Distinctive features of A. Ellis' rational-emotional-behavioral therapy and A. Beck's cognitive therapy approaches in clinical practice and psychotherapy of emotional disorders

Introduction

Cognitive therapy (CT) by A. Beck and rational-emotional-behavioral therapy (RAPT) by A. Ellis are the two most developed schools within the cognitive-behavioral direction of psychotherapy. Being the fundamental approaches of the so-called "second wave" of the development of cognitive-behavioral psychotherapy, exploring the specifics of dysfunctional thinking and the possibilities of its modification, the approaches of A. Beck and A. Ellis have individual theoretical and methodological features that are reflected in clinical practice in the implementation of cognitive, emotional and behavioral interventions in the context of psychotherapy of affective disorders. Having emerged in the middle of the last century, both of these methods remain relevant and of practical value, as evidenced by many studies ^[1-8].

RAPT-model of psychological health

A. Ellis, relying mainly on the ideas of various philosophers (first of all, Epicurus, Epictetus and Marcus Aurelius) presented the mechanism of formation of dysfunctional reactions using the visual formula A-B-C: activating event (A) activates irrational belief (B), which leads to emotional, physiological and behavioral consequences (C). At the same time, the founder of RAPT noticed that the formula A-B-C (activating event – beliefs – consequences), which explains the way a person perceives reality and indicates the source of his emotional and behavioral disorders, is easy to understand, like an alphabet, and is available for everyone to master. The continuation of this literal formula displays equally understandable steps to overcome dysfunctional reactions: D (disputations) – disputing (challenging) irrational beliefs (creating dysfunctional emotional, bodily and behavioral reactions); E (effective beliefs) – rational statement (more broadly, a new effective philosophy) formulated as a result of challenging irrational beliefs; F (functional feelings) – functional reactions (resulting from a rational statement); G (goals) – goals, values and desired results that are significant for a person (achieved on the basis of a rational statement and functional reactions).

So, on the way of realization by a person of significant goals for him (both situational – within a specific event, and global – in different spheres of life) and values (G) there are obstacles in the form of activating events (A) – unfavorable and undesirable factors and circumstances that prevent the implementation of these goals and values and the achievement of desired results. External or internal, real or imaginary events of the past, present or future can act as an activating event (from the point of view of the RAPT). Most often, the activating event (A) is an external event of the present, but it can also be an internal event of the present (thoughts, emotions, physical sensations), the past (memories) or the future (expectations, anticipation). When determining the activating event, the critical moment of the situation (critical A) is also revealed – the most specific aspect of the event that is associated with the greatest emotional distress, because this aspect is most closely associated with irrational belief (B).

The letter "B" in the RAPT refers to a person's belief system, which is the main intermediary between the activating event (A) and reactions (C). So, when an adverse event (A) occurs that violates the goals (G) and threatens the values (G) of the subject, the latter consciously or unconsciously turns to rational or irrational cognitions (C), which determine, respectively, functional or dysfunctional emotional and behavioral reactions (C). Understood extremely broadly, the belief system (C) includes thoughts, representations, judgments, attitudes, interpretations, attributions, anticipations and views of a person about the activating event (A) leading to emotional, physiological and behavioral consequences (C). According to A. Ellis, an irrational belief (In) necessarily contains a duty, as well as one or more of its derivatives (satellites) – catastrophization ("awfulness" of non-fulfillment of a requirement), low tolerance to frustration ("unbearability" of non-fulfillment of a requirement) and/or a global assessment (devaluation) (of oneself, others and/or the world) (negative assessment of oneself, others and/or the world in case of non-fulfillment of the requirement), which causes dysfunctional reactions and consequences (C).

The consequences (C) in the RAPT are understood as emotional, physiological and behavioral reactions caused by the belief system (C) of the subject in relation to the activating event (A) and contributing to or hindering the achievement of significant goals and values (G). In this regard, the fundamental position of both cognitive therapy (CT) by A. Beck and rational-emotional-behavioral therapy (RAPT) by A. Ellis is that a person is upset (C) not by the events themselves (A), but by the attitude (B) to them, i.e. irrational thoughts, ideas and beliefs. As E.A. Romek notes, "unlike other living beings, man is a talking animal. This means that all his behavioral reactions are mediated by artificial stimuli, or speech" ^{[9, p. 281]}, "which are initially used by other people (parents, educators, etc.), and then internalized. Once assimilated, artificial stimuli become internal means of regulating thinking, feelings, and the entire system of individual behavior" ^{[10, p. 198]}. Thus, the cause of emotional and behavioral disorders (C) is the product (and not a simple sum) A and B, because when undesirable events (A) occur, people do not just "add" their attitude to them (B), but "multiply" A and B, as a result of which they receive reactions (C) disproportionate and inadequate to the events (A), which can be expressed in the form of the formula A x B = C .

