010 – REBT – Endings in Counselling – Ethics versus Culture

In the tenth episode of the Counselling Tutor Podcast, Rory Lees-Oakes take a close look at Albert Ellis's rational emotive behaviour therapy (REBT), while Ken Kelly explores endings in counselling. In 'Ask Ken and Rory', our presenters debate ethics versus culture in counselling.













REBT







Rory introduces the modality of REBT using an anecdote from his own life, based on witnessing a car accident and talking to one of the drivers afterwards.







New York-based psychologist Albert Ellis, who is generally considered to be a key originator of cognitive-behavioural therapies, developed REBT (originally known just as 'rational emotive therapy': RET). Rory explains the concept of automatic negative thoughts (ANTs), which include:









overgeneralisation







filtering







all-or-nothing thinking







personalising







catastrophising







mind-reading.









In REBT, it is believed that an activating (A) event leads to a faulty belief (B) that results in consequences (C). An REBT therapist would look for the belief, and dispute (D) this using evidence (E). Thus, the therapist seeks to remove irrational beliefs and replace these with healthier, more evidence-based patterns.







Rory refers to Karen Horney's work on 'the tyranny of the shoulds', and to Albert Ellis and Robert Harper's book, A Guide to Rational Living (Image Book Company, 1969). He concludes that REBT, as a less complex modality than humanistic or psychodynamic therapy, focuses on the client's belief and invites them to ask themselves: 'Is there another explanation?'



























Skill of Ending in Counselling









"Termination is more than an act signifying the end of therapy; it is an integral part of the process of therapy and, if properly understood and managed, may be an important factor in the instigation of change." Irvin Yalom (1975, p. 365)









Ending the counselling relationship is sometimes called 'termination'. Endings in any part of life can be difficult, especially if unexpected. Some counselling students find endings tricky to navigate, because these are tied into a resistance to change that some clients may feel. Endings can key into our natural tendency to avoid loss.







It is therefore important to look at our own feelings about endings, and our experience of these, so developing good self-awareness that can help inform how we approach the ending of the therapeutic relationship with a client. Many complaints submitted to the British Association for Counselling and Psychotherapy (BACP) relate to endings being poorly handled or even avoided by therapists.







So why do we as humans tend to resist endings? Key reasons include resistance to change and fear of loss. The danger in avoiding endings in counselling is that the client may become dependent on us (and so risk losing their autonomy); Ken describes various warning signs that this may be happening.







He goes on to explore best practice when ending a counselling relationship, as well as looking at different types of endings counsellors are likely to encounter: for example, holidays and breaks, planned endings, unplanned endings, and endings of individual sessions.







If you, as counsellor, are going to take a holiday or break, it is best practice to tell clients as soon as possible (especially if a client has been coming to you for a long time), so providing the maximum notice. As for planned endings, there are three key stages: