Rational Emotive Behavior Therapy (REBT) for Addiction

REBT/CBT cognitive, behavioral, and imaging approaches to addiction

Posted Jun 04, 2015

Rational Emotive Behavior Therapy (REBT) posits addictions are caused by the interplay of cognition, behavior, and images. The addicted client thinks irrationally, acts self-defeatingly, and visualizes dysfunctionally. Consequently, REBT treatment involves a comprehensive approach that teaches the individual to intervene on these levels to address intense cravings for nicotine, for example, constructively, without a cigarette. 

Cognition. Irrational cognitions involve escalating one’s preference for a smoke into an absolutistic demand for one. For example, “Because I strongly crave and desire a cigarette, I absolutely must have one right now otherwise I cannot stand facing the discomfort of feeling deprived,” or “Because I’m stressed and prefer to relax, I desperately have to escape the stress and relax with a cigarette.” 

REBT teaches the smoker to question, challenge, and contradict these unrealistic assumptions and conclude more reasonably, “I choose to live with cravings and stress in the short-term in order to have a healthier, more comfortable, nicotine-free life in the long-term,” or “I can stand cravings and stress without smoking, even though I do not like such discomfort.” Positive control over smoking is achieved through practice, repetition, and reinforcement of this realistic philosophy of strongly preferring, never demanding, immediate comfort. 

Behavior. The REBT therapist recommends many behavioral strategies to increase the likelihood of success, including: rewarding oneself for refusing a cigarette, penalizing oneself for smoking, removing ashtrays in the home, setting a quit date, making tapering or abstinence commitments, substituting alternative pleasurable activities for smoking, delaying a smoke by minutes or hours, and others.

Images. REBT instructs the client in Rational-Emotive Imagery and Coping Imagery. These involve practicing imagery daily by vividly picturing and imagining either successfully resisting the impulse to smoke or comfortably navigating the day without a cigarette.