The stage of disputing irrational beliefs (D) is the process of actively, persistently and systematically challenging (questioning) irrational beliefs in cognitive and behavioral ways (as well as using emotional techniques). Disputation (D) aims to weaken faith in an irrational belief (C) and even destroy it for the subsequent formation and strengthening of a rational statement (a new effective philosophy) (E) against the background of the achieved cognitive shift in the subject's view of the initial activating event (A). Disputation of irrational beliefs (D) can be represented as a scientific discussion of the subject with his unreasonable ideas (C) in order to develop rational statements relevant to a particular situation (A) and (more broadly) the formation of a new effective philosophy (E), which he can generalize to other adverse events (A). Cognitive disputation (D) is launched at a therapeutic session and conducted using empirical, logical and pragmatic questions of the dispute, formulated and asked by the therapist in various styles (didactic, Socratic, metaphorical and humorous).

After successful disputation of an irrational belief (D), an alternative rational statement (a new effective philosophy) (E) is formulated in relation to the activating event (A), which leads to functional emotional and behavioral reactions (F) and contributes more to achieving meaningful goals, realizing values and solving urgent problems (G). A rational statement (E) is a realistic, logical and useful alternative to an irrational belief (B) and contains a wish, as well as one or more derived beliefs (functional satellite attitudes): facticity, cognitive continuum, perspective (for catastrophization), high tolerance to frustration (for low frustration tolerance), and also a specific assessment and unconditional acceptance (for global assessment (depreciation)).The importance of formulating a rational statement (E) is explained by the fact that challenging an irrational belief (D) does not automatically lead to the emergence of new thoughts (E). However, the development of a new effective philosophy (E) contributes to long-term emotional and behavioral improvements (F), which can be expressed using the following formula: A x (D+E) = F.

The letter "F" denotes functional emotional, physiological and behavioral reactions resulting from rational statements (E), the latter of which, due to their consistent practical use, can eventually turn into a new effective philosophy (E), according to which the subject can organize his life in order to get more desired and less undesirable (G). In addition, level "F" can also be designated as an emotional and behavioral goal (desired healthy emotions and adaptive behavior), which can be achieved by disputing irrational beliefs (D) and forming a new effective philosophy (E) in relation to specific adverse circumstances (A).

Finally, the letter "G" in the RAPT means a person's desire to achieve meaningful goals and realize values (G). This becomes more likely and less problematic (even if there are obstacles in the form of unfavorable activating events (A)) based on functional emotions and adaptive actions (F), which are the result of rational statements and a new effective philosophy (E). Indeed, in a state of emotional distress, a person's ability to achieve the desired and solve current problems can significantly to deteriorate, in connection with which the implementation of significant goals is most often expedient after the improvement of the emotional state. In this regard, R. Leahy draws attention to the fact that "solving practical problems can help in solving psychological problems, but this is rarely enough in the case of patients with protracted personal problems" ^{[11, p. 15]}.

Extended ABC model

In modern rational-emotional-behavioral therapy, automatic thoughts about the activating event (A) are justified as part of this event. In other words, a person's dysfunctional and distorted conclusions about a trigger event are one of the aspects of this activating event (A), while beliefs (C) include dysfunctional attitudes – ought and its derivatives. Thus, R. Digiuseppe, K. Doyle, W. Dryden and W. Bax distinguish three aspects of the activating event (A) ^{[12, p. 143]}:

• A-confirmed (confirmed reality) – an activating event that can be described in the same way and unanimously confirmed by a group of independent third-party observers ("No one sat down with me during lunch");
• A-perceived (perceived reality) – a person's subjective perception and description of the activating event (automatic thoughts about the activating event) ("Others reject me");
• A-deduced (deduced reality) –deductive conclusion of the subject about the activating event (automatic thoughts about the activating event) ("No one loves me").

Among the irrational beliefs (dysfunctional attitudes) (C) in the RAPT, imperative beliefs (duties – demands on oneself, others and the world) and derived evaluative beliefs (catastrophization, low tolerance to frustration and global assessment (devaluation) of oneself, others and/or the world) are distinguished. Thus, imperative beliefs are obligations that reflect a person's ideas about what should or should not happen ("I should be loved"), and are the source of derived beliefs (satellite attitudes). In turn, derived evaluative beliefs represent a person's assessment of an event as "terrible" or "unbearable" or a global negative assessment of oneself, others and/or the world in case of dissatisfaction with a specific requirement (for oneself, others and/or the world) ("It's terrible if no one loves me", "It's unbearable to be unloved", "If no one loves me, then I'm a loser").

