What is the difference between CBT and REBT?

Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavioral Therapy (REBT) are evidence-based therapeutic techniques for treating patients and supporting better mental health outcomes.

What is the difference between CBT and REBT?
Olivia Sayson

Introduction

In healthcare, there are so many different treatment techniques, coding processes, and billing methods that many of these overlap. You may find yourself frequently confused about the differences between CPT codes and ICD codes, using person first language vs using identity first language, and of course, how REBT is different from CBT. Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavioral Therapy (REBT) are two techniques of treating patients that are seeking therapeutic solutions. Although these treatment methods may sound alike and are technically grounded in a similar philosophy, there are essential differences that are important to know. In this guide, we’ll outline some of the key aspects of each of these therapy approaches, before diving into their key differences. By the time you’ve finished reading, you’ll be an expert on both!

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Overview of Rational emotive behavior therapy (REBT)

To begin, let’s take a look at what exactly rational emotive behavior therapy is. Essentially, REBT is a form of CBT that encourages patients to develop new ways of thinking that challenge negative thought patterns and behavioral responses. REBT is a fairly common technique used in both group practices and private practices and across a range of mental health practitioners, including therapists and psychologists. REBT primarily assumes that a specific event triggers negative beliefs, which in turn can lead to negative thoughts or behaviors. In order to prevent these resulting thoughts and behaviors, REBT encourages the patient to challenge triggering beliefs before they lead to adverse outcomes. Research has shown that REBT, when done correctly, can be effective in changing the way patients think about certain events, allowing them to achieve a higher quality of life. One of the most significant outcomes of REBT is demonstrating to patients that they have more control over their thoughts and behaviors than they originally realized. Patients will be able to use the skills they learned during therapy and apply them to a range of different circumstances within their life. 

Principles and techniques of REBT

The principles of REBT are modeled on what is commonly known as the ABC framework. This is separated into three different components: 

  1. Finding a solution to the problem
  2. Cognitive remodeling approaches
  3. Consequence/coping strategies. 

There is a range of different REBT techniques that exist within this framework, but the central method is called disputing. The process of disputing centers around the patient questioning the validity, accuracy, and possible outcomes of a negative event. Disputing is separated into different areas:

  1. Logical disputes
  2. Functional disputes
  3. Philosophical disputes
  4. Empirical disputes

In addition to these central techniques, REBT also involves modeling, reframing, and acting on rational beliefs. The field of mental health that you specialize in (e.g. if you are a counselor vs a therapist), as well as the age and needs of your patients, will play a role in determining what kind of techniques you typically employ. The end goal of utilizing REBT is to exchange irrational beliefs with rational beliefs, and this is often achieved by using a combination of the aforementioned techniques.

What is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy is another commonly used form of therapy treatment. Different mental health practitioners, like psychotherapists and counselors, employ CBT to treat mental health disorders, including anxiety and depression. CBT teaches patients how to recognize negative thoughts and behaviors, and also provides them with strategies to help them replace these. The key understanding of CBT is that a person’s thoughts, feelings, and behaviors are all linked. This means that when we experience negative thoughts, this will influence behavioral and emotional changes. CBT is problem-focused and provides individuals with effective ways in which they can achieve goals. CBT, while commonly used to treat patients who have been diagnosed with mental health disorders, can also be used for individuals looking to change certain thoughts or who are experiencing maladaptive emotions, including:

  • Anger
  • Grief
  • Sadness
  • Reduced motivation
  • Anxiety
  • Guilt 
Cognitive Behavioral Therapy (CBT) feedback

REBT vs. CBT: Understanding the differences

Now that we’ve introduced what REBT and CBT are, let's take a look at some of their specific differences.

Philosophic difference

The underlying philosophy informing REBT and CBT also have certain differences. REBT focuses on addressing emotional disturbance and cognitive distortions, whereas CBT primarily addresses just the latter of these. CBT tends to avoid the process of “mind-reading”, whereas REBT aims to unpack these thought tendencies to identify alternative reasons.

Cost comparison

Prices vary significantly for most types of therapy, and this remains the case for REBT and CBT. For a single one-on-one session employing either REBT or CBT methods, a patient can expect to pay anywhere between $50-$150. The specific cost will depend on the practitioner’s experience, and whether they are a counselor, mentor, coach, psychologist, or another mental health practitioner.

Availability of treatment

CBT is one of the most commonly used methods in therapy treatment, so you should be able to find a trained therapist quite easily. Alternatively, finding a therapist who is specialized in REBT may be more difficult. In saying that, because all REBT therapists are also trained in CBT, the techniques that different therapists employ may overlap quite significantly. 

Approximate length of treatment

The length of treatment for CBT and REBT aims to be somewhat short-term but will vary depending on what the patient or client is being treated for. For example, an individual who is being treated with either CBT or REBT for a specific phobia may only need 2-3 sessions before their treatment is complete. This will be much longer for someone who has been diagnosed with a mental health disorder that impairs their quality of life. 

Effectiveness

Studies completed on both REBT and CBT have high efficacy rates, indicating that these techniques are effective in treating patients. Based on this data, there aren’t many differences in effectiveness and both techniques appear to work equally well. 

In-session experience

The in-session experience for patients being treated with REBT and CBT techniques will look very similar. Therapists will assess the current events impacting the patient, conduct a general recap of the patient’s week, introduce coping mechanisms and collaboratively devise ‘homework’ for the patient to complete in-between sessions. While each therapist will have their own specific methods and techniques used during appointments, this is typically the structure for both CBT and REBT specializations. 

Out-of-session experience

Both REBT and CBT techniques involve the patient completing homework in-between sessions. These tasks may include implementing goals (e.g. replacing negative self-talk with positive self-talk) so that the patient can practice the new skills they have learned in therapy. 

Choosing between CBT and REBT

As a mental health practitioner, there are many different decisions you need to make throughout your career, including during the process of becoming licensed, and after you’ve been working for a few years. Although you may feel pressured to train in either REBT or CBT, this decision shouldn’t be too overwhelming. There are many aspects of each of these methods that overlap, and you can always brush up on your training later in your career. Fluidity and diversity of experience are important as a practicing therapist, and you may find yourself using techniques from both when treating patients. Figuring out the differences between these therapeutic methods can be difficult to wrap your head around, but hopefully, we’ve taught you a thing or two and you feel more confident with your understanding.

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