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How the ABC Model Works in CBT

Published: March 15, 2022 Updated: March 17, 2023
Published: 03/15/2022 Updated: 03/17/2023
Headshot of Renee Skedel, LPC
Written by:

Renee Skedel

LPC
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • How the ABC Model WorksHow It Works
  • ABC Psychology ExamplesExamples
  • Is the CBT ABC Model of Psychology Effective?Effectiveness
  • Not Sure Where to Start? Find a CBT TherapistFind a Therapist
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • ABC Model InfographicsInfographics
Headshot of Renee Skedel, LPC
Written by:

Renee Skedel

LPC
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD

The “ABC model,” also known as ABC analysis, was created to identify and process negative, “dysfunctional” thoughts as part of cognitive behavioral therapy (CBT).1, 2 However, it can be used in other forms of therapy to help clients learn how to process dysfunctional thoughts and belief systems.1

Find a therapist that specializes in CBT. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

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How the ABC Model Works

Albert Ellis created the ABC model while developing rational emotive therapy and CBT 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/react in unhealthy, inappropriate ways.1

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

  • Activating event or antecedent: an initial situation that is considered to have led to a negative or dysfunctional thought1
  • Beliefs: a negative or dysfunctional thought that happened at the time of the event1
  • Consequence: a negative feeling or inappropriate behavior that is perceived to have happened as a result of the event or the following thought(B)1

ABC psychology and CBT have been researched since 1960 for the treatment of different mental health issues.1,2 Ellis suggested that certain people may experience an event and misinterpret it as a result of unhealthy beliefs and thought patterns. This misinterpretation may lead to unhealthy or inappropriate reactions that negatively impact the person’s life.

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.

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 individuals to address problems in the present vs. 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. ABCs 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 to process the 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 event. 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. ABCs 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, 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

CBT Based Therapy Options

Cognitive Behavioral Therapy (CBT) is the most popular type of therapy in the US. The companies below offer therapists trained in CBT, offer live 1-on-1 video therapy, as well as the ability to communicate with your therapist by text.

Online CBT Therapy

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Is the CBT ABC Model of Psychology Effective?

The ABC model has been researched in comparison to 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?

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 find 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, speciality, and more.

Final Thoughts

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!

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Online Therapy 

BetterHelp – Get support and guidance from a licensed therapist. BetterHelp has over 20,000 therapists who provide convenient and affordable online therapy.  Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Online Psychiatry

Hims / Hers – If you’re living with anxiety or depression, finding the right medication match may make all the difference. Get FDA approved medication prescribed by your dedicated Hims / Hers Healthcare Provider and delivered right to your door. Plans start at $25 per month (first month)*. Get Started

Medication + Therapy

Brightside Health – Together, medication and therapy can help you feel like yourself, faster. Brightside Health treatment plans start at $95 per month. United Healthcare, Anthem, Cigna, and Aetna accepted. Following a free online evaluation and receiving a prescription, you can get FDA approved medications delivered to your door. Free Assessment

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Choosing Therapy partners with leading mental health companies and is compensated for marketing by Hims / Hers, Brightside, and BetterHelp. *Hims / Hers Disclaimer: Subscription required. After first month, price is $85/month for a monthly subscription or $49/month for a three-month subscription ($123 for first order, $147 billed quarterly thereafter). Subscription automatically renews unless you cancel at least 7 days before renewal is processed.

For Further Reading

  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov

ABC Model Infographics

How the ABC Model Works in CBT ABC Psychology Examples ABC Psychology Examples

Is the CBT ABC Model of Psychology Effective?

12 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Mcleod, S. (2019). Cognitive Behavioral Therapy (CBT) – Simply Psychology. Simply Psychology. Retrieved from https://www.simplypsychology.org/cognitive-therapy.html

  • Psychology Tools. (2022, January 28). ABC Model. Retrieved from https://www.psychologytools.com/resource/abc-model/

  • Selva, J. B. (2021, December 13). Albert Ellis’ ABC Model in the Cognitive Behavioral Therapy Spotlight. PositivePsychology.Com. Retrieved from https://positivepsychology.com/albert-ellis-abc-model-rebt-cbt/

  • Malkinson, R. (2010). Cognitive-behavioral grief therapy: The ABC model of rational-emotion behavior therapy. Psihologijske teme, 19(2), 289-305

  • Thinking Errors (Worksheet). (n.d.). Therapist Aid. Retrieved from https://www.therapistaid.com/therapy-worksheet/cbt-thinking-errors

  • Sælid, G. A., & Nordahl, H. M. (2017). Rational emotive behaviour therapy in high schools to educate in mental health and empower youth health. A randomized controlled study of a brief intervention. Cognitive Behaviour Therapy, 46(3), 196–210. https://pubmed.ncbi.nlm.nih.gov/27791532/

  • Fuller, Ryan & Digiuseppe, Raymond & O’Leary, Siobhan & Fountain, Tina & Lang, Colleen. (2010). An Open Trial of a Comprehensive Anger Treatment Program on an Outpatient Sample. Behavioural and cognitive psychotherapy. 38. 485-90. 10.1017/S1352465810000019. https://pubmed.ncbi.nlm.nih.gov/20420758/

  • Hickey M., Schwartz S. (2020) RE-CBT in the Treatment of Anxiety, Fears, and Phobias Among Youth. In: Bernard M., Terjesen M.D. (eds) Rational-Emotive and Cognitive-Behavioral Approaches to Child and Adolescent Mental Health: Theory, Practice, Research, Applications. Springer, Cham. https://doi.org/10.1007/978-3-030-53901-6_8

  • Hansen, Lars. “The ABCs of Cognitive-Behavioral Therapy for Schizophrenia.” Psychiatric Times, vol. 23, no. 7, 1 June 2006, p. 49. Gale Academic OneFile, https://go.gale.com/ps/i.do?p=AONE&u=anon~1558ebf4&id=GALE|A146541805&v=2.1&it=r&sid=googleScholar&asid=13e00baa.

  • Landa, Y., Silverstein, S.M., Schwartz, F. et al. (2006). Group Cognitive Behavioral Therapy for Delusions: Helping Patients Improve Reality Testing. J Contemp Psychother 36, 9–17. https://doi.org/10.1007/s10879-005-9001-x

  • Greimel K.V., Kröner-Herwig B. (2011) Cognitive Behavioral Treatment (CBT). In: Møller A.R., Langguth B., De Ridder D., Kleinjung T. (eds) Textbook of Tinnitus. Springer, New York, NY. https://doi.org/10.1007/978-1-60761-145-5_71

  • Life Charity. (n.d.). Cognitive-Behavioural Therapy. Retrieved from https://lifecharity.org.uk/wp-content/uploads/2019/10/CBT.pdf

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Headshot of Renee Skedel, LPC
Written by:

Renee Skedel

LPC
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • How the ABC Model WorksHow It Works
  • ABC Psychology ExamplesExamples
  • Is the CBT ABC Model of Psychology Effective?Effectiveness
  • Not Sure Where to Start? Find a CBT TherapistFind a Therapist
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • ABC Model InfographicsInfographics
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