Reality Therapy

Developed by William Glasser, MD 1960’s Based on his ‘Choice Theory’ -- we are responsible for the behaviors we generate or choose. Focused on present behavior We can re-evaluate our current reality and choose behaviors that will help us to satisfy our needs more effectively now and in

the future Emphasizes the acceptance of personal responsibility; equated with mental health To be happy and effective we must live and plan in the present

View of Human Nature

The reality therapist views individuals primarily in terms of their behavior. Behavior is measured against reality, an objective standard. This could be practical reality, social reality or moral reality. He believes all human behavior is motivated by people striving to meet basic needs – physiological and psychological are the same for all individuals.

Basic Psychological needs a. The need to love and be lovedb. The need to feel that we are worthwhile to ourselves and to others

i. The two needs = identity – need to feel a sense of uniqueness, separateness, and distinctiveness.ii. “Successful identity” vs. “failure identity” – are developed from our involvements with others, which leads us

to feel successful or unsuccessful. Key Concepts

Focuses on present behavior, not feelings and attitudes What we want! Ignore the past, cannot be changed – the past is the source of our wants and our ways of behaving. Past only discussed when it relates to client’s current behavior Clients make value judgments about their own behavior Engage in definite plan to reach realistic and responsible behavior Learn how to meet needs in reality Teach responsibility – you are responsible for your own behavior

Therapeutic goals

Help clients define and clarify their life goals; help them find alternative ways to reach the goals; the client decides on the goals of therapy.

Therapist’s function and role

Establish a positive relationship with the client but the client assumes responsibility for his or her own behavior Assist the client with facing reality Serve as a guide to help the client realistically appraise their own behavior. Do not make value judgments or decisions for the client Help clients accept the real world and help them to fulfill their needs in the real world so they have no thoughts of denying

their future (suicide) Help the individual achieve autonomy with responsibility for who he is, who he wants to become and to develop responsible

and realistic plans to fulfill his goals Teach clients the meaning of reality and how to act responsibly within that reality Because present perceptions influence present behavior, we must help the client work through these perceptions. Give praise when clients act responsibly; show disapproval when they do not act responsibly.

Client’s experience in therapy

People take responsibility for who they are and what they want to become To develop responsible and realistic plans to fulfill their goals Clarify ways they are frustrated with their progress toward their self-defined goals

Techniques and Procedures

Focus on the client’s strengths and potentials relating to their current behavior as they are trying to succeed in life (procedure) Teaching the client the meaning of reality and showing them how to act responsibly in the context of that reality (technique) The major skill is put the responsibility upon the client May utilize homework assignments

Control Theory – Reality Therapy

View of Human Nature:

It is humanistic.

The therapist may be directive or confrontive, but the process is humanistic, targeting the problem behaviors and not the

person.

Encourages positive, personal involvement with clients rather than impersonal, judgmental, or punitive behaviors.

Encourages positive growth and success.

Refutes the medical or disease model of classifying behavior.

Key Concepts:

People are ultimately self-determining.

Although internal and external psychosocial pressures can influence or relate directly to current emotional functioning, in the

long run, clients are autonomous, selective, responsible people who are able to control their behaviors, thinking, and destinies.

Everything clients do is to satisfy their basic needs: the human brain is a system that regulates and monitors the external

environment to find need-satisfying or need-threatening people, events, behaviors, objects, situations, and choices.

Five basic needs: (1) the need to survive; ex. breathing, digesting, and sweating, (2) to love and belong; involves need for

friends and family, (3) for power; self-esteem, recognition, and competition, (4) for freedom; to make choices, and (5) for fun;

including play, laughter, learning, and recreation. These all need to be balanced for people to be in maximum control of their

lives.

The process (genetics) that drives our thinking, feeling, and behaving is neither moral nor immoral, the process is neutral.

Success identity vs. failure identity. Fulfilling needs in responsible or infringing ways.

