The efficacy of two kinds of cognitive-behavioral therapy (CBT) in relation to a clinical population were compared. The therapies differed on the dimension of how wedded they were to the rational-emotive behavioral therapy (REBT), a subtype of CBT that emphasizes a directive, confrontational approach to encourage a patient to recognize the irrationality of specific thought patterns. Forty adolescents at an inpatient clinic for treatment of self-destructive behaviors were randomly divided into two groups of equal size, one of which received the less challenging type of CBT (Treatment A) and one of which received the more challenging kind of CBT (Treatment B). All patients were treated by trained therapists in one-on-one sessions for 1.5 hours per day (broken down into 45-minute sessions) for six weeks. null and alternative hypothesis