How the ABC Model Works in CBT

How the ABC Model Works

Albert Ellis created the ABC model while developing rational emotive therapy and cognitive behavioral therapy with Aaron Beck. Ellis suggested that people have different beliefs regarding themselves and the world, and these beliefs guide and influence their lives and reactions.¹ He stated that certain individuals’ belief systems are “irrational” or dysfunctional, and theorized that irrational beliefs cause people to act in unhealthy, inappropriate ways.¹

Ellis’ theory suggests that people can use the ABC model to identify the unhealthy belief system. Paying attention to a situation (without bias) and exploring how a person internally responds allows them to explore certain thoughts or beliefs, especially in a pattern of similar thoughts. Once the belief is identified, they can consider the behavior or feelings that occurred as a result.

In the Albert Ellis ABC model, the ABCs stand for:¹

• Activating event or antecedent: An initial situation that is considered to have led to a negative or dysfunctional thought
• Beliefs: A negative or dysfunctional thought that happened at the time of the event
• Consequence: A negative feeling or inappropriate behavior that is perceived to have happened as a result of the event or the following thought

ABC Psychology Examples

The ABC model can help increase awareness of triggers (physical, emotional, or cognitive), build a better understanding of long- and short-term consequences of behavior, and allow people to address problems in the present instead of focusing on their past.² The efficacy of the ABC model and CBT has been demonstrated in multiple studies, showing that it can be effective to treat depression symptoms, anger, and anxiety.³

Here are three examples of ABC and CBT:

1. The ABC Model For Dealing With Anxiety & Intrusive Thoughts

Jackie, a thirty-year-old female, was diagnosed with anxiety in her late teens. In her mid-twenties, Jackie began to experience intrusive thoughts about what others thought of her. Jackie and her therapist worked together using CBT techniques for anxiety symptoms and intrusive thoughts surrounding social judgement; part of this included ABC psychology.

Jackie identified:

• The activating event (A) is when a group of people looked at her for more than a few minutes, regardless of the area or situation.
• The belief (B) is Jackie’s thoughts of, “They are staring at me. I must have done something stupid or that made me look ridiculous. They will continue to judge me for this.” She and her therapist identified multiple thinking errors in this statement, indicating unhealthy thinking patterns and beliefs.
• The consequence (C) is when Jackie decided to leave the situation.

When this was explored, Jackie and her therapist identified that this was an unhealthy but common way for Jackie to respond to what she perceived as social judgement.^4,5 They started practicing the ABC model to challenge and achieve healthier and more functional behavior.

2. The ABC Model For Dealing With Anger

Since her early teens, Jamie, a twenty year-old female, has struggled to cope with and manage her anger. As an adult, it’s difficult for her to constructively calm down in arguments, leading to multiple impairments. Notably, Jamie has difficulty maintaining a job or friendly/romantic relationships as a result of exploding without warning and not being able to identify or communicate when she’s angry. Jamie begins working with her therapist to use CBT to calm her anger.

In therapy, Jamie starts applying the ABC model to different situations:

• The activating event (A) is when a friend asked Jamie to talk about something that happened at a recent group event.
• The belief (B) is when Jamie thinks, “She is going to say I did something and confront me about it. I’m an idiot and I shouldn’t have expected that they wouldn’t notice I made a mistake.” Jamie and her therapist covered this irrational thought in one of her sessions.⁵
• The consequence (C) is when Jamie gets angry automatically and yells at her friend.

Weeks later, Jamie and her friend still haven’t talked or discussed what happened. Jamie’s therapist discussed the ABC process with her, highlighting Jamie’s thinking errors as well as the lack of insight to what led to the blowup on her friend.³

3. ABCs For Dealing With Depression

Alex, a twenty-six-year-old male, has been experiencing depressive symptoms since he turned twenty. He has a history of attending general therapy to help with his depression, as well as taking prescribed medications, but he feels like they haven’t been effective. Within the last few weeks, he started experiencing more severe episodes with concerns of hopelessness, negative thoughts, lowered energy and motivation, significantly increased sleeping, lowered appetite, and continuous isolation.

Alex’s therapist decides to apply the ABC model to assess his thought process. Alex identifies:

• In the activating event (A), Alex has already been experiencing a low-level depressive mood when a friend comments that he hasn’t been around.
• In the belief (B), Alex immediately thinks, “I shouldn’t have missed those events even though I was tired. I’m an awful friend.”⁵
• As a consequence (C), Alex begins to experience more depressive symptoms to the point of not engaging with anyone, and experiencing negative and hopeless thoughts.

Alex and his therapist begin processing these thoughts and explore ways to challenge them and create a support system to discuss negative feelings.^1,3,4

Is the CBT ABC Model of Psychology Effective?

The ABC model has been proven to be effective for several mental health issues, including anger, depression, grief, and anxiety. While ABC psychology and CBT may have limitations, a significant amount of research notes its general effectiveness in a variety of mental health populations.

Here are examples of research studies that show the ABC model’s effectiveness:

• Saelid and Nordahl (2017) provided a number of high school students with several educational sessions of the ABC model in rational emotive behavioral therapy (REBT) and provided REBT treatment. There was a significant decrease in anxiety symptoms, depressive symptoms, and dysfunctional thinking; these decreases were maintained after a significant amount of time.⁶
• Although this study had a small population, Fuller et al. (2010) found that the ABC model – especially applied within REBT – was observed to influence significant decreases in anger, anger expression, and depressive symptoms.^3,7
• Malkinson (2010) reviewed a number of studies applying CBT protocol and the ABC model with PTSD. They noted several studies where CBT was observed as an evidence-based option to treat symptoms, especially emotional stress, from PTSD.⁴
• Hickey and Schwartz (2020) wrote that RE-CBT (a combination of both REBT & CBT) and the application of the ABC model were observed to be significantly effective in treating underage individuals with anxiety, fear, and phobia disorders.⁸
• Hansen (2006) observed that CBT, with a specific format in the ABC model that relies on socratic questioning, has been recognized as a realistic and effective treatment for individuals living with schizophrenia.⁹
• Landa, Silverstein, Schwartz, and Savitz (2006) provided group CBT – with ABC model application – for a population of individuals with schizophrenia who experienced delusions. They observed a significant decrease in commitment to one’s delusions, sadness related to considering delusions, lowered stress, and significantly increased capacity to dismiss the delusion.¹⁰

Are There Any Drawbacks to the ABC Model?

CBT and the ABC model do have limitations. CBT cannot yet define the exact expectation of thought processes in different individuals and, therefore, can only suggest a theory for how thoughts or beliefs would influence behaviors and actions. In addition, some forms of CBT and REBT can be quite confrontational and may not be the best fit for everyone.¹¹

Not Sure Where to Start? Find a CBT Therapist

Working with a trained CBT or REBT therapist (both were formed around and with ABC psychology) can guide you to identify the dysfunction in certain thought processes or reactions. If you want to try CBT and ABC psychology, it may be time to consider finding a therapist.

The first step is knowing where to look. Consider starting your search for the right match in a free online therapist directory where you can filter based on location, price, specialty, and more.

Final Thoughts on the ABC Model

The ABC model can be a helpful skill to have in your toolbox; however, you may be experiencing symptoms that you feel you cannot control or need more help with. If that’s the case, it can help to reach out to a qualified mental health professional. Remember, you are not alone!