Therapeutic Goals & Procedures + Therapist & Clients Roles:

Responsible behavior is the goal of therapy. This is defined as: fulfilling one’s needs in such a way that it does not deprive

others of the ability to fulfill their needs.

Focuses on four aspects of behavior: (1) acting; things you do, (2) thinking; thoughts and what you say to yourself, (3) feeling;

anger, joy, etc., and (4) physiology; ex. breathing.

Discussion and focus on the past are avoided because past behavior cannot be changed. Only current or present behaviors can

be changed.

*Learning is a central concept because it occurs throughout life and to a great extent we are what we do, what we learn to do.

Establish rapport with client, show support, warmth, and acceptance. Within this relationship the client and therapist, (1)

explore needs and perceptions, (2) explore and evaluate total behavior, and (3) plan and commit. It is important that the client

evaluate and come to conclusions in all of these areas.

It is important in this theory that clients take ownership of the problems and their behaviors now and ones being planned. The

therapist supports this process and may challenge or confront clients at times when they need extra support. The therapist also

talks about, focuses on, and reinforces positive and constructive planning and behaving.

Reference

Gilliand, B.E. & James, R.K. (1998). Theories and strategies in counseling and psychotherapy.

Needham Heights, MA: Allyn and Bacon.

Theory Summary 1- Reality Therapy (William Glasser)

View of Human Nature-Humans are responsible for their own behavior rather than genetics, society or history; humans make their own choices -Humans want to be in control; need to overcome perception of feeling inferior; need to feel secure and significant-Humans are motivated to satisfy one or more of five basic needs: 1) survival 2) love and belonging 3) power 4) freedom, and 5) fun; all humans have the same genetic need regardless of cultureKey Concepts-Almost all behavior is chosen; blaming others is unacceptable-Present perceptions of events influence our present behaviors -Emphasis is on the need for love and belonging since this is foundational to meeting the other four needs-Manifestations of mental illness and schizophrenia would disappear if person had a significant relationship with someone who cared and loved him/her, or if the person chose more need-satisfying behaviors; clients must not be labeled with mental illness diseases-All behavior is purposeful and effective behavior gets people what they want; ineffective behavior can also be purposeful (depression can be a way to avoid life situations)-Changing what we do is the key to changing how we feel and to getting what we want-Changing our emotions is difficult but need to focus on changing our thinking -Only look at past for successes; reliving painful past doesn’t benefit client -Reality theory is a therapy of hope; uses positive approach Therapeutic Goals-Empower client to find better ways to satisfy basic five needs (survival, love and belonging, power, freedom, and fun); encourage clients to establish satisfying relationships -Challenge client to evaluate what he/she is doing and to assess how well the behavior is working for client; client must accept responsibility for choices -Teach client more effective ways to deal with the worldTherapist’s Function and Role-Must establish good client-helper relationship or change will not occur; must be warm, empathic, and supportive; have egalitarian relationship; get involved with client; convey hope; focus on strengths and potentials that can lead to change and success-Help client to identify which of the five needs are not being met; -Help client recognize and be accountable for own behaviors; break negative patterns; help client to focus on new goals that are constructive and positive; may have to confront/challenge client sensitively -Ask what does client want? What is client doing to get what he/she wants? Is it working?-Help client make realistic goals/plans (simple, attainable, measurable, immediate, involved, controlled)

Client’s Experience in Therapy-Must be able to self-evaluate whether or not present behaviors are getting client closer to what he/she wants; identify voids in life-Change only occurs if client is willing to accept that current behaviors are ineffective-Understand that client can only control self not others; move towards having control over own lifeTherapeutic techniques and procedures-Uses WDEP system to identify: 1) client’s wants and perceptions; 2) what client is doing (acting, thinking, feeling, physiology); 3) whether client’s behavior is getting him/her closer or further from goal (evaluate); 4) create and implement workable plan to make positive changes (Is it working?)-Use “SAMIC” Plans- simple, attainable, measurable, immediate, involved, controlled-Therapy is educative; establish immediate, short term and long term goals; be specific-Makes use of positive addicting behaviors or meditations (running, visualization, chanting, swimming, etc.) to replace negative addictions (drugs, etc.)

