The ABC of Therapy

What we can learn from a successful and much-used form of cognitive therapy.

Patrick Heller
5 min readFeb 6


The basic idea behind cognitive therapy is that rational thoughts of the client can overcome their irrational beliefs. Therapists will “force” clients to think from different angles by asking many questions or by stating observations that contradict the beliefs of the client.

American psychologist Albert Ellis (1913–2007) fell out of love with psychodynamic therapy in the 1950s. Instead of the elaborate therapy, Ellis introduced his now widely used ABC theory of emotions — in which A stands for Activating event, B for Belief, and C for Consequent emotion. With that, Ellis meant that the client was at one point triggered by an Activating event to a certain Belief, that led to a Consequent emotion.

For instance, one of your colleagues said “hi!” to another colleague this morning in the hallway on the way up to the coffee machine, but the “ hi!” was not returned. Your colleague now has the belief that nobody likes them at work and is therefore sad and a bit angry. The saying hi and the subsequent not returning of the hi is the Activating event. The Belief is that nobody likes them, and sadness and anger are the Consequent emotions.

The therapist will now address the irrational belief that “nobody likes them” by disputing that belief. Ellis was one to ridicule irrational beliefs with a sense of humor. He might have told our colleague to stop “awfulizing” — to stop making things worse than they truly are. One could question if the other colleague even heard the “hi”, or if they were sunken in thoughts instead. Or, even if this one colleague truly didn’t like them, that wouldn’t mean “nobody” liked them. The disputation by the therapist would eventually have to lead to a new belief in our client, namely that it is actually not the case that “nobody likes them”. Some have extended the ABC of Ellis to ABCDE, with the D standing for the Disputation, and the E for the Effective new belief.

Even though the therapist goes against the irrational belief of the client, the cognitive therapist will do so from an empathic and caring point of view, more in line with the humanistic therapy approach than with the psychoanalytic approach. Hence Ellis’ use of humor to dispute the irrational belief.

Having had this one-time insight and new belief is not the end of the therapy. The second phase takes longer and is more difficult. To replace long-held erroneous ideas with more healthy thoughts, the client is often given homework. Where psychodynamic psychotherapy is mostly done in the therapist’s office, cognitive therapy moves from the office to the client’s environment. The client might receive homework in the form of keeping a sort of diary in which they would have to write down any irrational thoughts they have during the day, and what might be a more healthy thought instead. Thus, the client makes themselves aware of the better, healthier alternatives, needing less and less help from the therapist. The therapist's role in this phase slowly transforms from being a teacher to being more of a coach. The frequency of meetings will go down and will — eventually — not be necessary anymore when the client has gained the upper hand on irrational thoughts.

ABC at work

This direct and thought-based therapeutic approach is very usable in an office environment. If I, as an Agile Coach, encounter a manager who has very old-fashioned ideas about running a department — very Theory X — then I need to be aware of Activating events happening to which the manager will respond with a certain belief and feel certain emotions about.

If, for instance, new unexpected work is coming in (Activating event), the manager might believe (Belief) that they must estimate the size of the work and divide the work among their teams, feeling irritated (Consequent emotions) by this new work forcing them to replan what was carefully planned out by them up-front.

I can then dispute the belief that the manager has to estimate the size of the work and that they have to divide the work among the teams. I can ask why the teams cannot do that themselves. I can suggest having a few people from different teams quickly have a look at the inbound work and have them assess which team would be best to pick this up. Once decided on the team, I will suggest to have that team estimate how much work it actually is, in their eyes. Once we know that, we can make a proper decision about when we should do this work.

In an Agile environment, I would insist the Product Owner of that team would take the lead on that decision. Thus, the estimate of the work will be much more realistic, the prioritization of the work will be healthier — business-wise, and the role of the manager in this process would have been minimized almost entirely, diminishing a lot of stress for both the manager and the rest of the department.

Every time unexpected work comes in, I — as a coach — will step in and confront the irrational beliefs of the manager, until the day comes when the manager themselves will say, I don’t need to worry about this, I’ll take this to the teams. Then my work — in that area — is done.

The biggest difference with the therapy is that it is a bit harder to give people homework in a work environment, but in some cases, even that might be applicable.

If you are interested in stories like these and more, you can buy Essential Psychology for Modern Organizations from Amazon and other bookstores:

Book cover.