So, the beliefs derived from ought are a triad of the following dysfunctional attitudes (irrational beliefs):

• catastrophization: X should happen (exist), and if X does not happen, then it will be terrible ("Others should love me, and if they don't love me, then it's terrible").
• low tolerance to frustration: X should happen (exist), and if X does not happen, then it will be unbearable ("Others should love me, and if they don't love me, then I won't survive it").
• global valuation (devaluation) (of oneself, others and/or the world): X should happen (exist), and if X doesn't happen, then I/others/the world are bad ("Others should love me, and if they don't love me, then I'm a loser").

The consequences (C) in the RAPT are divided into emotional, physiological and behavioral reactions caused by one or another irrational belief (C) about the activating event (A):

• C-emotions – emotional consequences of irrational beliefs (depression);
• C-physiology – physiological consequences of irrational beliefs (weakness in the arms and legs);
• C-behavior – behavioral consequences of irrational beliefs (avoidance of communication).

It is also important to make terminological clarity: due, catastrophization, low tolerance to frustration, global assessment (depreciation) are attitudes or beliefs (in A. Beck's cognitive therapy, they are also called cognitive distortions). In other words, the concepts of "attitude", "persuasion" and "cognitive distortion" are relative synonyms (D.V. Kovpak suggests using this approach). The specific cognitions arising from these dysfunctional attitudes (irrational beliefs) that arise in various activating events (A) and cause dysfunctional reactions (C) are called "irrational beliefs" (B). Thus, a quartet of dysfunctional attitudes (irrational beliefs) can be called a kind of perception matrices, or paradigms of thinking, from which specific irrational beliefs grow. If the obligation is a dysfunctional attitude (or an irrational belief), then a specific cognition that has manifested itself in a particular situation and reflects this attitude (belief) is called an irrational belief: "Others owe me."

Accordingly, the wish (alternative to duty), facticity, cognitive continuum, perspective (alternatives to catastrophization), high tolerance to frustration (alternative to low frustration tolerance), as well as concrete assessment and unconditional acceptance (alternatives to global assessment (depreciation)) they are revealed as functional attitudes (rational beliefs). Specific cognitions arising from these attitudes (beliefs), arising in various activating events (A) and causing functional reactions (F), are defined as rational statements (E). In particular, if a wish is a functional attitude (rational belief), then a specific cognition that has manifested itself in a particular situation and reflects this attitude (belief) is called a rational statement: "I would like others to love me, but this does not mean that it should be so."

Mutual determination of dysfunctional beliefs

At the same time, the obligation and the satellite installations growing from it reinforce each other. Thus, the obligation leads to increased catastrophization, low tolerance to frustration and global assessment, which, in turn, strengthen the obligation. A. Ellis and K. McLaren describe the mutual reinforcement of dysfunctional attitudes as follows: "So, the belief that "I cannot be falsely accused" often leads to the following conclusion: "I was accused – it's terrible!” However persuasion “It's terrible that I was falsely accused” leads already to the conclusion “It shouldn't be!"" ^{[13, p. 49]}. Starting with demands ("She shouldn't behave like this!"), this kind of circular thinking inevitably generates additional irrational beliefs ("The fact that she behaves like this is unbearable!"), which, in turn, reinforce the original obligation ("If her behavior is unbearable, then she categorically does not must behave like this!").

It is important to emphasize separately that the attitude of duty appears to be the foundation of all other dysfunctional beliefs (or cognitive distortions) that are derived from duty and conditioned by these human requirements (for oneself, others and the world). In other words, behind each cognitive distortion (among which, in addition to the triad of derived evaluative beliefs identified by A. Ellis, representatives of A. Beck's cognitive therapy also include selective filtering (selective abstraction), polarization (dichotomous thinking), over-communication (overgeneralization), exaggeration (hyperbolization), prediction of a negative future, mind reading, personalization, unrealistic comparison, perfectionism, emotional argumentation and magical thinking), one or another obligation is always hidden. It is worth noting that the above-described inter-determination of the ought and its triad of satellites is also traced between the ought and the rest of the dysfunctional beliefs (cognitive distortions) arising from the requirements. Thus, the obligation leads to an increase, for example, personalization, and personalization, in turn, reinforces the obligation. This kind of vicious circle condones the rooting and spreading of a web of dysfunctional beliefs.

However, from the point of view of A. Ellis, the most important consequences of imperative requirements are three evaluative beliefs – catastrophization, low tolerance to frustration and global assessment (depreciation). At the same time, it is important to emphasize separately that the presence of obligations does not guarantee the automatic presence of the entire Ellis triad of evaluative beliefs. So, a person can often catastrophize, but he may not be so characterized by low tolerance to frustration. In addition, the same catastrophization resulting from a specific requirement (in one situation) does not necessarily mean catastrophization in the case of another obligation (in another situation). In other words, in the genesis of emotional dysfunctions, requirements are always present, but their consequences are always individual.