Reality Therapy- William Glasser

View of Human Nature: Based on principle that all of our motivation and behavior is an attempt to satisfy one or more of our universal human needs; people are responsible for the behaviors that they generate or choose. Whatever humans do, think and feel has a purpose. Regardless of past experiences and influences, we can re-evaluate our current reality and choose behaviors that will help us satisfy our needs now and in the future.

Key Concepts: Based on Choice Theory, which places emphasis on person’s internal control, and that most (if not all) of our behavior is internally motivated, or chosen; focuses on the conscious, rather than unconscious aspects of living. Involves morals, standards, values, right/wrong behavior. This therapy rarely focuses on diagnosis, which is viewed as a label that keeps the client from accepting responsibility and achieving identity.

Therapeutic Goals: To get clients to face reality and take responsibility for decisions, not to make decisions for the client. It is important that the client achieves autonomy and that they take responsibility for who they are and who they want to become.

Therapist’s Function To act as a facilitator for the client’s actualizing process and help client & Role: realistically appraise their own behavior. The therapist shows praise when client acts in a responsible way, and

disapproval when they don’t. The counselor must be involved with the client and get the client involved in the process.

Client’s Experience: The client and counselor establish a trusting, involved relationship so that they can work together on an

individualized plan. The client begins to see the reality of their choices and their actions, and takes responsibility for their decisions. They work with the therapist to determine how they want to change and who they want to be. Through the process, they develop a sense of identity and responsibility for who they are.

Therapeutic Techniques The counselor acts as a teacher for the client, teaching them the meaning of & Procedures: reality and how to act responsibly within the context of that reality; ensuring that responsibility is placed on the

client. When the client is able to follow through with plans independently, they no longer need to see the counselor. The counselor also points out any discrepancies between what the client says and what the client does. Role playing, the use of humor, confronting the client, and helping the client formulate plans are all techniques used in this therapy.

Resources: Palmer S, ed. Introduction to Counselling and Psychotherapy: the essential guide. London, England: SAGE Publications; 2000:292-303.George RL, Cristiani TS. Theory, Methods, and Processes of Counseling and Psychotherapy. Englewood Cliffs, NJ: Prentice-Hall, Inc.; 1981:117-122.

Reality Theory

Theory Description

The Reality Theory is based on the theory that people are always trying, consciously or not, to meet the five basic needs: 1.

power, 2. love and belonging, 3. freedom, 4. fun, and 5. survival. The Reality Theory states that regardless of a client’s past, their

present and future is their own and is based on the behaviors chosen by the client. For example, the Reality Theory can help the client

reconnect with the people they need love or a sense of belonging from, starting with a connection between client and helper, which

can serve as a model to follow. This connection between client and helper requires the helper to create an environment of trust.

Along with this environment of trust is helping the client discover what they really want. Doing so requires a number of techniques

such as focusing on the present rather than the past, and not discussing symptoms or complaints. Also, this theory is based on what

the client can do directly which is act and think, and not based on feelings and physiology which are things this theory states most

likely cannot be changed by the client.

The Reality Theory states that the helper should avoid criticizing, blaming or complaining and help the client avoid these same

behaviors. The helper should aid the client in understanding that making excuses stands in the way of moving forward. This theory

states that it is appropriate to suggest plans to the client, but not condone any one particular plan and leave this choice up to the client.

The client’s responsibility is to be proactive in their therapy by working on what they can do in the present and future, rather than

what they may have done in the past.

Reality Therapy- “a therapy of hope, based on the conviction that we are products of the past but we do not have to go on being its victims.”

By Dr. William Glaser since the 1960’s

The approach is people friendly and people centered. Focuses on our future because our future is ours and success is based on the behaviors we choose.

