Prioritising Which Irrational Beliefs to Target for Change
What It Is
When a client holds multiple irrational beliefs about a situation (or multiple situations), the therapist helps the client decide which belief to work on first. This is strategic: working on the right belief at the right time maximises progress and builds momentum.
Why It Matters
Clients often present with a tangled web of irrational beliefs. Without prioritisation:
- They feel overwhelmed (“Where do I even start?“)
- Therapy becomes unfocused
- Early wins are missed, which builds motivation
- Deeper beliefs may not be addressed because surface ones consume time
Prioritisation Criteria
1. Functional Impact
Which belief is causing the most distress or dysfunction?
- High impact: The belief directly drives major emotional symptoms or behavioral avoidance
- Lower impact: The belief contributes but isn’t the primary driver
2. Accessibility
Which belief can be most easily addressed right now?
- Start with beliefs the client is ready to examine (not the deepest trauma-related belief yet)
- Sometimes a smaller belief is a gateway to deeper ones
3. Sequential/Foundational
Are some beliefs foundational to others?
- Example: “I must be liked” may underlie “If people don’t like me, I’m worthless”
- Addressing the foundational belief may shift the secondary one
4. Client Readiness
What does the client want to work on?
- Respect their priorities; motivation matters
- Sometimes a “smaller” belief they care about provides momentum for deeper work
5. External Demands
Are there immediate life stressors requiring focus?
- A job presentation happening this week might take priority over longer-term relationship beliefs
- Meet urgent needs, then return to deeper work
How to Prioritise Collaboratively
1. Map the Beliefs
“I hear several beliefs operating here:
- You believe you must succeed at the presentation
- You believe that if you don’t succeed, people will judge you
- You believe that judgment means you’re not good enough
Which of these feels most important to work on first?“
2. Discuss the Impact
“If we worked on the belief that you must succeed, what might shift?”
“Which belief, if we changed it, would make the biggest difference in how you feel?“
3. Consider Practicality
“We could work on all of these, but often it helps to start with one. What feels doable?“
4. Agree Explicitly
“So let’s focus on the belief that you must be perfect. We can come back to the others. Does that feel right?”
Common Prioritisation Patterns
| Situation | Likely Priority |
|---|---|
| Acute crisis (panic, acute grief) | The belief driving the immediate distress |
| Multiple “smaller” beliefs | Often the one with highest functional impact or easiest to address |
| Foundational belief + derivatives | The foundational belief usually (shifting it cascades) |
| Conflicting values | The one blocking the client’s stated goal |
| Multiple domains (work, relationships, self) | Start with the one causing most distress or affecting others |
What NOT to Do
- Don’t impose your priority: Respect the client’s sense of what matters
- Don’t get distracted: Once you’ve agreed on a belief to address, stay with it in the session
- Don’t assume: Ask, don’t assume which belief is most important
- Don’t skip foundational work: If multiple beliefs are connected, addressing the root often helps most
Sequencing Over Time
Early sessions often address:
- Accessible beliefs (“This presentation situation”)
- High-impact beliefs (“I must be perfect”)
- More concrete situations
Later sessions often address:
- Foundational beliefs (“I’m only valuable if others approve”)
- Deeper fears (“I’m fundamentally unlovable”)
- Core philosophical positions on worth, control, fairness
Practice Criteria
You know you’ve prioritised well when:
- The client feels less overwhelmed
- Work on the first belief produces tangible shifts in emotion/behavior
- The client understands why you’re focusing here first
- Progress is visible and builds motivation for deeper work
Sources
A technique from REBT.