Thus, "the more strongly a person is convinced of the need to owe and the more strongly he believes his requirements, the more often he will have automatic thoughts in the styles of catastrophization, low tolerance of frustration and global evaluation (depreciation)" ^{[14, pp. 137-138]}, as well as in the styles of other dysfunctional beliefs (cognitive distortions). In addition, distorted conclusions (automatic thoughts) arising from the attitude of duty may be subjected to the onslaught of secondary requirements, which leads to the appearance of even more distorted conclusions (secondary automatic thoughts). So, adhering to the irrational belief "I should not make mistakes when creating a text," a person at the time of making a mistake is more likely than if there is a desire not to make mistakes, he will think: "I have dementia!", after which another requirement "I should not have dementia!" will "wedge" into these cognitions, which will lead to an even more distorted conclusion: "I have not just dementia, but its last stage!" While most clients notice only the most superficial automatic thoughts (if they notice at all, because they are often focused on their consequences, for example, anxiety and the bodily symptoms created by it). In other words, people, as a rule, realize only the tip of the iceberg, not seeing its foundation in the form of absolutist and rigid obligations (both primary and secondary).

The philosophical foundation of emotional dysfunctions

According to the methodology of rational-emotional-behavioral therapy, a person's perception and conclusion about an activating event (in other words, automatic thoughts in the form of A-perceived and A-deduced) do not create dysfunctional emotional and behavioral reactions as strongly (and with less probability) as imperative (duties) and evaluative derivatives (catastrophization, low tolerance to frustration and global assessment) beliefs. Indeed, as it appears from the example given earlier, the basis of the automatic thought "No one loves me" (A-derived) are catastrophic ("It's terrible if no one loves me"), "low-tolerant" to frustration ("It's unbearable to be unloved") and devaluing ("If no one loves me loves, so I'm a loser") attitudes that are the main cause of emotional stress in the context of the activating event. In this regard, S. Waltman notes that "irrational beliefs directly affect emotional disorder, which cannot be explained only by automatic thoughts" ^{[15, p. 152]}, and S. Nielsen, V. Johnson and A. Ellis emphasize that in addition to identifying and changing automatic thoughts, it is necessary to "help the client realize that he himself creates a dysfunctional philosophy and can constructively change it" ^{[16, p. 32]}.

So, if a person thinks: "Others reject me" (A-perceived) and "No one loves me" (A-derived), but at the same time does not require everyone to love him, and does not evaluate the absence of this love as "terrible", "unbearable" or as a sign of his own "inferiority", then will experience less pronounced negative emotions than in the case of adherence to imperative and derivative evaluative beliefs. Therefore, rational-emotional-behavioral therapy focuses on the elaboration of irrational beliefs (the duty and the triad of its satellites), and not on changing distorted and dysfunctional automatic thoughts, as it happens in A. Beck's cognitive therapy, which initially checks the accuracy of these automatic perceptions and conclusions. The RAP approach is especially relevant in cases where it is impossible to actually verify the accuracy of the perceptions and conclusions of the client, for example, who is worried that an acquaintance who did not greet him on the street does not respect him.Behind automatic thoughts of disrespect, the therapist can, together with the client, discover all four Ellis irrational beliefs: "Friends should respect me!", "If friends don't respect me, then it's terrible!", "It's unbearable if friends don't respect me!", "If friends don't respect me, it means that Naturally, in this situation, the therapist can (in the spirit of A. Beck's cognitive therapy) help the client to consider alternative interpretations of the behavior of an acquaintance (for example, an acquaintance might not notice the client; an acquaintance may have shortsightedness that the client does not know about; an acquaintance could be in a hurry on business and not to want to talk to anyone, etc.). However, from the point of view of RAPT, this would not be an elegant (philosophical) solution, since the fundamental attitudes that became the source of these dysfunctional automatic thoughts would not be affected.

Philosophical (elegant) and cognitive solutions

In this regard, the desire of some RAP therapists, first of all, to change the distorted perceptions and conclusions of the client. Dryden and M. Ninan call "temporary amnesia in the ABC model" and note that "if at this stage the psychotherapist can stimulate the client to study and change his distortions of conclusions, he will really be able to help the client, but will not penetrate into the underlying rigid/extreme attitudes" ^{[17, p. 203]}. The primary impact on dysfunctional beliefs (ought and its derivatives) is called an elegant (philosophical) solution by REPT representatives, while the initial change in the cognitive aspects of the activating event (A-perceived and A-derived), characteristic of A. Beck's cognitive therapy, is called an inelegant (cognitive) solution by REPT therapists. The elegance of the primary modification of irrational beliefs (the level of thinking that in cognitive therapy is called intermediate beliefs) also lies in the fact that the restructuring of these beliefs also contributes to the change of inaccurate perceptions and conclusions – automatic thoughts that grow out of these beliefs. In this regard, RAP therapists do not come into confrontation with dysfunctional or distorted automatic thoughts (A-perceived and A-deduced), but, as a rule, allow the worst scenario, temporarily recognizing the "truth" of perceptions and conclusions and focusing on challenging that this worst should not happen (as well as the fact that that dissatisfaction with this requirement will be "terrible", "unbearable" or negatively characterize a person, other people or the world as a whole).

