Rational Emotive Therapy

Rational Emotive Therapy (RET) sounds more intimidating than it is. It is an approach that was developed by Dr. Albert Ellis in the 1950’s to help people cope with anxiety and stress (Clark, 1998). Strategies based on RET are particularly helpful for individuals who tend to engage in irrational thinking. If someone thinks that the world is unfairly judging her, she will likely feel miserable and powerless which can increase the chances that she will have increased stress related to the irrational thinking. The idea behind RET is that our thinking tends to guide our feelings and our feelings can trigger stress.

RET literature explains the approach through an ABC analogy. The A stands for the activating event or what is the assumed cause of the person’s stress (not being first in line, getting a D on a test, or losing at a game). The B stands for the belief the person has about what happened or the person’s self-talk about what happened. For some individuals with ASD, how they think about social situations or emotional feelings can be irrational or negative. They may have negative self-talk such as “Nobody likes me” or their thinking may be very black and white such as “The cafeteria has to have macaroni on Wednesday!” The C stands for the consequences of the negative thinking or the actual emotions or stress the person might feel when macaroni is not an option at lunch on Wednesday. The RET approach explains that how a person thinks about a particular event and the self-talk they use to process the event can lead to irrational levels of stress and anxiety.

RET can be used with individuals with autism through the use of cartooning, illustrating thoughts different people might have in their thinking bubbles in response to a particular situation and showing how their feelings will be different depending on the words in their thinking bubble. RET can be paired with the Incredible 5-Point Scale to work on the lunchroom example mentioned above.

Johnny has Asperger Syndrome and is very rigid in his thinking. He tends to get very upset when things do not happen as he is anticipating. He is expecting macaroni for lunch and is horrified when the school cafeteria offers “chef’s surprise” instead. Johnny believes this is wrong and should not be allowed to ever happen. He begins to yell at the ladies in the lunch line. He insists that they make him macaroni immediately. He sits down in protest and refuses to leave even when the principal is called. He uses rude and hurtful language towards the entire kitchen staff. When Johnny has calmed down and is able to think more reasonably, his special education teacher can process what has happened by using RET and a scale.

Johnny’s teacher draws a cartoon illustrating Johnny looking at the chef’s surprise with a horrified look on his face. The teacher then draws a large thinking bubble and asks Johnny to remember what he was thinking when that happened. Johnny uses words like “horrible” and “stupid” which the teacher writes in the thinking bubble and also on a large sheet of paper. She can later discuss these as “irrational thoughts or words”. The teacher then asks Johnny to list the things he did in response to there being no macaroni for lunch (screaming rude things, sitting on the floor, etc.). Finally the teacher draws a 5-point scale with 1 being something mildly irritating for Johnny and 5 being the most horribly frustrating thing ever. She then has him help her fill in each of the levels (figure 3) with how each level feels and examples of what could make him feel that way and the behavior that might be reasonable in that situation.

The teacher can then review with Johnny, in a visual and concrete way, what happened, how he felt about what happened and what he did about what happened. The teacher can then relate this report to his frustration scale, which serves as the ‘voice of reason’ and illustrates that having the wrong food served at lunch, though frustrating, is really only a 2 on the scale. She can then point out that Johnny’s behavior was at a 4 level response which means it is not level with the situation, which means his thinking in this situation was irrational (refer back to the list of words he was thinking).

The objective of this process is to help Johnny to relax in frustrating situations by clearly illustrating that how he thought about the situation guided his feelings. If Johnny can understand this about himself, he is more apt to recognize an irrational response in the future so that he can change his response or be more open to negotiation. The scale helps by making use of Johnny’s rigid thinking and preference for order to process an emotionally difficult social situation.

RET has only recently been tried with students with Asperger Syndrome and may not be as appropriate for people with severe forms of ASD.