Goal: help people reconnect

People have basic needs:

Power – achievement, feeling worthwhile, and winning

Love and Belonging – includes groups, families and or loved ones

Freedom – independence, autonomy, and having ones own space

Fun – pleasure and enjoyment

Survival – nourishment, shelter, and sex* We are always acting to meet these needs whether we are aware of it or not.

Questions asked to check if a client is meeting their needs:- What do you want? - What are you doing to get what you want?- Is it working?

* Our wants drives us as social beings

Counselor: - Helps the client to make a workable plan to get what he/she wants.

- Visits the past, but probably to a lesser extent than those who use other therapies.

*This past is seen as the source of our wants and of our ways of behaving.

- Helps client create a plan that concentrates in things that are in their control.- Helps client work through their present perceptions because these are what influences their present behavior.

- Avoids criticizing, blaming, and or complaining and helps client do the same

- Avoids discussing symptoms and complaints as much as possible since these are the ways that counselees choose to deal with unsatisfying relationships.

- Be patient and supportive but keep focusing on the source of the problem, disconnectedness.

Client:

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- Are able to know their responsibility and find self-empowerment.

- Are able to realize a positive change in their behavior.

* Our emotions are a good source of information about how we are doing and whether we are happy with what is going on in our lives.

- It’s very hard to change our emotions directly.

- It’s easier to change our thinking by concentrating on what we can do rather than what we think everybody else ought to do.

Changing what we do is the KEY to changing how we feel and to get what we want – control is important

The two primary ways in which control gets us in trouble:

- When we try to control others.

- When we use drugs and alcohol to give us a false sense of control.

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William Glasser developed the Reality Theory in the 1960’s. It is based on a concept called Choice Theory (originally called Control Theory). Since its introduction, Glasser and others have gradually polished both the theory and practical application of reality therapy. Reality therapy focuses on present behavior; the here-and–now of the client’s behavior. It emphasizes making decisions and taking control of one’s own life. Pointing out that our actions do have consequences. Typically, clients look to discover what they really want and whether what they’re currently doing (how they are choosing to behave) is actually bringing them closer to, or further away from, that goal. From his own observation and practice, Glasser found that by enabling clients to take responsibility for their behavior, they were able to make positive changes.

Reality therapy is based upon the assumption that there is a single psychological need for an identity that all people in all cultures possess from birth to death (George and Cristiani, 1981). Glasser distinguishes two kinds of identity: a success identity and a failure identity. Individuals with success identities define themselves as capable, competent, and worthwhile. People with failure identities see themselves as incapable, incompetent, and powerless. Reality therapy suggests that each of us develops our identity from out involvements with others and with our self-image, leading us to feel relatively successful or unsuccessful (George and Cristiani, 1981).

Reality therapy is centered on our five basic needs. The first is our primary and physical need for survival (food, clothing, nourishment, shelter, personal security). The remaining four needs are psychological. Connecting, belonging, love (including groups as well as families or loved ones). Freedom (autonomy, the ability to make choices, one’s own physical space). Self-worth, power (self-esteem, competence, empowerment). And the forth need being fun and enjoyment. Reality therapy emphasizes that we are acting (behaving) to meet these needs all the time. But we do not necessarily act effectively.

Becoming aware of present behavior is a very important aspect of reality therapy. Therapy focuses on current behavior rather than past experiences. Since the past cannot be changed, it is discussed in therapy only when it is related to current behavior. Helpers ask client to judge their behavior on the basis of whether it is good for them and the significant others in their lives. Once clients have made a value judgment about their behavior, they then formulate a realistic plan to carry out the judgment. Part of the helper’s job is to make sure the plan is not beyond the client’s ability and motivation to carry it out. In reality therapy, the client must then make a commitment to carry out the plan. Having a good plan does not necessarily mean that clients will carry it out, thus the need for commitment. The helper must hold clients to the commitment and accept no excuse for failure to follow the plan. In reality therapy, if there is no punishment, then there is no reason to accept excuses. The helper insists that the client carry out the plan.

