Journal of Rational-Emotive & Cognitive-Behavior Therapy (2021) 39:522–537

https://doi.org/10.1007/s10942-020-00384-x

Rational‑Emotive Behavior Therapy for Dysfunctional

Anger: A Case Study

Fedai Kabadayi1 · Galip Yuksel2

Accepted: 24 November 2020 / Published online: 1 January 2021

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021

Abstract
Anger and related problems are common conditions in everyday life. Anger is
often experienced as a feeling that leads to disruptive consequences. Often, anger
can be seen among young people, especially in romantic relationships. This case
study didactically presents rational-emotive behavior therapy treatment of dysfunc-
tional anger in an 18-year-old Turkish woman. The client mostly experienced inten-
sive anger problems including physical signs and symptoms. The therapy sessions
covered the client’s problems with her boyfriend. Treatment focused on disputing
irrational beliefs, engaging in imaginal exposure, providing psychoeducation about
the principles of rational-emotive behavior therapy, and cognitive restructuring.
Treatment was provided in eight sessions with a three-week follow-up. The client
filled out the Oxford Happiness Questionnaire – Short Form and the Trait Anger and
Anger Expression Scale. The questionnaires were used during the pre-test, mid-test,
post-test, and follow-up. The psychometric scores were clinically significant. Lev-
els of happiness and anger control increased, moreover the level of anger decreased
after the end of the rational-emotive behavior therapy-based sessions.

Keywords Dysfunctional anger · Disputing · Rational-emotive behavior therapy ·

Case study

This research was presented as an oral presentation at the 21st International Psychological
Counseling and Guidance Congress, October 2019, Antalya, Turkey.

* Fedai Kabadayi
[email protected]
Galip Yuksel
[email protected]
1
Faculty of Education, Department of Counseling and Guidance, Recep Tayyip Erdogan
University, Rize, Turkey
2
Gazi College of Education, Department of Counseling and Guidance, Gazi University, Ankara,
Turkey

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Rational‑Emotive Behavior Therapy for Dysfunctional Anger:… 523

Introduction

Anger is a forgotten emotion (DiGiuseppe and Tafrate 2007) that does not exist in
the categories of the DSM-5 (American Psychiatric Association 2013). Anger can
be characterized in terms of whether it is functional or dysfunctional. Functional
anger may occur as the result of an uncomfortable event or situation (Deffen-
bacher 2011) or as a means of mobilizing against a certain threat or while one is
under attack (Novaco 2011). Nevertheless, anger can be a subjective and negative
emotion that occurs under a certain threat or attack (Thooney 2019). Anger starts
with emotional injury and discomfort and can lead to a certain behavioral conse-
quence, including harm to oneself and others (Eifert and Forsyth 2011). Anger
may occur due to inflexible and demanding thoughts (Thooney 2019), particu-
larly interpersonal problems (Gorgu and Sutcu 2016).
The main reason why individuals have problems is believed to be demanding-
ness in classical rational-emotive behavior therapy (REBT) sessions, according
to Ellis (Ellis 1997). This assumption is evaluated based on Ellis’s ABC model.
Also, in DiGiuseppe’s model, irrational beliefs directly cause psychological dis-
turbance. Awfulizing, demandingness, global evaluation of worth, and frustration
intolerance directly cause psychological disturbance (DiGiuseppe et al. 2013).
Demandingness is related to unrealistic and excessive desire (Ellis 1997), includ-
ing the terms must, have to, and got to Dryden et al. (2010). Clients who use
demandingness intensively are exposed to psychological disturbance (DiGiuseppe
et al. 2013). Their frustration intolerance level in terms of withstanding problems
is low. The tendency to see even-worse problems is also related to awfulizing.
Additionally, awfulizing is a source of irrational beliefs regarding the evaluation
of worth self, others, and world (Dryden et al. 2010).
Clients with anger problems externalize the source of the problem and want
others to change when setting treatment goals (DiGiuseppe 2011). REBT focuses
on how events or situations are evaluated (Torun 2017). Anger can decrease indi-
viduals’ quality of life, as well as cause them to inflict physical harm on them-
selves and negatively affect their social relations, including with family. The
counseling process aims to reduce the severity of dysfunctional anger in REBT
sessions. In particular, dysfunctional anger from excessive demandingness must
be redefined as a disturbed negative emotion.
There are some Becks’ cognitive therapy or cognitive-behavior therapy (CBT)
(Beck 1993), Ellis’s REBT (Ellis 1995), and CBT or REBT based case stud-
ies (Kassinove and Tafrate 2011; Tudor et al. 2018) and effectiveness studies in
groups on anger (Askari 2019b). Cognitive-behavioral therapists do not focus on
eliminating anger completely (Kassinove and Tafrate 2011) because anger is a
natural feeling (Deffenbacher 2011). Instead, CBT focuses on reducing dysfunc-
tional anger. It is important to start sessions with a therapeutic alliance. Secondly,
it is necessary to motivate the client to change. After that, the therapist should
focus on anger in specific situations (DiGiuseppe 2011). Irrational thoughts of
the client are targeted in the disputing phase. It is important to challenge and dis-
pute irrational beliefs in REBT. If the client is prepared to dispute, the counseling

