. is to identify the unhelpful or irrational beliefs and overlook some of the strengths that the client has some of the great values and airy areas in which they are quite resilient. So it's uh a pitfall if we just move into disputing the irrational beliefs without looking at the strengths and values of the client and even the client's resilience and how they may respond to the disputation. So those that's that can be a drawback. And I think sometimes if we jump into the dispute without connecting with the client, they can that they can feel that they're being criticized or attacked. Now when we orient the client or clients to REBT, we will let them know what this process is, how we operate. So they have some psychoeducation here about what we're going to to do. And we let them know that we are not criticizing them. We are u because they have helped us to realize and identify some of the beliefs that are not helpful. We will join with them to kind of show the unhelpfulness of it and give a pathway to challenge and replace those with beliefs that may help them uh deal with the issues that brought them into therapy in the first place. So it's very important that we do begin with uh assessing the strengths of the client and their resilience because um we want to know what's already going well. So most clients when they come in they may be focusing on what's not going well but we can by talking to them determine whether there are times when they have the issue that that that's under consideration and it goes well and there are times when it doesn't go well and find out what the difference and then we can zero in on the beliefs that make the difference in terms of whether the um they move toward those goals or or not. So, uh it's really important that we avoid um this one uh focusing solely on the negative.
Another one is being overly aggressive. Now, um a lot of people think that Albert Ellis was extremely aggressive and disputing. I worked with him for years and I was just blown away often. I mean, he was often blunt and to the point, but very very supportive of the clients and um and wasn't overly aggressive. I mean, you know, it's New York kind of style sometimes and to get to the point, you know, because he wanted to help them so that they wouldn't be in therapy forever, you know, but it is direct and but it's not an interrogation. And so people who think that it's we interrogate and we aggressively challenge those dysfunctional beliefs that is not REBT. Um challenging a belief too forcefully or if we use sarcasm can uh or frustration uh can shut clients down. Um the disputing remember it's not the client the therapist disputing those beliefs but it is a collaborative exploration between the therapist and the client not a debate not a takedown or a put down.
The third common pitfall is lack of a tailored approach. Um not all clients respond to the same kind of questioning. Some may benefit by asking Socratic questions, others uh by uh using analogies or humor. And we need to tailor our approach um otherwise we risk um disengagement with the client or confusion. So again, part of that will come uh will will go better if we set the stage at the beginning of the therapy about what we're going to do and what the process of uh disputing the beliefs is all about that it's never an attack upon them and that um we and therefore we try to make it unique to the client that is sitting in front of us. I can't think of any time where I just dispute everybody in the same way. You have to tailor that to the uh to the client.
Okay. Um another one is um to adopt strategies for effectively disputing. And I think there are three key ways to do that. I mean many many ways but I just wanted to point out three key ways to effective disputing. One of course is to build a strong therapeutic alliance. Now when I say that sometimes I I I notice among my graduate students they think okay we can't do any therapy we couldn't do any cognitive restructuring until until we have fully formed a therapeutic alliance. I think that's not the REBT way. Of course REBT is about forming a sound therapeutic alliance. But often a sound therapeutic alliance begins with how we say hello. And also when we listen to the issues that brought them in and even show them how they can begin to challenge dysfunctional beliefs and replace and replace them with more functional beliefs and they have more hope at that point that they can overcome whatever issue that they're dealing with. Right? So part of forming a sound therapeutic alliance is having this open non-defensive non-aggressive interaction with a client and clarity and purposeful in the way that we challenge those uh unhelpful or dysfunctional belief. Okay. And in that process and we know this from common factors, it is important for our clients to feel respected and heard so that they can develop the trust in us.
Two, um, use active listening and empathy. Empathy is core here to any therapy. If if we can't be empathic, then therapy is not happening. So, it's going to take a little time, but that therapeutic alliance begins before we even do an intervention. And we don't wait till this magic moment when there's this perfect therapeutic alliance. It's an ongoing process throughout the therapy. So, we have to listen to the client so we understand their beliefs and how they function in the life of the client. Now this is really key. A lot of times individuals will hear the therapist will hear the belief of the client and then they want to challenge it. But that is not the RBT way. The beliefs that the client holds are always within a context. And it is extremely important for us to understand the com uh context in which the client holds those um uh those um beliefs. Okay. And when we understand the context and the function of those beliefs and what they were trying to solve, we better um understand the client and the client better feels understood by us. they're more open to us questioning those beliefs and then beginning to try to replace them. Uh before I go any further, just a reminder that if you do have any questions, feel free to make a comment and I will get to those as I am as I am able.