The temporary assumption of the worst-case scenario is important because even if the client is mistaken and misinterprets reality, he experiences dysfunctional emotions not so much due to an incorrect interpretation of what is happening, but due to the fact that he frames his interpretations with imperative and value judgments. Therefore, one of the tasks of a RAP therapist is to demonstrate to the client that his dysfunctional automatic thoughts and distorted conclusions are the result of imperative beliefs (ought) and derived evaluative beliefs (catastrophization, low tolerance to frustration and global evaluation). In addition, as emphasized by A. Ellis and W. Dryden, "it is easier for people to make profound philosophical changes when they first admit that their conclusions are correct, and then challenge their irrational ideas, than when they first correct their distorted conclusions and then challenge the underlying irrational beliefs" ^{[18, p. 48]}. However, if the client's perceptions and conclusions (automatic thoughts) are clearly distorted and exaggerated ("I'm going to die soon!"), the therapist no longer admits the worst scenario, but shows the client that such distorted conclusions are the result of the same requirements ("I must not die in any case!").

It is advisable to demonstrate the fundamental difference between an elegant (philosophical) and inelegant (cognitive) solution using the following example:

A-confirmed. A student yawns at my lecture.

A is perceived. "The student doesn't listen to me well."

A-derived. "I'm boring lecturing."

In (irrational belief). "A student should listen to me with interest, and if he yawns and listens to me badly, then I am a boring teacher."

C (consequences). Depression.

Inelegant (cognitive) solution. The cognitive therapist, first of all, will start with a perception check and a conclusion: "How do you know that the student did not listen to you well? Could it be that he yawned not because you were bored with the lecture, but because he didn't get enough sleep or he was stuffy?" etc. Such arguments may temporarily convince a person of the falsity of his perceptions and conclusions, however, evidence to the contrary may gradually accumulate or an event disturbing a person may occur, and then the restructuring of automatic thoughts may not be sufficient.

An elegant (philosophical) solution. The RAP therapist will temporarily admit the truth of perception and inference and begin to challenge the irrational belief underlying these dysfunctional automatic thoughts: "Why should a student listen to you with interest?", "Why are you a boring teacher if he listens to you badly?", etc. Disputing these irrational beliefs will automatically change inaccurate perceptions and conclusions and allow the client to develop functional coping strategies for coping with similar situations in the future.

Correlation of automatic thoughts and irrational beliefs

If, after disputing an irrational belief (intermediate level – according to A. Beck), perceptions and conclusions (automatic thoughts) continue to cause dysfunctional emotions (which also happens), the RAP therapist can help the client assess the accuracy of these perceptions and conclusions, but will do so only after making an elegant attempt to challenge (underlying automatic thoughts) irrational belief and replace it with a rational statement (a new effective philosophy). Indeed, from the point of view of rational-emotional behavioral therapy, changing the quartet of irrational beliefs to rational analogues contributes to changing the more superficial automatic (distorted and dysfunctional) thoughts that grow out of them. Moreover, the triad of derived evaluative beliefs will also weaken its negative impact on a person's emotions and behavior if he abandons the nuclear installation of duty – demands on himself, others and the world.

Thus, an elegant solution in the form of philosophical disputation of irrational beliefs is a priority choice in RAPT, while a less elegant approach (assistance in changing the A-perceived and A-derived, as well as the A itself) for a RAPT therapist, as a rule, is less preferable. However, if the client for one reason or another cannot challenge his irrational beliefs, the RAP therapist helps him to change perceptions and conclusions about the event or even the event itself. So, for intellectually limited clients or clients with severe emotional stress, elegant philosophical interventions in the spirit of RAPT may not be too clear or accessible. A more appropriate solution in these cases may be to challenge the truth of perceptions and conclusions (distorted automatic thoughts), as well as the formulation and persistent training of rational coping thoughts. However, after that, the RAP therapist can return to more elegant (philosophical) solutions in the form of disputing irrational beliefs (intermediate level - according to A. Beck).