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process is more efficient (Dryden 2019). There are ways to dispute a client’s irra-
tional beliefs. The therapist can use logical, empirical, or functional styles (DiGi-
useppe et al. 2013). The therapist and client should consider alternative thoughts
after disputing. Thus, the client can experience a transition from irrational think-
ing to rational thinking, which means cognitive restructuring (Ellis 2003). After
that, cognitive, emotional, and behavioral techniques are used to reduce dysfunc-
tional anger in cognitive-behavioral therapies (Gorgu and Sutcu 2016). Imaginal
exposure can be used to reveal dysfunctional thoughts that cause anger. Alterna-
tive thoughts are created instead of irrational thoughts (DiGiuseppe 2011).
A recent meta-analysis indicates that CBT-based and other cognitive interven-
tions can be helpful in reducing anger (Del Vecchio and O’Leary 2004; DiGi-
useppe and Tafrate 2003; Lee and DiGiuseppe 2018). The effectiveness of group
interventions was tested in studies included in this meta-analysis (Askari 2019a;
Askari 2019b; Fuller et al. 2010; Shahkaram et al. 2020). There is cognitive therapy
(Dahlen 2007) with studies testing group effectiveness, and many clinical case stud-
ies based on CBT (González-Prendes and Thomas 2009; Takebe et al. 2017; Tudor
et al. 2018). Moreover, although there are classic REBT-based case studies (Cun-
ningham and Turner 2016; Johnson 2013; Newman 2014; Turner et al. 2020; Wood
et al. 2017), there are few classic REBT-based case studies which found a reduction
in anger (Schiffman 2016). Also, theoretical research, case studies, and experimental
practices regarding anger are minimal compared to those investigating depression
and anxiety (DiGiuseppe and Tafrate 2007). In other words, although there are clas-
sic REBT-based case studies on anger reduction, these studies remain limited, and
the classical REBT-based case study constitutes an important deficiency in the lit-
erature. This study aimed to present irrational beliefs about a partner in a romantic
relationship in a non-clinical case. We attempted to present a didactic perspective
for researchers and mental health practitioners about how irrational beliefs towards
partners in romantic relationships can be evaluated in a classical REBT-based case
study.
According to Markus and Kitayama (1991), self-structures affect cognition, emo-
tion and motivation. There are self-structures that are included as the independent
construal and the interdependent construal (Markus and Kitayama 1991). In com-
paring American and Japanese undergraduates student, Matsumoto et al. (1988)
found that American subjects reported experiencing their emotions (anger, frustra-
tion, pride etc.) longer than Japanese subjects. Turkish culture is more homogene-
ous, which leads to a collective perspective (Triandis 1995). Thus, Turkish society
also has more interdependent construal. Individuals in community culture focus
their emotions and emotional definitions according to relational-contextual factors
(Kagitcibasi 1996; Kagitcibasi 2019). This study provides evidence for the effective-
ness of REBT in individuals with interdependent construal. This study is distinct
from previous work in this regard. Moreover, some empirical findings are aimed at
reaching the effectiveness of a classic REBT-based therapy for partners and young
adults within romantic relationships. Also, in this case study, dysfunctional anger is
conceptualized based on the independence of DiGuiseppe’s irrational beliefs. This
may allow further testing of DiGuiseppe’s model in future studies. The present case
study seeks to apply the core principles of REBT, including disputing irrational

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Rational‑Emotive Behavior Therapy for Dysfunctional Anger:… 525

beliefs and engaging in imaginal exposure, cognitive restructuring, and psychoedu-

cation during sessions. Finally, this case study aims to provide a perspective on how
classic REBT can be effectively applied to a case that includes dysfunctional anger.