I want to continue the disputing. And again, I think a theme that I really want to emphasize this that goes along with common factors research is that we want this to be a collaborative relationship and we take a collaborative approach that it's gradual. We don't just start hard-hitting. So, we just kind of start with gentle curious questions. So we're mod model modeling for a client to adopt a curiosity about the way we think, the beliefs and the inferences that we hold about the self and other people, our life, the world around us. And then we explore what kinds of evidence or logic or even the functionality of those beliefs. And we do that together. For example, here's some some examples that I just uh thought of when I was developing this. We might pose what's the evidence that you must never fail. Where is that? What's where's the evidence for that? Right? And and the other one is how realistic is that? How logical is that to expect everyone to treat you fairly all the time? Okay. And how does holding that belief help or hurt you? So, the first one is where's the evidence? That would be kind of an empirical dispute. And and that kind of a dispute may work for your client. Um, is it realistic um to expect everyone to treat you fairly all the time? That's a more logical dispute. Not as many people respond to logical disputes as empirical uh disputes, but for many individuals, a logical dispute works really well. And so this is why it's really important when we're first u teaching the concept of disputation of dysfunctional irrational beliefs that we try a a a bunch of different styles and find out which ones work best for the client. And of course the last one, how does holding this belief help or hurt you is really a pragmatic or a functional way to uh dispute that. And often I will start with that because people tend to have an intrinsic interest in whether something is helping or hurting them. And then I might go to empirical and endological until I learn what tends to work better for my client. Okay? And this process if we and we don't rigid about and we're doing it in conversational ways using examples from the situation that the client is in in the context of that then they learn this and then they become more empowered to participate very actively in their own transformation. The last thing we want to do is for the client uh happen I mean is for the client to be rather passive. We get change not just through mere insight but actively engaging in the challenge and replacing of some of those dysfunctional beliefs.
Now changing dysfunctional beliefs is not the only approach within our EBT. It is one of them. And so uh please don't think that cognitive restructuring is all that we do. It is very very important but it's certainly not all that we do. We have all kinds of different interventions that I will be covering in uh subsequent kinds of um webinars.
This is another one that is really really important and it's a pitfall. It is if you do not you as a therapist don't apply um the disputation to realworld situations for the client then it doesn't go quite as well. That's why early within the very first session, right? Um, of course we do an intake, but often we use um handouts and forms for clients in advance before they come in so that we can um have some of the intake on on paper or electronically so that we can spend some time jumping in to an example of the situation of the of the issue that they're bringing to therapy. So a realworld situation of a client. Um and so uh I want to look at some of the common irrational beliefs and how disputing may be able to help. And these are just examples on some very common things that we encou encounter. Now I'm a professor at a university so I often see and I teach um graduate students but I'm also a director for the undergraduate program. So I do teach undergrad. um undergraduate students and I find uh many of my students tend to be very perfectionistic. They have to believe they believe that they have to do everything perfectly or they're or failing. Well, psychotherapy is not the kind of thing that you quickly learn how to be perfect. In fact, I've never learned how to be perfect. I'm hoping that I'm good enough so that we can h I can collaborate with clients to um make some important changes in their life so that they feel better and do better in in their life. And so let's say that I have a someone who's a perfectionistic because often they can be highly anxious or even get depressed because of the perfectionism or even angry if they get a you know bad comment from me or I take a good number of points off or something. Um then I you know um if someone had that kind of perfectionistic belief we might go where's the evidence that being imperfect making mistakes makes you an utter failure. Is that standard helping you or hurting you? So notice that dispute combines two different types of dispute. One is empirical. Where's the evidence that being imperfect makes you an utter failure? And then it also has a functional or pragmatic dispute. How is that standard helping you? Is it helping you or hurting you? Okay.