Changing distorted and dysfunctional automatic thoughts (perceptions and conclusions) by searching for alternative justifications and calculating the probability of negative events can be useful, but in this case there is a risk that a person will not form functional coping strategies in the event of the possible occurrence of these negative events (described by a person in perceptions and conclusions) and will continue tocontinue to believe in the original dysfunctional attitudes that will generate new distorted automatic thoughts in trigger situations for a person (activating events). In this regard, A. Joshi and K. Phadke note that "elegant therapeutic intervention does not focus only on eliminating symptoms, but provides coping strategies that clients can apply to solve a wide range of similar problems… This minimizes their chances of creating new emotional disorders in the future" ^{[19, p. 174]}. It should be noted that RAPT also distinguishes between elegant and inelegant therapeutic goals, the first of which includes the reduction of cognitive, emotional and behavioral symptoms, and the second includes not only the reduction of symptoms, but also the formation and consolidation of a new effective rational philosophy, leading to a decrease in the ability to generate dysfunctional emotional and behavioral reactions.

In addition, if working at the level of automatic thoughts requires (from the point of view of RAPT) many separate interventions for each cognition, then the philosophical challenge of irrational beliefs underlying automatic thoughts contributes to a massive change in these maladaptive cognitions. Although the RAP therapist sometimes discovers and corrects the cognitive distortions of the client, he especially focuses on the duties that are the philosophical core of irrational beliefs that generate various emotional dysfunctions. In this regard, deep philosophical discussion of irrational beliefs helps to eliminate unhealthy reactions of the client in many situations and to live healthy negative emotions if the worst still happens. Thus, both the RAP therapist and the cognitive therapist ultimately evaluate the accuracy of automatic thoughts (A-perceived and A-inferred), however. if the cognitive therapist starts with such an assessment, then the RAP therapist finishes with it (if necessary).

The sequence of changing levels of thinking

So, if in the context of A. Beck's cognitive therapy there is a layer-by-layer downward restructuring of deeper and deeper levels of thinking, then within the framework of A. Ellis's rational-emotional-behavioral therapy, nuclear irrational beliefs containing a duty and satellite attitudes growing out of it (catastrophization, low tolerance to frustration and global assessment (depreciation) immediately change). It should be noted once again that the quartet of these attitudes in cognitive therapy plays the role of intermediate beliefs (cognitive distortions), while for RAP therapists these beliefs are the deepest (nuclear) - especially due. In other words, if for a cognitive therapist, due acts as an intermediate belief, then for a RAP therapist it is the deepest level of thinking - a nuclear installation. However, for cognitive therapists, the most fundamental level of thinking appears to be deep–seated beliefs – ingrained ideas of a person about himself, others and the world, reduced to categories of worthlessness, unattractiveness and helplessness - according to J. Beck ^{[20, p. 257]}.

It should also be noted that if in rational-emotional-behavioral therapy, due plays a major role in emotional disorders and is the foundation of three derived beliefs, then in the context of cognitive therapy, due plays a lesser role in the genesis of emotional dysfunctions, because it is equivalent to other (intermediate – according to A. Beck) beliefs (cognitive distortions). At the same time, in RAPT, the negative self-concept of the client, called deep beliefs by cognitive therapists, does not have such a fundamental meaning as in cognitive therapy, in which these beliefs represent and reflect the most fundamental level of thinking. Indeed, as emphasized by J. Ruggiero, D. Sarracino, G. Caselli and S. Sassaroli, in the context of rational-emotional-behavioral therapy, "emotional disorders do not depend on distorted deep beliefs about themselves, but on functionally maladaptive assessments that are only partially related to "I" beliefs" ^{[21, p. 143]}. In this regard, in RAPT, the most "deep" beliefs are duties, from which, among other things, a person's global assessment of himself, others and the world grows, while in cognitive therapy these global value judgments (about himself, others and the world) reflect the level of deep beliefs, and duties act as "derivatives" from them beliefs (intermediate), compensating for these deep beliefs.

So, in A. Beck's cognitive therapy, the deepest level of thinking is deep beliefs (reduced to categories of worthlessness, unattractiveness and helplessness), the cognitive coping of which are intermediate beliefs (equivalent to each other dysfunctional attitudes, or cognitive distortions). Deep and intermediate beliefs are the foundation of distorted and dysfunctional automatic thoughts that arise in specific situations and generate dysfunctional emotional, physiological and behavioral reactions. In A. Ellis' rational-emotional-behavioral therapy, imperative beliefs (duties) appear to be the deepest level of thinking, from which derived evaluative beliefs (catastrophization, low tolerance to frustration and global assessment (depreciation)) follow. Similarly, imperative and derived evaluative beliefs are the foundation of distorted and dysfunctional automatic thoughts, but dysfunctional emotional and behavioral consequences are determined (mainly) by irrational beliefs containing a quartet of these dysfunctional attitudes. At the same time, it should be noted that, according to modern research, ought and global assessment (self-condemnation) are organized as autonomous cognitive structures (so-called "schemes"), while catastrophization and low tolerance to frustration are mostly derived (evaluative) cognitions. In this regard, the prospects of an integrative model synthesizing the methods of A. Beck's cognitive therapy and A. Ellis' rational-emotional-behavioral therapy can be associated with the designation of duty as a general attitude among intermediate beliefs (according to A. Beck), as well as with the consideration of a global assessment (which is one of the intermediate beliefs – according to A. Beck and one of the derived evaluative beliefs – according to A. Ellis), also as a deep conviction (worthlessness, unattractiveness and/or helplessness) (according to J. Beck).

