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Rational Emotive Behavior Therapy (REBT) offers a distinct treatment option for people who are having difficulty with AA or the 12-step approach. REBT was founded by Albert Ellis, PhD, in 1955, and provides people with a way to work on their emotional and behavioral problems, primarily by focusing on the way they think about the situations in their lives. According to Ellis' famous A-B-C model, it is not the Activating Events (A's, or trigger situations) that cause people to drink or use drugs (the C's, or Consequences), but their Beliefs (B's) about the events that actually cause addictive behaviors. Counselors and therapists who have learned REBT, including many who are strong believers in 12-step programs, use a wide variety of cognitive, emotive, and behavioral techniques to help their clients examine their beliefs and to learn how to better control their thinking, emotions, and behaviors.
While Ellis, an avowed atheist, has written that some people may not be helped by AA partly because they insist on interpreting its steps in an absolutistic fashion, he has also argued that working on many of the 12 steps can be useful.[ 1] And there is no reason that REBT cannot be used very effectively with people for whom spirituality is a central aspect of their lives. Whether spiritual or not, REBT posits that people can take more responsibility for their emotional and behavioral lives and provides techniques and tools for them to do so.[ 2] Indeed, the majority of clients who use REBT are religious, and find REBT very helpful in their attempt to fulfill their goals and to live a life in line with their values, often including ethical, spiritual, and religious values.
Because it is based on REBT, it is worth digressing to give some description of Rational Recovery (often referred to as RR but more accurately RRSN, Rational Recovery Self-Help Network). Founder Jack Trimpey discusses its self-help tenets in an accompanying essay. RRSN was founded by Mr. Trimpey in 1985; currently there are over 500 groups operating nationwide. Each group meets once or twice a week for approximately 90 minutes and is led by a coordinator; most groups also have a professional advisor, often a psychologist or alcohol counselor, who is available for professional advice and referrals. Because RR is a new organization, a specific meeting format has not been agreed upon. Some groups focus on Ellis' ABC model and Trimpey's Addictive Voice Recognition Training (see Mr. Trimpey's essay), while others are less structured and spend more time on sharing and discussing various problems that members bring up.
Though RR is also an abstinence-based program; it represents a significant alternative to AA for several reasons: 1) like REBT, it urges people to help themselves without relying on a higher power, although as noted, the majority of people in RR groups are religious; 2) labeling of any kind is discouraged on the grounds that it encourages people to overgeneralize; thus, RR members do not have to acknowledge that they are alcoholics; 3) RR asserts that people can be "recovered," i.e. they do not need to think of themselves as "recovering" for the rest of their lives. 4) meetings focus on helping people learn to use REBT to better control their thinking, emotions, and behaviors. Crosstalk is encouraged, so meetings sometimes resemble group therapy meetings; however, since RR is a lay-led, self-help network, participants are urged to focus on recent events and to deal with significant psychological problems, such as sexual abuse, in a professional setting. Participants review their successes and failures, and discuss how to effectively handle upcoming potential trigger situations such as business trips or parties. Many of the relapse prevention techniques used are similar to those developed by Marlett and others.
Trimpey[ 3] has argued that people often develop dysfunctional dependency on groups; hence he has written that many people need only attend for about a year, and then should focus on enhancing their lives through non-recovery activities. However, most coordinators, advisors, and participants assert that it takes more than a year.
Although Ellis and Trimpey talk about "RR versus AA, almost all of the people working in RR respect the value of AA for many people, are not interested in attacking AA, and are primarily working to provide an alternative to people who desire one. Research (e.g., Miller[ 4]) suggests that more people get better when options are available to them, and it would certainly be surprising if only one self-help technique were to be shown to be the answer for such complex problems as alcoholism and substance abuse. Those of us who are involved in RR are primarily interested in providing an option to people who are looking for ways to help themselves overcome their problems with alcohol and drugs, and recent research by Galanter, Egelko and Edwards[ 5] suggests that RR is providing that help.
Most of us, including RR coordinators, still recommend to some people that they go to AA meetings, and some RR members go to both RR and AA meetings and find both helpful for different reasons. This is certainly a rational approach, given the complexity of the problem, and hopefully, more professionals will follow their lead.
Reflection Exercise #12
Personal Reflection Exercise #12
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