Another one would be to look at should statements, shoulds, oughts, must, have to, needs, and that kind of thing. Now, we're not word police. Uh we don't react to words. Uh we react to um demandingness and dysfunctional uh beliefs. and but we don't react to the words. So if a client just says should or ought or must, we don't pounce on that. We have to determine whether they're actually being demanding in a way that is not helpful because sometimes we just say should or must and we're just using the word conversationally but not in a dysfunctional way. So we don't pounce on those. I know uh early in the semester my students sometimes pounce on, oh they say it should. And I'm like, wait a minute, wait a minute. We need to check the context of it in what how they're using those words. We're not word uh police. We are looking at the ideas and concepts here. But let's say that they are engaging in a should that is really a demand and they and they hold a belief such as people should treat me with respect. Now, of course, we would want that. But do people absolutely have to do that? No. There's all kinds of evidence that people can be rude, mistreat you, all of that. It's not great. We don't like it. But they have, you know, free will and they may do that. And um morally, should they? Yeah. But do they absolutely have to do it? No. There's a difference between morally what would be good or and then what actually happens in reality. So morally, yeah. But uh in reality, they may not. there's no necessity in reality that they do it especially if they don't embrace the that moral value. So disputing it would be to recognize that um that it would be nice like yeah it's nice to get respected but it is it really to expect everyone to act that way behave that way. What happens when they don't? Because sometimes they will combine that with that that's terrible, it's horrible. it's awful. And then life isn't necessarily terrible, horrible, and awful. There's still good things in the world, etc. It may get in the way of performance and enjoyment and those kinds of things. And sometimes it can be on a serious matter. And so looking at what the consequence of it u may be a disputation of the awfulizing about it. Okay. So this is really important though. Remember that shoulds can be all different types. There are legal shoulds like I must I should drive um 25 miles or under in a 25 m an hour zone. Yeah, that's a legal should. RBT isn't worried about legal shoulds. It could be a moral should. You know, um I shouldn't kill people. I shouldn't harm them deliberately. Yeah, that's a moral should and yeah, that's a good one, right? Um, but if I hold something in a if it's a non-moral should or a non-legal should, then that can be problematical. We often call those metaphysical shoulds about re that reality has to be the way I want it to be. Absolutely has to be. Well, we don't have that kind of control over the world or um sometimes on even oursel and certainly not over other people. So, that kind of should will not help us.
Um, another uh real world situation is catastrophizing or aizing which we often see when we're angry or anxious or depressed. Um, for example, belief that would be an example of catastrophizing or awfulizing would be if I lose this job, it'll end me. My life uh is over at this point. Now, that's a gross exaggeration. I know the feeling, right? I understand that. Um, but if they really embrace that belief, it's not going to be really helpful. So, helping them learn how to dispute that and embrace something more functional would be really helpful. Is it truly the end or would it just be very difficult? What other options would you have? You see what I mean? We set the stage with the dispute and then we open it up to something more practical, other options. But when we are demanding and the demand is absolute and rigid, we often can't see options that may be right in front of us. So it's really helpful in in those situations. So um in treating anxiety and depression we uh RBT dispute disputing helps them identify these exaggerated or rigid thinking and replace them with what in REBT and if you read the works of Wendy Dryen you can read them in great detail and and in an excellent excellent way that we want to have adopt beliefs that are flexible. They're based in uh embased in reality, not a denial of reality. Um I once heard um Dr. Eldas say that the goal of psychotherapy is to help clients accept reality as it is, not necessarily like every aspect of it, but accept that that's the way it is right now without unduly disturbing oursel. That doesn't mean we're going to not be disturbed at all sometimes, but not unduly disturbing oursel in the sense that it gets in the way. It causes dysfunctional emotions and gets us in the way of us attaining our desired life goals. So um um that's what we try to help them do in RBT. Um and we know from research that um how targeting disputing can reduce all kinds of emotions, panic, it can lift a mood, it can empower long-term change, right? So uh real world situations are really really important. And if we ignore those real world situations that the clients are going through and just talk in abstract ways or philosophical ways about REBT and try to just explain the theory, but without the application to their case, it doesn't go so well. We lose the power of REBT.
How can we maximize the effectiveness of BT? Because that's what we all want to do. It's what I know I want to do. I've done REBT for decades as well as other models and I just am trying to improve all the time. I'm learning new ways to explain things as I talk to colleagues and deal with different clients in different contexts. I'm always trying to maximize the effectiveness of the re of my REBT. Not always successful with it, but I hope that's a a trend. One way that we do this is by behavioral activation. Not just go after the cognitions, but put these beliefs into practice. If you uh read the uh handbook on REBT that was done by um Wendy Dryden, Raymond Dappy and Christine Doyle and Bel Valter um then you will see that um in that book um it is said that when we give homework that it's almost always a good idea for it to be behavioral in nature. We want to put our new beliefs into practice. Um if they can dispute their fear of failure, then we may right um then we may say okay let's take a small calculated risk in your life this week. Okay. in a particular situation and and discuss that with the client about what would be a small step to take a risk um uh of failing. Okay. In in the hope that they'll overcome the awfulizing about the possibility of failure or the demandingness of perfection.
