Rational behaviour therapy

Domain II · Behavioural & cognitive · Maxie C. Maultsby Jr. · 1973

What it is

RBT is a short-term, homework-centred cognitive-behavioural therapy. It was developed by psychiatrist Maxie C. Maultsby Jr. (1932–2016), drawing on his years as a family physician, Luria's neuropsychology, Skinner's learning theory and, above all, Ellis's rational-emotive therapy. Maultsby worked…

Format

• RBT is a teaching sequence, not a fixed-session manual. No standard session count is given in the sources. Wirga et al. (2020) give this teaching order. First the ABCD model: no new concept is introduced until the client understands it, accepts it and can apply it to their own life, which may take…
• New habit formation. The new way of thinking, feeling and acting is automatic.

Who practises it, and how they are trained or regulated

• Stages of emotional re-learning (Maultsby): learning a brand-new habit has four stages. Re-learning, which replaces an old habit, adds cognitive-emotive dissonance before emotional insight, giving the five below. An older training text gives three (intellectual insight, dissonance, emotional insight).
• Sources and status (read first): The main source is Wirga et al. (2020), a detailed description of RBT by Maultsby's collaborators. Also drawn on: the Wikipedia pages on RBT and on Maultsby, Turknett's rational self-counselling training dialogue, the Albert Ellis Institute page on rational emotive imagery, and a Chicago juvenile-detention activity table. Tagged: history; the ABCD model; the Five Rules and the…
• RBT is a short-term, homework-centred cognitive-behavioural therapy. It was developed by psychiatrist Maxie C. Maultsby Jr. (1932–2016), drawing on his years as a family physician, Luria's neuropsychology, Skinner's learning theory and, above all, Ellis's rational-emotive therapy. Maultsby worked at the University of Wisconsin (Madison) and from 1971 at the University of Kentucky. In 1973 he founded the Training and…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• quick checks used to skip written work before the skill is solid. It is working when the client reports catching and changing reactions as they happen.
• the client relying on the therapist to rewrite; shame about "wrong" RSAs. It is working when the number of corrections per RSA falls from session to session.
• an HB that feels false because it is false or unrealistic. Fix the statement rather than pushing more practice. It is working when clients get through the dissonance and later report that the…
• using the rules to argue the client into the therapist's values, which breaks the client-goal principle; mechanical box-ticking without belief. It is working when the client applies the rules on…
• clients who feel invalidated ("so I'm making it up?"). Make clear that the event was real and only its meaning is being sorted out. It is working when A sections shrink to plain facts and clients…

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.