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Rational Emotive Behavioral Therapy

REBT for the Treatment of Panic Disorder


Updated August 01, 2013

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If you have been diagnosed with panic disorder, you may be considering your therapeutic treatment options. Rational emotive behavioral therapy (REBT) is one type of psychotherapy that may be used in the treatment of panic disorder. The following describes REBT and how it can help treat panic symptoms.

What is Rational Emotive Behavioral Therapy?

REBT is a form of cognitive behavioral therapy (CBT) that focuses on assisting a client in adjusting their faulty thinking and maladaptive behaviors. American psychologist, Albert Ellis, developed REBT in the 1950s. Dr. Ellis felt his patients were not benefiting from the traditional psychoanalytic therapy that was common at the time. He noticed that clients would share their thoughts and gain insights, but they were not making a connection to actually changing their unwanted behaviors.

REBT is based off of the idea that a person’s interpretations of life events, not the events themselves, are what leads to stress, anxiety, and unhappiness. REBT works to adjust irrational and self-defeating beliefs that are contributing to unhealthy feelings and behaviors. REBT is an action-oriented therapy, meaning that the therapist assists in shifting insights into long-lasting changes in thoughts, emotions, and behaviors.

REBT has been widely researched and is one of the theoretical orientations that a professional who treat panic disorders may use. It can be effective in changing a person’s views and beliefs that are negatively impacting their mental health disorder. REBT is currently used in the treatment of a variety of mood and anxiety disorders, including depression, social anxiety disorder, and generalized anxiety disorder.

The ABC Model of REBT

According to the theory of REBT, people learn and develop their negative beliefs over time. Therefore, these faulty perceptions will need to be unlearned. The process of how a person with panic disorder develops irrational beliefs can be explained through Ellis’ ABC Model:

Activating Event: This is when an unpleasant event occurs. For example, a person is driving on a busy road and has a panic attack.

Beliefs: After the activating event occurs, the person interprets the event. For instance, the person begins to believe that their panic attack could have caused them to lose control or experience a medical emergency.

Consequence: The consequence is how the person responds to their beliefs about the event. In this example, the person may feel ashamed and begin to fear situations that they believe could have triggered the panic attack. The person may then avoid driving or being in crowded areas.

REBT for the Treatment of Panic Disorder

REBT suggests that people with mental health disorders experience negative self-talk and beliefs that contribute to their symptoms. According to REBT, these mistaken beliefs can include:

Musts, Shoulds, and Oughts - A person with panic disorder may have rigid thinking that can reveal itself through self-talk. The person may think, “I must get over my fears,” “I should be able to drive without getting nervous,” or “I ought to be able to be anxiety-fear.” These pessimistic self-statements only lead to more stress and dissatisfaction.

Perfectionism - Many people with panic disorder hold themselves to impossibly high standards. They may feel intense shame about their condition, believing that others will not approve of them if they knew about their struggle. Having such unrealistic expectations can increase feelings of anxiety and intensify avoidance behaviors.

Blame - It is not uncommon for a person with panic disorder to believe that they do not have any control over their life because of their symptoms. They may blame their condition for any disappointments they experience. A person may also blame themselves or others for their struggle with panic disorder. Blame may offer temporary feelings of relief and resolution, but does not provide any long-term solutions.

REBT works to help the client identify and change self-defeating beliefs so they can adjust how they respond to events. The REBT therapist must remain caring and supportive. However, the therapist will need to dispute the client’s beliefs to help them recognize how irrational their thoughts may be. The therapist will challenge the logic behind the client’s beliefs, such as asking why the client supposes that it is important to have approval of other people.

The REBT therapist also acts as a teacher, instructing the client on how to use different behavioral techniques. Some common behavioral skills practiced though REBT include role playing, guided imagery, writing exercises to overcome limiting beliefs, and relaxation techniques, such as meditation, deep breathing, progressive muscle relaxation (PMR), and visualization.

Finding Help Through REBT

REBT has been found to be an effective treatment option for panic disorder, panic attacks, and agoraphobia. If you are interested in finding help through REBT, start by discussing your options with your treatment provider. The Albert Ellis Institute also keeps an online database of REBT-trained therapists where you can locate a specialist in you area. Your therapist will help you determine the best treatment plan to help you manage the symptoms of panic disorder.


Corey, G. (2009). Theory and Practice of Counseling and Psychotherapy, 8th Ed. Belmont, CA: Thomson.

Ellis, A. (2001). Overcoming Destructive Beliefs, Feelings, and Behaviors. Amherst, NY: Prometheus.

Ellis, A. & Dryden, W. (2007). The Practice of Rational Emotive Behavioral Therapy, 2nd ed. New York: Springer.

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