Method

Research Design

The present case study consists of A-B-A single design that involves the baseline,
intervention, and maintenance. Baseline is related to the measurements before the
intervention, intervention to the measurements at the intervention stage, and mainte-
nance to the permanence of the change after the intervention.

The Case

The client is an 18-year-old single Turkish woman. She has a romantic relationship
with her boyfriend, who has lived in another city for a year. She spent much of her
life in a small town in the western part of the Aegean region of Turkey. She has been
attending university for one year in Ankara, the capital city of Turkey. She enjoys
watching television and travelling. The client describes herself as an emotional,
angry, and thoughtful (kind) person. Her positive features include not turning away
people, being funny, and spending time with loved ones. The client defines herself
as a Muslim. The client has no history of smoking or alcohol/drug use.
The client applied at the counseling center of Gazi University because she had
been experiencing intensive anger problems for the past few months. She thought
that her problems had arisen, especially after she and her boyfriend started living
in different cities. She tried to stay calm and control herself when events and peo-
ple annoyed her, but her coping strategies failed. She experienced intensive anger
directed toward other people, especially her boyfriend. She did not physically attack
her boyfriend. The client reported many physical signs and symptoms (see Table 1).
She did not report a psychiatric diagnosis or chronic disease. The client stated that
she had previously used medication. The first problem she, which was dysfunctional
anger, was not adequately solved using coping strategies.

Table 1  Client’s physical signs Signs and symptoms Intensity

and symptoms
Headache Mostly
Nausea Mostly
Crying jags Often
Sleep-onset insomnia Mostly
Lack of energy Mostly
Poor appetite Mostly

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526 F. Kabadayi, G. Yuksel

The client has dysfunctional anger directed toward her boyfriend. Because of this
anger, she recently disrupted his daily work. The client called her boyfriend many
times and was furious when she couldn’t reach him on the phone. She said that her
boyfriend was extremely irresponsible and that he should fulfill his responsibilities.
According to the client, her boyfriend must have been someone who needed to bet-
ter understand responsibilities. She expressed this thought as: “If he had been organ-
ized, he would have had time to talk to me anytime.” She said, “We used to find time
before, now we can’t find time to meet.” The client was also angry that her boyfriend
did something without telling her. In a recent incident, she hadn’t been able to reach
her boyfriend for hours. Her boyfriend had lost his phone and, according to the cli-
ent, her boyfriend had to tell her somehow. Thus, she was violently angry with him.
Such issues were situations where responsibilities must be met. She rated her anger
toward her boyfriend at a level of 9 points (0 = min. anger, 10 = max. anger). The
client also stated that she was upset at a level of 7 out of 10. She hoped that, by the
end of the sessions, she would remain calmer during these events instead of reacting
so much to them. The client realized that this anger primarily hurt her and her boy-
friend. Her own solutions weren’t working, so she wanted professional help.
The client’s anger problem was conceptualized using the ABC model (see Fig. 1).
The emotional, behavioral, and physiological responses related to the client’s beliefs
are mainly determined in REBT (Ellis 1991). There are four types of irrational
beliefs, with demandingness being one of them. A variety of extreme desires, vio-
lent rules, and strict demands for others can be the basis of anger. The therapist aims
to demonstrate to clients how there is a working link between B and C (DiGiuseppe
et al. 2013). Psychoeducation can be used to focus on the link between B and C.

