American Psychological Association

Chapter Title: Instructions for the Rational Emotive Behavior Therapy Deliberate Practice
Exercises

Book Title: Deliberate Practice in Rational Emotive Behavior Therapy

Book Author(s): MARK D. TERJESEN, KRISTENE A. DOYLE, RAYMOND A. DIGIUSEPPE,
ALEXANDRE VAZ and TONY ROUSMANIERE
Published by: American Psychological Association. (2023)
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 ECXHEARPCTIESRE

2
Instructions for the Rational
Emotive Behavior Therapy
Deliberate Practice Exercises

This chapter provides basic instructions that are common to all the exercises in this
book. More specific instructions are provided in each exercise. Chapter 3 also provides
important guidance for trainees and trainers that will help them get the most out
of deliberate practice. Appendix A offers additional instructions for monitoring and
adjusting the difficulty of the exercises as needed after getting through all then client
statements in a single difficulty level, including a Deliberate Practice Reaction Form
the trainee playing the therapist can complete to indicate whether they found the
statements too easy or too difficult. Difficulty assessment is an important part of the
deliberate practice process and should not be skipped.

Overview

The deliberate practice exercises in this book involve role-plays of hypothetical situations
in therapy. The role-play involves three people: one trainee role-plays the therapist,
another trainee role-plays the client, and a trainer (professor/supervisor) observes and
provides feedback. Alternatively, a peer can observe and provide feedback.
This book provides a script for each role-play, each with a client statement and also
with an example therapist response. The client statements are graded in difficulty from
beginning to advanced, although these difficulty grades are only estimates. The actual
perceived difficulty of client statements is very subjective and varies widely by trainee.
For example, some trainees may experience a stimulus of a client being angry as being
easy to respond to, whereas another trainee may experience it as very difficult. Thus,
it is important for trainees to provide difficulty assessments and adjustments to ensure
that they are practicing at the right difficulty level: neither too easy nor too hard.

[Link]
Deliberate Practice in Rational Emotive Behavior Therapy, by M. D. Terjesen, K. A. Doyle, R. A. DiGiuseppe,
A. Vaz, and T. Rousmaniere
Copyright © 2023 by the American Psychological Association. All rights reserved.

17

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18 Overview and Instructions

Time Frame

We recommend a 90-minute time block for every exercise, structured roughly as follows:

• First 20 minutes: Orientation. The trainer explains the rational emotive behavior therapy
(REBT) skill and demonstrates the exercise procedure with a volunteer trainee.

• Middle 50 minutes: Trainees perform the exercise in pairs. The trainer or a peer
provides feedback throughout this process and monitors and adjusts the exercise’s
difficulty as needed after each set of statements (see Appendix A for more informa-
tion about difficulty assessment).

• Final 20 minutes: Review, feedback, and discussion.

Preparation

1. Every trainee will need their own copy of this book.

2. Each exercise requires the trainer to fill out a Deliberate Practice Reaction Form after
completing all the statements from a single difficulty level. This form is available in
the “Clinician and Practitioner Resources” tab online ([Link]
books/deliberate-practice-rational-emotive-behavior-therapy) and in Appendix A.

3. Trainees are grouped into pairs. One volunteers to role-play the therapist and one to role-
play the client (they will switch roles after 15 minutes of practice). As noted previously,
an observer who might be either the trainer or a fellow trainee will work with each pair.

The Role of the Trainer

The primary responsibilities of the trainer are as follows:

1. To provide corrective feedback, which includes both information about how well the
trainees’ response met expected criteria and any necessary guidance about how to
improve the response.

2. To remind trainees to do difficulty assessments and adjustments after each level of

client statements is completed (beginning, intermediate, and advanced).

How to Practice

Each exercise includes its own step-by-step instructions. Trainees should follow these
instructions carefully because every step is important.

Skill Criteria

Each of the first 12 exercises focuses on one essential REBT skill with two to four skill
criteria that describe the important components or principles for that skill.
The goal of the role-play is for trainees to practice improvising responses to the client
statement in a manner that (a) is attuned to the client, (b) meets skill criteria as much

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Instructions for the Rational Emotive Behavior Therapy Deliberate Practice Exercises 19

as possible, and (c) feels authentic for the trainee. Trainees are provided scripts with
example therapist responses to give them a sense of how to incorporate the skill criteria
into a response. It is important, however, that trainees do not read the example responses
verbatim in the role-plays! Therapy is highly personal and improvisational; the goal of
deliberate practice is to develop trainees’ ability to improvise within a consistent frame-
work. Memorizing scripted responses would be counterproductive for helping trainees
learn to perform therapy that is responsive, authentic, and attuned to each individual client.
The example scripted responses were collaboratively designed with the aim to stay
genuine to good therapy practice while also demonstrating the specific REBT skill.
However, trainees’ personal styles of therapy may differ slightly or greatly from that in
the example scripts. It is essential that, over time, trainees develop their own style and
voice, while simultaneously being able to intervene according to the model’s principles
and strategies. To facilitate this, the exercises in this book were designed to maximize
opportunities for improvisational responses informed by the skill criteria and ongoing
feedback. Trainees will note that some of the scripted responses do not meet all the
skill criteria: These responses are provided as examples of flexible application of REBT
skills in a manner that prioritizes attunement with the client.
The goal for the role-plays is for trainees to practice improvising responses to the
client statements in a manner that

• is attuned to the client,

• meets as many of the skill criteria as possible, and
• feels authentic for the trainee.

Review, Feedback, and Discussion

The review and feedback sequence after each role-play has these two elements:

• First, the trainee who played the client briefly shares how it felt to be on the
receiving end of the therapist’s response. This can help assess how well trainees are
attuning with the client.

• Second, the trainer provides brief feedback (less than 1 minute) based on the skill
criteria for each exercise. Keep feedback specific, behavioral, and succinct to
preserve time for skill rehearsal. If one trainer is teaching multiple pairs of trainees,
the trainer walks around the room, observing the pairs and offering brief feedback.
When the trainer is not available, the trainee playing the client gives peer feedback
to the therapist, based on the skill criteria and how it felt to be on the receiving end
of the intervention. Alternatively, a third trainee can observe and provide feedback.

Trainers (or peers) should remember to keep all feedback specific and brief and not
to veer into discussions of theory. There are many other settings for extended discussion
of REBT theory and research. In deliberate practice, it is of utmost importance to maximize
time for continuous behavioral rehearsal via role-plays.

Final Evaluation

After both trainees have role-played the client and the therapist, the trainer provides
an evaluation. Participants should engage in a short group discussion based on this
evaluation. This discussion can provide ideas for where to focus homework and future

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20 Overview and Instructions

deliberate practice sessions. To this end, Appendix B presents a Deliberate Practice Diary
Form, which can also be downloaded from the “Clinician and Practitioner Resources”
tab online ([Link]
behavior-therapy). This form can be used as part of the final evaluation to help trainees
process their experiences from that session with the supervisor. However, it is designed
primarily to be used by trainees as a template for exploring and recording their thoughts
and experiences between sessions, particularly when pursuing additional deliberate
practice activities without the supervisor, such as rehearsing responses alone or if two or
more trainees want to practice the exercises together—perhaps with another trainee
filling the supervisor’s role. Then, if they want, the trainees can discuss these experiences
with the supervisor at the beginning of the next training session.

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