Another one is emotional regulation interventions. Um often clients and we and all of you know sometimes when you're anxious um or fearful you get um physiologically aroused you know when the brain perceives the threat then we see the activation of the HPA axis cortisol is produced and then we have all of those consequences in in sympathetic activation heart rate increases we breathe faster we may even get dizzy lightaded so one of the things that we can do is help that decrease some of that physiological arousal and emotion response that are triggered by those irrational beliefs that they may have. And there are many ways to do this. Um, deep breathing. Um, mindfulness techniques we've also integrated into REBT. imagery can be used. So they imagine a situation and then shift um shift the way they're thinking about that situation so they do better job of emotional regulation, right? And then what they learn is something tremendously important. When we're highly aroused, we perceive threat in the environment. Sometimes we perceive overwhelming threat. And when we perceive overwhelming threat, we often are unable to see the resources that we have. Some of those resources are in the environment itself, other people, other support systems there. Other resources are in internal, our own motivation, our own uh abilities to be optimistic, those kinds of things. And so um helping them regulate their emotions um rather than staying highly physiologically aroused will help them move from seeing the overw perception of threat as overwhelming to maybe a manageable threat that includes the presence of some resources within the environment and the client can better use those resource sources. I hope that makes uh I hope that makes sense. Okay. So, we include all of that within the with within REBT2.
Another some other ways to maximize the effectiveness is one of what we try to do is help build self-efficacy. What it's not us doing the disputation all the time. We're teaching them how to dispute their own dysfunctional beliefs. We want them to internalize that process of identifying the unhelpful belief. um become one become curious about their emotional response in a situation. Identify the dysfunctional belief that may have contributed to that emotion or behavior. uh challenge it and then replace it in the hope that we're and then put that new belief into practice so that we're moving them into uh habituating a more functional adaptive belief and behavioral repertoire. Okay. And that will give them self-efficacy when they can take on that entire process. And then of course uh provide ongoing support and practice. I mean it is really important um that clients realize and we realize that disputing a belief is not a oneandone. Um Wendy Dryden often says that um thinking that you know disputing is a oneandone is like thinking that I have to eat once and for all. Well that's not the way eating is. It's not the way human nutrition goes. It's an ongoing process and so can dispute there. We as we learn it, we may need to do it less, but there are always going to be challenging situations in a client's life and in our lives that may necessitate or give us the opportunity to dispute that. So um it's a skill that we want to help practice with the client and that's why we would give homework assignments regularly review progress how they think it's going celebrate um you know the client's progress and uh sp build some time into the therapy that we do that that's also part of that focusing on positive rather than just on uh negative and dysfunctional beliefs that they're moving toward more rational rational thinking.
Okay, I want to conclude there. I was wanting to keep this short because I know it's Sunday um at least in my part of the world and um so I do want to conclude this and and um and um talk about something uh quite briefly. Yes, disputing is part of the heart of our EBT. It does take some finesse. It does take some skill building on the part of the therapist and that'll come along as we practice it and practice it. By the way, in a few weeks I will be announcing the formation of um some REBT practice groups where individuals who are learning REBT and want to practice with other individuals who are learning or farther down the road. um an international group that we will uh learn how to do that together. It'll be small groups and so that everyone has a chance to uh learn that and practice skill building within our EBT. We want to inv I hope this was helpful to um identify and and see how we could avoid common traps like focusing on the negative and uh grilling the client interrogating them or using a onesizefits-all kind of approach which is not rebt that we want to build a trusting relationship listen very very closely and empathetically and enjoy this collaborative jourer journey with our clients so that they develop more helpful beliefs so they experience greater freedom and joy in their life. And when that's done um it's more than just cognitive work. It's really an important pathway that we have helped clients form and a pathway to freedom and meaningful uh change in their in their life.
Uh one of the next steps is if you found this particular video helpful in some way then you know if you like subscribe and that kind of thing then I can I will be forming um more content on REBT CBT and even uh third-way behavioral models like um dialectical behavioral therapy, DBT and acceptance and commitment therapy. I also will be looking at stages of change model, motivational interviewing and um uh narrative exposure therapy which is really really important in the treatment of PTSD and trauma related disorders. If you want to get even deeper into this um you if you want to participate in special training workshops and webinars, you might consider joining the psychotherapy education and training YouTube channel that I've formed and get special membersonly kind of training and and workshop. This is my way to give very very affordable uh ways to get this more individualized uh individualized attention for for individuals. Okay. So, um, you're welcome to um to do to do that. Also, um I do want you to um uh I want to thank you for taking some time out of your day to listen to this information. It shows your dedication to wanting to improve as a therapist as we all want to do. And I hope you will um I I really do hope that you will consider joining the group that I will be announcing on YouTube and that is small groups of those of us who are dedicated to improving our REBT. Whether you're a new be you're a beginner, you're more at the advanced stage or whatever, we can all join together and help each other. Thank you so much and I just want to wish you a great day and I look forward to seeing you again. If you have recommendations for topics, always feel free to let me know through YouTube or even in the comment sections here. Goodbye and have a great day.