Measurement Tools

Oxford Happiness Questionnaire – Short Form (OHQ‑SF)

The original version of the Oxford Happiness Questionnaire – Short Form (OHQ-
SF) was developed (Hills and Argyle 2002). The Turkish version of the OHQ was
adapted by Dogan and Akinci-Cotok (2011). The short form of the scale consists
of eight items and an a-dimension. OHQ-SF measures happiness. Item examples
include “I am well satisfied about everything in my life.” and “I feel fully mentally

A B C

Emotions

Activating Beliefs Behaviors

Physiological Reactions

Figure 1  Conceptualizing Anger

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Rational‑Emotive Behavior Therapy for Dysfunctional Anger:… 527

alert.” The scale is a 5-point Likert type. Cronbach’s alpha value was .74. Item fac-
tor loads of the scale are between .53 and .72. Confirmatory factor analysis (CFA)
values were χ2 / df = 2.77, NFI = .92, GFI = .97, AGFI = .93, IFI = .95, RMR =
.04 and RMSEA = .04 (Dogan and Akinci-Cotok 2011).

Trait Anger and Anger Expression Scale (TAAES)

The original version of the State-Trait Anger Expression Scale (TAAES) was devel-
oped (Spielberger 1988). The Turkish version of the TAAES was adapted by Ozer
(1994). The Turkish form of the scale consists of 34 items and 4 dimensions include
Trait Anger (10 items), Anger Control (8 items), Anger In (8 items), Anger Out (8
items). Trait Anger dimension emphasizes anger, anger control dimension empha-
sizes control level of anger, anger out the orientation of anger, and anger in empha-
sizes internal orientation of anger. The scale is a 4-point Likert type. Cronbach’s
alpha value were between .67 and .92 for Trait Anger .80 and .90 for Anger Control,
.58 and .76 for Anger In, .69 and .91 for Anger Out (Ozer 1994).

Procedure

Counselor and Supervision

The first author is a counselor with six years of experience applying rational-emotive
behavior therapy in counseling sessions. He received licensing in a rational-emotive
behavioral therapy pre-practitioner program and was supervised at the Albert Ellis
Institute in Turkey. The second author is continuing studies as a counselor and pro-
fessor with 33 years of experience at Gazi University. The first author conducted the
sessions under the supervision of the second author.

Sessions and Assessment

Eight sessions and a follow-up session were held with the client. The sessions fol-
lowed the principles and techniques of REBT and included the ethical codes of the
counseling process. The counseling process was presented during the first, middle,
and final sessions as well as the follow-up. The sessions were recorded on video
because of the supervision process. Measurements were taken during session-1, ses-
sion-5, session-8, and the 3-weeks-follow-up.

Results

First Sessions

The first step in therapy is to develop a therapeutic alliance. This involves presenting
the client’s problem, conceptualizing the case, defining the problem theoretically,

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528 F. Kabadayi, G. Yuksel

assessing the problem using the principles of REBT, and, finally, identifying treat-
ment goals in the first session.

Middle Sessions

The intervention phase focused on the core principles of REBT: healthy and
unhealthy feelings (basically, anger), A-B-C, the connection between B and C, dis-
puting irrational beliefs, imaginal exposure, and cognitive restructuring. In this way,
the client would be able to convert dysfunctional anger into functional anger, have
more rational beliefs, and achieve treatment goals.

Principles of REBT (Psychoeducation)

The basic principles of REBT in psychoeducation were didactically presented to the

client. In this stage, the process was carried out in the context of a teacher-student
relationship. The focused principles were the following (DiGiuseppe et al. 2013).

1. Our feelings are determined mainly by thoughts and not by the event or situation.
2. Irrational thinking causes psychological disturbance.
3. Rational and irrational thoughts can be recognized by analyzing and interfering
with thoughts.
4. It is important to know healthy and unhealthy feelings. Healthy emotions are
functional and adaptive.
5. Irrational beliefs may be inflexible, but they can become rational thoughts by
concentrating on irrational beliefs and making efforts to change them.

Understanding the principles is extremely important. The client’s views on the

theoretical framework were critical to the continuation of therapy. The lack of a the-
oretical framework could have negatively affected the process. The basic principles
of REBT were reasonable for the client, and the consultation process could proceed
within this framework. Teaching the ABC model was the next step.

Introduction to A‑B‑C

The ABC model was taught to the client. It was emphasized that events or situa-
tions (A) cannot directly lead to consequences (C). It was also taught that reactions
(including emotions, behaviors, and physiological responses) are based on the indi-
vidual’s evaluation style. The way in which events were evaluated (B) was the deter-
minant of our responses (David 2015). Some of the statements (texts) discussed in
the sessions are given in order.

• “He shouldn’t leave his phone silent.”

