REBT is a part of the group of 16 cognitive behavior therapies. It is based on the premise that most emotional and behavioral disturbances are due to irrational beliefs that an individual holds, which causes him or her to interpret events in a way that is inconsistent with reality (Szentagotai, David, Lupu, and Cosman, 2008). Therefore, REBT assumes that not the events themselves, but interpretations and perceptions of events cause neurotic disturbances. In other words, it is not the event that affects us, but our interpretation of the event. For instance, an earthquake could be considered a normal and natural phenomenon for Japanese people, but on the other side, for Americans, it could be psychologically catastrophic and depressing.

Thus, it is not the earthquake, but rather, our perceptions or interpretations of the earthquake that determines our reactions and/or emotional state. The theory locates two main categories of irrational thinking or belief. One is called “low frustration tolerance,” where an individual’s thinking leads him or her to believe that having to dealing with undesirable circumstances that are not exactly as the individual desires them to be and they are absolutely intolerable and the second is low self-worth (Harrington, 2006). Thus, the goal of REBT is for the patient to achieve a different, more philosophical outlook on life, where he or she stops to think in absolute terms, and allows reality to take place without having a strong adverse reaction to it (Engels, Garnefski, and Diekstra, 1993). This also means that our perceptions determine our reactions; thus, when we change our perceptions we may be able to change our emotional, behavioral, and cognitive responses to events. Furthermore, Szentagotai et al. (2008) note that irrational beliefs can be broken down to four subcategories: demandingness, 11awfulizing/catastrophizing, low frustration tolerance, and global evaluation/self- downing (p. 525).

According to the REBT theory, most psychological disturbances can be traced back to one of these modes or irrational thinking (Harrinton, 2006). Harrington (2006) uses depressed moods as an example of 5worthlessness, or a belief that life is intolerably difficult.Therefore, it can be assumed that there may be numerous reasons to have depression, mood disorders, anxiety disorders, phobias, personality disorders and other neurotic disturbances; however, as seen in the REBT approach, there is no interest in “what happens.” Rather, it focuses on the client’s “interpretations of the events,” or, in REBT terms, it is not interested in “A” (activating event) but “B” (beliefs) (Gonzalez, Nelson, Gutkin, Saunders, Galloway and Schwery, 2004).

Therefore it can be assumed that a REBT therapist does not heavily concentrate on what causes neurotic problems as in Psychodynamic Therapy, but the beliefs, thoughts, and emotions of the client. A REBT therapist does not directly attempt to change his or her client’s problems as in Behavioral Therapy, but the beliefs, thoughts, and emotions of the client on activating event. Szentagotai et al. (2008) defines irrational beliefs as distorted beliefs which lead to dysfunctional and unhealthy emotions, behaviors and cognitive consequences (in REBT term, these are “C” – consequences) and rational beliefs as undistorted beliefs or cognition which lead to functional and healthy emotions, behaviors and cognitive consequences (healthy “C’s”). According to Albert Ellis, little dysfunctional cognition cause the development of psychological problems and a change in these beliefs to healthy and functional beliefs will make the symptoms disappear (Szentagotai et al., 2008). When irrational belief is replaced by rational belief, the client can make healthy decisions for “A” (activating event) (Harrington, 2006). For instance, if a man who cannot get along with his wife, rather than trying to change his wife’s personality or attitudes, he changes his beliefs about the relationship or women, and as a consequences he will be able to see the problems clear and objective way, therefore, he may be able to establish some healthy behaviors rather than unhealthy reactions toward his wife and activating events. Harrington’s (2006) study shows that variety of irrational beliefs are related to different anxiety problems. For instance, anger seems to be caused by low self-worth, and though suggests the possibility of anger being caused by a threatened high self-esteem, which would put frustration intolerance as its root cause (Harrington, 2006). Mood disorders are common in psychopathology cases, among which is major depressive disorder (MDD) which is reported to be the first cause of disability worldwide, accounting for 20-35% of all suicides (Szentagotai et al., 2008, p. 523).

There are many wide variety of symptoms of depression and other mood disorders, and a corresponding variety of therapies available. Many researchers are hard at work trying to find the most effective therapies. The predominant treatment for MDD has been Cognitive Therapy (CT) and pharmacotherapy for some years (Szentagotai et al., 2008). However, in reviewing the literature in preparation for the study, Szentagotai and David (2008) found that 30-40% of the patients undergoing this type of treatment remained non-responsive to it. Szentagotai et al. (2008) set out to test the effectiveness of rational emotive behavior therapy instead, and discovered that REBT was more effective at a six months post-test than pharmacotherapy, according to the Hamilton Rating Scale for Depression. This result may suggests that REBT is not only a strong contender for being one more effective therapy in alleviating mood disorders, but also possibly more effective than some of the more traditional treatment methods. Notably, REBT has been shown to be effective even with such hard-to-tackle problems as obesity (Block, 1980). In the study of obesity, overeating was chosen to test the effectiveness of REBT because it is one of the most resistant of maladaptive habit patterns, often resistant to other forms of therapy (Block, 1980).

The study found that overweight REBT recipients underwent a significant weight loss during treatment, and were able to maintain it, and continue to lose weight over an expended follow-up period (Block, 1980). This reveals an interesting aspect of REBT, where studies often show that both positive and negative self-evaluation can be dysfunctional, and a self-perception based in reality is rather much more important (Harrington, 2006). The results of a meta-analysis of studies measuring positive affect (PA), conducted by Pressman and Cohen (2005) suggest a similar conclusion.