The purpose of this paper is to introduce REBT (Ratinal and Emotive Behavioral Therapy), one of the most prominent cognitive and behavioral therapies among counselors and clinical psychologists, on the basis of the present author's long-term studies and practices as a clinical psychologist and a specialist of Oriental (or Chinese) medicine. REBT is inclusive integrative, and eclectic counseling invented by Ellis, A. The characteristics of REBT are as follows: (a) It's main purpose is to let the patients be aware of their implicit incoherence in their personal philosophy. (b) Being based on existential humanistic standpoint, which puts great values on just being and living, admits that human being is incomplete and makes mistakes, encourages to accept and overcome their weaknesses. (c) Emphasises the importance of the roles of emotion and behavior, whose malfunctioning can be recovered by modifying irrational beliefs. This paper ends with the introduction of some of my case studies on (1) atopic dermatitis, (2) eating disorder, and (3) menstrual disorder.

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The cause of various behaviors, such as severely challenging behavior, that are observed in persons with mental disabilities can often be traced to the interaction between the individuals and the environment, rather than to some impairment of the individuals. For these cases, pro-active treatments (Foxx, 1996), which use positive reinforcement to enhance alternatives to the individual's present behavior, are to be adopted, rather than reactive interventions, that is, ones in which the only focus is on eliminating the challenging behavior.
The present article presents the concept of “Behavioral QOL”, in which the quality of life of individuals is measured by the kinds of choices available to them and the number of opportunities they have for making choices among various positively reinforcing behavioral options. Behavioral QOL involves two aspects of individuals' quality of life simultaneously; environmental aspects and subjective satisfaction. In other QOL measures, the former have been measured by the improvement in environmental equipment and facilities, and the latter, usually by questionnaires given to individuals. In those QOL measures, each of the two dimensions has been considered separately. In contrast, Behavioral QOL is measured by individuals' behavior, where the individuals can choose aspects of their environment by themselves and express their degree of satisfaction with their choice by their ongoing interaction with the environment (=behavior).
Behavioral QOL can be classified into three levels. In the first level, only one behavior is possible, and that behavior is positively reinforced; in the second, alternatives are prepared, and the individuals can choose from among them; and in the third, the individuals can reject all the given alternatives and request something else.(View PDF for the rest of the abstract.)

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Studies on associations between social relations and health-related behaviors were reviewed. Most of the empirical studies show that individuals with good social support and social networks practice preventive health behaviors and that community adhesion is also related to healthy behaviors. However, there are inconsistent results according to support resources and gender. Intervention to promote healthy behaviors involving the significant others as a strategy seems to be effective for the patients with chronic illness. Since the effect of educational community intervention based mainly on the social learning theory seems to have limitations, more effective methodology is warranted.

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Change in the secretion rate of salivary s-IgA was examined on a basis of a typical triadic-yoked design. Thirty undergraduate women performed two response selection tasks continuously. In the former task they were exposed to controllable or uncontrollable aversive noise or rested (control group). Then the subjects in all groups were tested in another response selection task. Performance on the second task was poorer and the secretion rate of s-IgA increased more in the uncontrollable group than in the other two groups. However, perception of the controllability and subjective intense of stress did not differ between the groups. These results suggest that the controllability over aversive stressors defines performance in a subsequent task and modulates secretion of s-IgA without mediation of perception or consciousness about the controllability.

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To clarify the relationship between perceived job stress and sleep habits in Japanese healthy daytime workers, a total of 334 female employees of an electric equipment manufacturing company (age, 23 to 59, mean, 30.3 years) were surveyed using mailed questionnaires. Perceived job stress, i.e., job control, quantitative workload, variance in workload, skill underutilization, cognitive demands, and buffer factors as social support from supervisor, coworker, and family or friends was assessed by means of the Japanese version of the NIOSH job stress questionnaire; mean overtime per month was also calculated. The workers were asked about eleven sleep habits with greater score indicating poor sleep quality (daily sleeping hours (DSH), insufficiency of sleep, time to fall asleep (TFA), awakening during sleep (ADS), early morning awakening (EMA), sleeping poorly at night, dozing or napping in daytime, excessive daytime sleepiness (EDS) at work, being absent from or late for work due to oversleeping, use of medication to help sleep, and sought medical help for sleep problems).
After controlling for age by partial correlation coefficients in all workers, skill underutilization was positively correlated with DSH; cognitive demands were inversely correlated with dozing or napping in daytime and EDS at work; overtime was inversely correlated with DSH, and positively correlated with sleeping poorly at night. Also, supervisor support was inversely correlated with sufficiency of sleep and EMA; coworker support was inversely correlated with ADS; and support from family or friends were inversely correlated with insufficiency of sleep, TFA, ADS, and EMA. In addition, unmarried women showed an inverse correlation between quantitative workload and EDS at work; cognitive demands were positively correlated with sought medical help for sleep problems; overtime was inversely correlated with DSH. Married women showed a positive relation between quantitative workload and insufficiency of sleep or being absent from or late for work due to oversleeping; supervisor support was related to use of medication to help sleep and support from family or friends were inversely correlated with ADS and EMA.
The results suggest that job stress is associated with sleep habits in female daytime workers in Japan. Although some differences were found in married and unmarried women, sleep quality might be affected by job demands and social support at workplace and by family or friends.

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This study was conducted in order to find a way to manage the health care for elementary and junior high school pupils on the basis of the relation between psychosomatic symptoms and their stress for life event and living behavior. The subjects were the third-year junior high school pupils in 45 boys and 38 girls, who went to the one of three public junior high schools in Y town, near Himeji City in Hyogo Prefecture. The initial investigation was carried out in February 1996, when the subjects were the fifth-year elementary school pupils. The second investigation was conducted in July 1999. Psychosomatic symptoms were assessed by the questionnaire, consisting of fourteen conditions including “abdominal pain”, “orthostatic dizziness”, “sleeplessness” and “pains in upper or lower extremities” etc. According to the symptoms, the rates of “feeling oppressed in breathing”, “general malaise”, “orthostatic dizziness” and “bad feeling in the morning” significantly increased among boys (P<0.01, respectively). In addition, the rates of “feeling oppressed in breathing”, “general malaise”, “orthostatic dizziness”, “bad feeling in the morning”, “feeling strained in the eyes” and “feeling stiff in the shoulders” significantly increased among girls (P<0.01, respectively). The rates of “carsickness” and “sleeplessness” in girls were significantly larger than those in boys during elementary school period (P<0.05, respectively). The multivariate analysis, which uses Hayashi's quantification method I, indicated that “not having breakfast” in boys and “high stress score for not enough time to sleep” in girls were the most highly correlated with increase in the number of psychosomatic symptoms among elementary school pupils. In junior high school pupils, “going on a diet” in boys and “high stress score for not enough time to play” in girls were the most highly correlated with increase in the number of psychosomatic symptoms. These results suggest that an effective prevention strategy for decreasing the level of psychosomatic symptoms in junior high school pupils would be controlling sleep time and eating habits with careful consideration.

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