• “I must reach him when I phone him.”
• “I can’t bear this kind of behavior.”
• “He should have informed me when he lost his phone.”

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Rational‑Emotive Behavior Therapy for Dysfunctional Anger:… 529

• “Responsibilities must be fulfilled.”

Targeting Connection B and C

It is important to teach the A-B-C model to the client. Among clients, the A-C con-
nection has been established many times instead of the B-C connection. If the client
learns the connection between B and C, they can more easily focus on their irra-
tional thoughts. A situation was evaluated according to the ABC model in the ther-
apy (see Fig. 2).

Disputing Irrational Beliefs

The client’s understanding of the model and learning connection between B and C
are the starting steps for the process. Indeed, many counselors with psychological
disturbances have reinforced their irrational thoughts many times, used them many
times, and molded them. Therefore, it is extremely important to show that irrational
thoughts are not functional or pragmatic. The client’s irrational thought is not func-
tional and must be challenged so that the client can focus on alternative thoughts.
At this stage, after information was provided about the disputing phase, the client’s
irrational thought was challenged through questions of functional and empirical ref-
utation (see Table 2).
The disputing phase was the most concentrated during the sessions. The targeting
of irrational thoughts during the refutation questions posed to the client caused the
client to pause in thought from time to time. The client’s identification of irrational
thoughts made the process much easier.

Imaginal Exposure

Cognitive interventions aim to make individuals feel things in a less emotionally

severe manner. The severity of anger decreases as the way of thinking changes
and becomes more controlled (Deffenbacher et al. 2002). During the disputing
phase, the client realized that her existing irrational thoughts should change. She
understood that the problem was not about the events themselves, but about how

A B C

Anger and sadness

Inability to reach The phone should not Repeated calls and

boyfriend by phone be left silent disruption of daily work

Increased heart rate and

frequency of breathing

Figure 2  Client’s A-B-C Model

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530 F. Kabadayi, G. Yuksel

Table 2  An example of dialogue between the counselor and client

Speaking Dialogs Strategy

Counselor I will ask you some questions at this stage. These questions Preparation to dispute
can make you feel stuck and tense. These questions will
target your way of thinking
Client Alright
Counselor You are saying that “The phone should not be left silent.” Empirical
Where are these allegations in writing?
Client There is no written rule, but… (silence)
Counselor But what?
Client The thought I believe
Counselor How does having this thought contribute to you? Functional
Client It does not contribute
Counselor So, what is the reason to keep believing this thought? Functional
Client Maybe I can change it

she evaluated those events. She said, “I think we will go to a big change; I think
there will be a change about myself.” Through the study of imaginal exposure,
a “rehearsal” is held so that the client can practice forming alternative rational
thoughts and experiencing how the events will take place. In this context, the cli-
ent performed this practice after each refutation stage. She realized that, in par-
ticular, feelings of anger and sadness will decrease through imaginal exposure.

Cognitive Restructuring

Cognitive restructuring aims to ensure that the client engages in rational think-
ing. The fact that new thoughts are rational features makes a change in the client’s
responses. The therapy was redesigned according to the client’s A-B-C model,
with the cognitive restructuring work carried out in this context (see Fig. 3).

Anger (0/10)
Sadness (0/10)

Inability to reach I can't reach him every Going through daily

boyfriend by phone time I call routines

No physiological reaction

Figure 3  Cognitive restructuring

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Rational‑Emotive Behavior Therapy for Dysfunctional Anger:… 531

New Rational Thoughts (Effect)

We discussed new ideas after cognitive restructuring with the client (see Table 3).

Final Session

The client’s changing views toward anger were discussed in the final session. The
client evaluated what had happened since the first session and what had changed.
She stated that it was important to be able to change her irrational thoughts ration-
ally, because of the excessive demands they made of her and the inability to tolerate
frustration. She stated that her thoughts toward her boyfriend were more flexible and
that she was happier and less angry. She focused on how, later in life, she could use
what she learned within the core principles of REBT.

Follow‑up

A follow-up was carried out with the client at the end of three weeks. The follow-up
study focused on how her life had progressed after the sessions. The client stated
that she could use the core principles of REBT in her current relationship, and that
she noticed her irrational thoughts and started with them. As a result, the client
stated that she had achieved the session’s goals.