The main goal of reality therapy is to help clients become responsible and to achieve a success identity (see themselves as capable and competent). However, Glasser insists that identity must come as a by-product of responsible action (Gilliland et al., 1984). In addition to the ultimate goal of responsibility, clients establish more immediate goals. Reality therapy helps people define and clarify their like goals and helps them clarify the ways they frustrate their progress toward those self-defined goals (George & Cristiani, 1981).

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Like most other theories, reality therapy regards the establishment of a warm and accepting relationship to be essential for effective helping to take place. The reality helper focuses on current behaviors and asks many questions about the client’s current life. The questions are focused on leading the client to greater awareness of behavior, and then planning more responsible behavior. In dealing with clients who say, “I’m very unhappy,” the reality helper does not ask them to elaborate on the feeling. Instead, the helper asks, “What are you doing to make yourself unhappy?” Reality helpers are very interactive and intervene by asking questions and discussing issues. They cling to the belief that the client can make better or more effective choices now in order to live a happier and more satisfying life. The reality helper is essentially a teacher. Helpers need to be responsible: tough, interested, human, sensitive (Mobley, 2005). They should be able to meet their own needs and be willing to share their struggles with others. Helpers must also experience and communicate empathy for and acceptance of the isolated, failure-identity client.

Reality therapy tends to make sense to clients because it emphasizes personal involvement, responsibility, success and action. Even though it can be confrontive, the helping targets problem behaviors, not the person. In reality therapy, when the client learns how to meet their needs more effectively in the present, the possible impact or influence of any past memories start to dissolve and the client can move forward. Such change is only achieved through persistence and hard work by the client and with caring and empathic support by the helper (Mobley, 2005).

In reality therapy, the basic technique is teaching; specifically, teaching clients the meaning of reality and showing them how to act responsibly within the context of that reality (George & Cristina, 1981). Reality therapy focuses on the present and leads clients to evaluate their own behavior in the light of their own goals. The value judgment needs to be followed by a realistic plan. Once the plan is developed, the clients need to make a commitment to carry out the plan. Confrontation may be needed due to the fact that in reality therapy, the helper does not allow any excuses. Setting limits is also important in reality therapy. Arguing constructively or discussing intelligently may be therapeutic for some clients (Mobley, 2005). Humor, too, can and should be a part of the helper’s approach. Reality therapy uses questioning more so than other approaches. The WDEP System provides a questioning framework. Each of the letters represents a idea:W-What do you Want? D-explores what the person is Doing to get what they want. E-Evaluation of direction, actions, wants, perceptions, new directions, and plans. P-Plan (Mobley, 2005). The reality helper may ask questions such as:Is what you want realistic and attainable?How committed are you to working things out?Is what you are doing getting you closer to the people you need?What else could you do?

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Reality Therapy Summary—NOW Choice Theory (1998)

William Glasser, 1965

View of Human Nature—--we are all social animals----our problems result from our need for power over others—we want to control others because of this power need. this causes disconnectsWe are all either involved in an unsatisfying relationship or lack what would even be called a relationshipWe have five genetically encoded needs: survival, love, power, freedom and fun-these needs drive all of us to try to figure out behaviors to satisfy these needs.

TREATMENT GOAL: HELP PEOPLE RE-CONNECT!!!!

Assumptions: need for power over others has resulted in our “disconnection” from important figures in our lives Therapeutic Techniques: Focus on the PRESENT--- all problems are caused by the present……Avoid discussing past and complaints, symptoms as these have been the ways clients have dealt with the problemsDon’t focus on the symptoms—these are what have “protected us”Avoid criticizing, blaming, complaining Focus on total behavior---on what clients can do directly—…….the only person I can control is me…………..Ask ourselves the Constant question:“Is what I am doing getting me closer to the people I need?”Counselor-Client Roles: this Relationship is vital to help with connections—use this connection as the model for all others…Counselor-----Non-judgmental--- help make specific, workable plans-always open to revisionMentoring process where the therapist is teacher—“We’re in this together”Rejects Medical Model of Mental Illness----we are depressing, instead of depressed—all is BEHAVIOR!

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