Resolving a Difference between Cognitive Therapy and Rational Emotive Behaviour Therapy: Towards the Development of an Integrated CBT Model of Psychopathology

Purpose – The field of cognitive-behavioural therapy contains many different theoretical models of psychopathology, with each discipline ascribing greater emphasis to a particular cognitive process or organisation of beliefs. This paper seeks to propose a method of integrating the two most widely practiced and researched schools of CBT; Beck's cognitive therapy (CT) and Ellis's rational emotive behaviour therapy (REBT).

Design/methodology/approach – Although there exist a large degree of similarity between the two therapeutic approaches, the two models do differ in relation to their respective hypothesises regarding the core psychological variable in psychopathology. Cognitive theory hypothesises that negative representational beliefs are of central importance whereas rational emotive behaviour theory hypothesises that negative evaluative demands lie at the core of psychological disturbance. This paper evaluates these competing predictions on the basis of the available empirical literature.

Results – The empirical literature provides greater support for the organisation and interrelations of the irrational beliefs proposed by REBT theory over CT theory, however the research data clearly indicate the importance of the cognitive variables stressed by CT theory in the pathogenesis of psychological distress. Based on the available evidence an integrated CBT model which incorporates elements of both CT and REBT theory is presented. It is proposed that this integrated model can serve as the stepping-stone toward a larger, single, coherent CBT model of psychopathology.

Research limitations/implications – Few empirical studies have directly compared the competing predictions of CT and REBT theory. If future research supports the findings presented in this paper, the proposed model can serve as a template for the development of a unified, general-CBT theory of psychopathology.

Practical implications – The integrated model presented in this paper can serve as a guiding theoretical model for therapeutic practice which takes into account therapeutic methods from both CT and REBT.

Originality/value – This paper proposes the first theoretical model which incorporates the competing theoretical conceptualizations of psychological distress from the two main schools of CBT.