Measurements and Clinical Significance

The Oxford Happiness Questionnaire – Short Form (Dogan and Akinci-Cotok 2011)
and Trait Anger and Anger Expression Scale (Ozer 1994) were used to assess the
change in the client’s scores. These were chosen to determine whether anger, anger
control, and happiness scores had changed. The questionnaires used pre-test (ses-
sion-1), mid-test (session-5), post-test (session-8), and follow-up after 21 days. The
scores were evaluated with RCI (reliable change index) only for the pre-test and
post-test. RCI scores are expected to be greater than 1.96 or less than − 1.96 (Jacob-
son and Truax 1992). Happiness (Dogan and Akinci-Cotok 2011), along with anger

Table 3  New rational thoughts

Oldest Newest

"I must reach him when I phone him", "I can’t bear this kind of “I may not reach him every time I call”
behavior"
"He shouldn’t leave his phone silent" “It would be nice if he did not leave his
phone silent, but it’s not terrible if it
happens”
"He should have informed me when he lost his phone", “Fulfilling responsibilities may be
“Responsibilities must be fulfilled” important, but it does not always
have to be like a law”

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532 F. Kabadayi, G. Yuksel

and anger control (Rahmatulin 2015), are compared for RCI. RCI scores indicated
that therapy has a significant rate of change (see Table 4).

Discussion

Anger is a negative emotion that can often be devastating, as it can seriously harm
oneself and others (Thooney 2019). It is usually caused by demandingness and frus-
tration intolerance toward others (McDermut et al. 2009). This feeling is divided
into dysfunctional anger (an unhealthy negative feeling) and functional anger (a
healthy negative feeling) (DiGiuseppe et al. 2013). This case study focuses on dys-
functional anger with a non-clinical client within the framework of REBT. The find-
ings revealed that a REBT-based treatment process can be effective in addressing
dysfunctional anger. There are similar studies in the literature and some evidence
regarding the effectiveness of REBT (Bulut-Serin and Genc 2011; Sharp 2003; Fla-
nagan et al. 2010).
In particular, this study focuses on the disputing phase. Disputing is an important
phase, as discussed in previous researches (Aldahadha 2018; Bernard 2009; Kopec
et al. 1994). Targeting the client’s irrational thoughts is an integral part of the pro-
cess. It helped her understand how harsh, certain, and absolute her thoughts could
be. However, the client contributed positively to the process through her rehearsing
and reinforcing of new ideas. After the disputing phase, she focused on alternative
thoughts with cognitive restructuring.
This study focuses on reducing dysfunctional anger in Turkish culture. There are
some risks, although the disputing phase is functional for the client. While indi-
vidualism is extremely high in the USA, it is lower in Turkey, where a collectivist
mentality is more common (Hofstede-Insights 2020). Turkish individuals may feel
stronger and more ready for change within the community because of their interde-
pendent construal society. This can be clearly observed during the therapy process.
Because individuals from Turkish culture may be more open to suggestions from
others (friends and/or especially experts) while seeking help, client’s may need the
opinions of others in addition to than their own opinions. Therefore, these clients
may have more difficulty in creating new alternatives (Phase E) after the disputing
phase (Phase D). The risk of the client’s need for expert opinion may have occurred
during the present therapy process. Because after the disputing phase, the shaking
of the irrational thoughts of the client that did not work revealed the need to have a

Table 4  Psychometric Scale Pre-test Mid-test Post-test Follow-up RCI

Measurements
Happiness 13 25 29 27 4.97*
Anger 30 16 15 12 4.40*
Anger Control 14 27 25 27 4.66*

RCI compared to pre-test and post-test

*Clinically Significant (greater than ±1.96)

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new thought. In this case, the client may not be able to produce a new and effective
rational thought in order to believe in a more flexible understanding. Interdepend-
ent construal cultures belonging to a particular group are important and may occur
later (Hofstede 1986). There are practical and psychological relations that involve a
mutual dependence between individuals within groups (Hofstede et al. 2010). Inter-
dependent construal individuals care about harmony in the group and do not want
the group to fall apart. In addition, stress can occur when the group process goes
backwards (Hofstede 2011). Thus, the client’s difficulty in producing a new alterna-
tive may increase her pressure and anxiety towards the counselor during the therapy
process. Although there is a more collective understanding in Turkish culture, these
risks always exist. Because individuals in the interdependent construal society may
cause them to pay more attention to the views of other people in the society than
occurs for individuals within an individualist society, and to be more open to the
views that come from them.