Cognitive, emotional and behavioral differences

In addition, the difference between cognitive therapists and RAP therapists is that if the former, when identifying the client's thoughts, strive to preserve their individuality and the original language of the client's presentation, then the latter seek to discover among the client's cognitions the duties and their derivatives (including those not called by the client). Similarly, cognitive therapists strive for an objective description of the trigger situation, while in RAPT, an activating event can mean almost anything, including perceptions and conclusions (automatic thoughts). At the same time, if the very work with the client's cognitions carried out by the RAP therapist can be called disputing (challenging), which is more active, directive, energetic and philosophical than in cognitive therapy, then within the latter, it is more appropriate to call the work with the client's thoughts cognitive restructuring, proceeding, among other things, from the standard questions of the Socratic dialogue and conducted in a less directive format.

Thus, when describing dysfunctional patterns of thinking and behavior of the client, RAP therapists do not use the concept of "deep beliefs" (as well as the concept of "coping strategies"), but consider a specific irrational belief of the client as the cause of a specific emotional and/or behavioral problem manifested in a specific situation (activating event). Therefore, RAP therapists, unlike cognitive therapists, do not resort to building an abstract cognitive conceptualization of the client, but work on a deep philosophical dispute of a specific irrational belief of the client. In this regard, the formulation of the problem takes the place of the formulation of the client's (clinical) case in rational-emotional-behavioral therapy, since RAP therapists tend to quickly begin to solve a specific emotional and/or behavioral problem of the client that has arisen in the context of certain circumstances.

It should be particularly noted that rational-emotional-behavioral therapy is the only method and approach in psychotherapy that makes a qualitative distinction between healthy negative (justified, appropriate, adequate) and unhealthy negative (excessive, inappropriate, neurotic) emotions. In this regard, the purpose of RAPT is to replace unhealthy (dysfunctional, maladaptive) negative emotions that control a person with healthy (functional, adaptive) negative emotions that a person is able to control himself. The first include anxiety, anger, resentment, depression, guilt, shame, dysfunctional jealousy and dysfunctional ("black") envy. Healthy analogues of these maladaptive emotions are, respectively, excitement, irritation, annoyance, sadness, remorse, regret, functional jealousy and functional ("white") envy (admiration). So, the REPT seeks to eliminate unhealthy negative emotions, but to preserve negative emotions adequate to adverse situations, which are provided by rational statements (a new effective philosophy) and which contributes to the realization of human goals and values. Thus, the qualitative (rather than quantitative, as in cognitive therapy) difference between functional and dysfunctional emotions characteristic of RAPT allows the client not to demand from himself absolute disposal of a specific negative emotion, but to focus on changing only its dysfunctional part. It should also be pointed out that if the main attention in the REPT among dysfunctional reactions is paid to emotional and behavioral consequences, then A. Beck's cognitive therapy takes into account physiological (bodily) manifestations to a greater extent.

An important methodological difference between cognitive therapy and rational-emotional-behavioral therapy is the understanding of the nature of emotional disorder. While in cognitive therapy, emotional disorder is usually understood as one or another nosology (for example, "generalized anxiety disorder" or "obsessive-compulsive disorder), in rational-emotional-behavioral therapy, "emotional disorder" is often referred to as a specific emotionally charged episode from a person's life (for example, anger at his wife, anxiety about In other words, an emotional disorder is understood here as an unhealthy negative emotion experienced by a person about a particular problem (activating event). However, in the psychotherapeutic environment, an emotional disorder is considered to be not just a deterioration in mood or the presence of certain unhealthy negative emotions in a person, but a stable uncomfortable emotional state that forces a person to build his life around this state and does not allow him to realize his goals, desires, needs and interests.

Speaking about other distinctive and specific features of rational-emotional-behavioral therapy, it is also necessary to note its following characteristics:

• philosophical content content;
• existential-humanistic orientation;
• rejection of conditional self-acceptance (self-assessment) in favor of unconditional acceptance of oneself (as well as other people and the world (life) as a whole);
• emphasis on the priority elimination of secondary violations (for example, anxiety about anxiety);
• the choice in favor of exposure rather than desensitization techniques in order to prevent the increase of low tolerance to frustration;
• differentiation of the "feeling" of improvements and real qualitative changes in the client's condition;
• orientation towards vigorous, active challenging of the client's irrational beliefs;
• the desire for unconditional acceptance by the therapist of the client (and not for a positive attitude, which often implicitly leads to an increase in the neurotic dependence of the client on approval and love).

