The A B C in Cognitive Therapy

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The A B C D E model of Cognitive Behaviour Therapy (CBT) was developed by Albert Ellis in the mid-20th century. He based it on his Rational Emotive Behavioural Model of empirical based psychotherapy which believed that irrational beliefs are developed by people in response to perceived goals being achieved or failed. He understood that people construct ways of thinking based on their experiences in life including philosophy, language, belief systems, educational experiences and upbringing. Sometimes these rational (positive and useful) or irrational (negative and damaging) beliefs link to emotions and thus impact on our future thoughts, feelings and behaviours.

Ellis believe there different types of irrational beliefs. These he suggests are:

  • Demanding – absolutism; very inflexible dogmatic and extreme terms used by individuals such as must, should, ought.
  • Demanding – love or approval; the need to seek love form people they view as important (parents, partners, teachers, friends)
  • Demanding – success; having to achieve or be best at what they do
  • Demanding – comfort; struggle with any form of discomfort or distraction in their lives (working with noise, untidiness, cold/hot)
  • Awfulsizing; events are categorised as the worst they could possibly be, rather than in context.
  • Low Frustration tolerance; as above they believe they can’t cope with distraction rather than they actual can’t
  • Depreciation of Self; global negatives all of them is bad because of one issue.

Ellis proposed the A B C D E solution to these issues. This is broken down as follows. It is often used by therapist to help clients understand themselves better and to make changes in previously help irrational beliefs and the subsequent behavioural responses.

A=Activating – this is the event, activity or adverse condition that causes the irrational thoughts to become a problem.

B=Beliefs – usually irrational, about the event

C=Consequences – the belief that develops has physical and emotional response or reaction

D=Disruption of beliefs – challenge and alter them. Argue against the irrational.

E=New Effect, or approach to emotions and irrational thoughts

An example I would offer is of a relationship where a fear of harm has developed.

A=partner has failed to arrive home with a reasonable time of when they were expected – the activating event.

B=thought process “oh dear what is they’ve been in an accident and they’re dead” irrational thoughts or beliefs. Can often develop from previous experiences – i.e. they may have had someone die in an accident or they may have learnt from a parent or traumatic event previously.

C=consequences can be mental, emotional and physical i.e. feeling sick, being sick, panicked, anxious, pacing, ringing people, hot/cold, headache etc.

D=disruption of these thoughts would be to use the question “what is here was an alternative?” then suggest answers – they may have had a meeting, there might be traffic, they may have gone to a friends, they’ve never had an accident before, they are often late, they may have got the time wrong.  It is about recognising the irrational thoughts and finding positive alternatives. About dislodging the old learnt behaviours and emotions.

E= Find a new emotion – I get to enjoy alone time, I trust them to drive safely, the worst doesn’t always happen, I would have been told by now if something was wrong, they came home late X times before and it was alright. Use a calming technique to find a new emotion to link to the situation.

This shows how Ellis believed thoughts and emotions can link together in a negative emotional way but that when challenge a new positive link can be created. Sometimes the stages overlap or aren’t clear cut but the therapist will work with the client using the ABCDE as a guide to their process of change.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304