Limitations

The present case study has some limitations. These limitations are listed. We used
the Oxford Happiness Questionnaire - Short Form (Dogan and Akinci-Cotok 2011)
and the Trait Anger and Anger Expression Scale (Ozer 1994). It was also important
to determine the irrational beliefs of the client and to take measurements throughout
the sessions. However, when we designed the case study, no measurement instru-
ment could be preferred for the Turkish language in the current literature. This was
the first limitation of the present study. Second, we tested clinical significance by
including the pre-test and post-test. However, the clinical significance was not tested
for mid-test and follow-up. The third limitation, we calculated single measure for the
baseline. We avoided taking measurements in each therapy session due to the time
effect.

Conclusion

Anger has remained in the background in daily life, though the frequency of its
occurrence is higher as compared to that of other emotions. REBT-based case
studies focusing on dysfunctional anger are promising. This study has shown that
demandingness can be very beneficial to evaluate with various disputing questions.
The present study gives an idea of how to overcome their excessive demands, espe-
cially young adults in romantic relationships for mental health practitioners, counse-
lors, psychologists.
The difference of this study from CBT interventions is that it contains a com-
pletely classical REBT-based therapy. The classical REBT-based case study deter-
mined DiGuiseppe’s framework on irrational beliefs may directly cause psychologi-
cal discomfort during a clinical case study. Findings on psychometric measurements
have revealed preliminary evidence suggesting that DiGuiseppe’s model can be veri-
fied. Second, this study provides an insight into the effectiveness of an anger-related

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534 F. Kabadayi, G. Yuksel

REBT-based case study. This study plays an important role in case study research,
counseling and psychotherapy (McLeod 2003). Case studies are valuable for testing
clinical theoretical frameworks, and for describing causal relationships and demon-
strating in-depth interventions (Jones 1993). This case study can serve as a guide for
both testing the clinical significance of anger and happiness variables and for dem-
onstrating the classical REBT application for the treatment of anger.
The present study shows that the case studies on the treatment of anger in differ-
ent cultures should be expanded. Because the cultural context can affect the coun-
selor’s role in individuals to have a new effective rational thought. This case study
shows that the client from a more collectivistic culture may need counseling support
more to see new effective thoughts in phase E.

Recommendations

The research provides an important contribution by focusing on how young people

in romantic relationships can deal with dysfunctional anger. Classic REBT can be
very useful for young adults, especially for university students who utilize univer-
sities’ mental health or counseling centers. Future studies should focus on classic
REBT-based case studies that address other irrational beliefs (awfuling, global eval-
uation of worth, and frustration intolerance) in young people’s romantic relation-
ships. Moreover, classic REBT-based case studies can be tested in the ability of this
therapy to reduce the dysfunctional anger of partners in couple therapies. Further-
more, future studies may focus on various disputing questions in clinical cases.
Another key point may be what the role of the therapists or psychologists is
in collectivist cultures such as Turkish culture. Therapists should be careful and
develop some strategies for clients to produce alternatives in future studies. This will
help to create new and effective thoughts in classical REBT applied case studies
with individuals in the collectivistic community. Thus, they can carry out interven-
tions that can assist the client in the therapy to be effective.
We did not use a measuring instrument that measures irrational beliefs in this
study. However, in the expanding Turkish literature, there are now some scales that
can measure irrational beliefs, including Attitudes and Belief Scale-2 (Artiran and
DiGiuseppe 2020), General Attitudes and Beliefs Scale Short Form (Artiran 2019)
from 2019. These measuring instruments can also be used in future case studies.
Finally, future studies may also include follow-up and mid-test measurements for
RCI. Finally, future studies may include multiple measurements in the baseline and
follow-up.

Compliance with Ethical Standards

Conflict of interest The authors declare that they have no conflict of interest.

Informed Consent Informed consent was obtained between the counselor and the client, including volun-
taryparticipation, the theoretical framework of therapy, video recording, psychometricmeasurements, and
the research permit.

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Rational‑Emotive Behavior Therapy for Dysfunctional Anger:… 535

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