It should be emphasized separately that the most important goal of cognitive-behavioral and rational-emotional-behavioral therapy is to teach the client to be a therapist to himself, and not a mechanical "repeater" of rational statements voiced by the therapist. However, within the framework of RAPT, the client also learns to be a research scientist for himself, since the RAPT therapist teaches clients a scientific approach to thinking, as A. Ellis writes in this way: "He shows them that incorrect conclusions about objective reality or themselves arise from incorrect premises… He trains them to accept hypotheses as hypotheses, not as facts… It also shows how to experiment… with their own desires and activities to discover what they really would like to have in life" ^{[22, p. 100]}.

Conclusion

Thus, according to the cognitive model, which appears as the theoretical and methodological foundation of rational-emotional-behavioral therapy (RAPT) by A. Ellis and cognitive therapy (CT) by A. Beck, it is not the external circumstances of life, but the attitude towards them, expressed in the form of rational or irrational cognitions, that determines, respectively, the functional or dysfunctional reactions of the subject. Both therapeutic methods are solidified in a common understanding of the diagnostic and therapeutic stages of psychotherapy of emotional disorders, the essence of which is to identify dysfunctional cognitions, transform the latter into functional ones, as well as the practical consolidation of new worldview positions in the context of various situations. However, if in cognitive therapy the process of restructuring dysfunctional cognitions occurs due to the sequential change of deeper and deeper levels of thinking (automatic thoughts – intermediate beliefs – deep beliefs), then in rational-emotional-behavioral therapy a similar process, called disputing (challenging) irrational beliefs, is implemented in reverse order, because (from the point of view of The modification of imperative and evaluative beliefs derived from them (intermediate level – according to A. Beck) contributes to the automatic change of distorted perceptions and conclusions. In addition, if in A. Beck's cognitive therapy, the most fundamental level of thinking is a person's deep beliefs about himself, others and the world, then in RAPT these evaluative cognitions are derived from imperative beliefs – ought. The latter in A. Beck's approach is one of the intermediate beliefs (cognitive distortions), equal among others in the degree of its negative impact on human emotions and behavior, while in the RAPT A. Ellis's requirements act as a nuclear installation and the basis of a triad of satellites – catastrophization, low tolerance to frustration and global assessment.

As a result of the conducted research, other distinctive features of the considered therapeutic methods were also highlighted. Particular attention is drawn to the fact that if the cognitive solution to the problem of emotional disorders consists in verifying the truth of the client's perceptions and conclusions (including through alternative justifications and calculating the degree of probability of the worst scenario), then the philosophical (elegant) solution proposed by the REPT is to assume the worst outcome and challenge the catastrophic, "low-tolerant" to frustration and devaluing beliefs. Important in therapeutic terms are also such differences between rational-emotional-behavioral and cognitive therapy, as, respectively, subjectivism or objectivism in describing a trigger situation, a unified or individual approach in determining dysfunctional cognitions, qualitative or quantitative differentiation of negative emotions, the desire for exposure or desensitization behavioral interventions, emphasis on the formulation of client (clinical) the case or formulation of a specific client problem.

In addition, the work clarified the concepts of "belief" and "attitude", which are defined as perception matrices, or paradigms of thinking. In their dysfunctional expression, attitudes or beliefs (also regarded as cognitive distortions in cognitive therapy) are the source of irrational beliefs (from the point of view of RAPT) and distorted and dysfunctional automatic thoughts (from the point of view of CT) that arise in specific situations and cause emotional disorders. In turn, functional attitudes, or beliefs, appear as the cognitive foundation of rational statements (according to A. Ellis) and functional automatic thoughts (according to A. Beck). Finally, the study also outlines the prospects for creating an integrative model that combines elements of the approaches under consideration. This model can be based on the recognition of the attitude of duty as the main one among all intermediate beliefs (cognitive distortions), as well as on the situational consideration of the global assessment as a deep belief.

In conclusion, it is important to note that RAPT is not just an abbreviation of one of the areas of psychotherapy. Under these letters, as well as under each letter of the ABCDEFG model of psychological health, there is a designation of the process of therapeutic changes that are relevant both for the method of A. Ellis and for the approach of A. Beck:

R. Formation and consolidation of rational thinking (by disputing irrational beliefs).

E. The use of emotional techniques to consolidate the results of cognitive debate.

P. Consolidation of a rational worldview by bringing behavior in line with a new effective philosophy of life.

T. Achieving the set therapeutic goals.