Reality therapy

Reality therapy (RT) is an approach to psychotherapy and counseling. Developed by

William Glasser in the 1960s, RT differs from conventional psychiatry, psychoanalysis and
medical model schools of psychotherapy in that it focuses on what Glasser calls psychiatry's
three Rs: realism, responsibility, and right-and wrong, rather than symptoms of mental
disorders.

Reality therapy maintains that the individual is suffering from a socially universal
human condition rather than a mental illness. It is in the unsuccessful attainment of basic
needs that a person's behavior moves away from the norm. Since fulfilling essential needs is
part of a person's present life, reality therapy does not concern itself with a client's past.
Neither does this type of therapy deal with unconscious mental processes. In these ways
reality therapy is very different from other forms of psychotherapy.

The reality therapy approach to psychotherapy and problem-solving focuses on the

here-and-now actions of the client and the ability to create and choose a better future.
Typically, clients seek to discover what they really want and how they are currently choosing
to behave in order to achieve these goals. According to Glasser, the social component of
psychological disorders has been highly overlooked in the rush to label the population as sick
or mentally ill.

Reality therapy attempts to separate the client from the behavior. Just because
someone is experiencing distress resulting from a social problem does not make him sick, it
just makes him out of sync with his psychological needs. Reality therapy was developed at
the Veterans Administration hospital in Los Angeles in the early 1960s, by William Glasser
and his mentor and teacher, psychiatrist G. L. Harrington. In 1965, Glasser published the
book Reality Therapy in the United States. The term refers to a process that is people-friendly
and people-centered and has nothing to do with giving people a dose of reality (as a threat or
punishment), but rather helps people to recognize how fantasy can distract them from their
choices they control in life.

Glasser posits that the past is not something to be dwelled upon but rather to be
resolved and moved past in order to live a more fulfilling and rewarding life. By the 1970s,
the concepts were extended into what Glasser then called "Control Theory", a term used in
the title of several 2 of his books. By the mid-1990s, the still evolving concepts were
described as "choice theory", a term conceived and proposed by the Irish reality therapy
practitioner Christine O'Brien Shanahan and subsequently adopted by Glasser. The practice
of reality therapy remains a cornerstone of the larger body of his work. Choice theory asserts
that we are self-determining beings because we choose our behavior and we are responsible
for how we are acting, thinking, feeling and also for our physiological states. Choice theory
explains how we attempt to control our world and those in it.

Reality therapy is based on choice theory; it explains why and how we function. Reality
therapy provides a delivery system for helping individuals take more effective control of their
lives. If choice theory is the highway, reality therapy is the vehicle delivering the product
(Wubbolding, 2011a). Therapy consists mainly of helping and sometimes teaching clients to
make more effective choices as they deal with the people they need in their lives. Glasser
maintains that it is essential for the therapist to establish a satisfying relationship with clients
as a prerequisite for effective therapy. Once this relationship is developed, the skill of the
therapist as a teacher assumes a central role.
Key concepts

View of Human Nature

Choice theory posits that we are not born blank slates waiting to be externally motivated by
forces in the world around us. Rather, we are born with five genetically encoded needs that
drive us all our lives: survival, or self-preservation; love and belonging; power, or inner
control; freedom, or independence; and fun, or enjoyment. Each of us has all five needs, but
they vary in strength. For example, we all have a need for love and belonging, but some of us
need more love than others. Choice theory is based on the premise that because we are by
nature social creatures, we need to both receive and give love. Glasser (2001, 2005) believes
the need to love and to belong is the primary need because we need people to satisfy the other
needs. It is also the most difficult need to satisfy because we must have a cooperative person
to help us meet it.
Choice Theory Explanation of Behavior
Choice theory explains that all we ever do from birth to death is behave and, with rare
exceptions, everything we do is chosen. Every total behavior is our best attempt to get what
we want to satisfy our needs. Total behavior teaches that all behavior is made up of four
inseparable but distinct components—acting, thinking, feeling, and physiology—that
necessarily accompany all of our actions, thoughts, and feelings.
 The “WDEP” System
Wubbolding (2000) uses the acronym WDEP to describe key procedures in the practice of
reality therapy. The WDEP system of reality therapy can be described as “effective, practical,
usable, theory-based, cross-cultural, and founded on universal human principles”. The WDEP
system can be used to help clients explore their wants, possible things they can do,
opportunities for self-evaluation, and design plans for improvement (Wubbolding, 2007,
2011a, 2011b). Grounded in choice theory, the WDEP system assists people in satisfying
their basic needs. Each of the letters refers to a cluster of strategies: W= 5 wants, needs, and
perceptions; D =5 direction and doing; E =5 self-evaluation; and P= 5 planning. These
strategies are designed to promote change.
 wants (exploring wants, needs, and perceptions) :Reality therapists assist clients in
discovering their wants and hopes. All wants are related to the fifi ve basic needs.
The key question asked is, “What do you want?” Through the therapist’s skillful
questioning, clients are assisted in defining what they want from the therapeutic
process and from the world around them. It is useful for clients to define what they
expect and want from the counselor and from themselves
 direction and doing: The focus on the present is characterized by the key question
asked by the reality therapist: “What are you doing?” Even though problems may be
rooted in the past, clients need to learn how to deal with them in the present by
learning better ways of getting what they want. Problems must be solved either in the
present or through a plan for the future. The therapist’s challenge is to help clients
make more need-satisfying choices.
 self-evaluation: Self-evaluation is the cornerstone of reality therapy procedures. The
core of reality therapy, as we have seen, is to ask clients to make the following self-
evaluation: “Does your present behavior have a reasonable chance of getting you what
you want now, and will it take you in the direction you want to go?” Specifically,
evaluation involves the client examining behavioral direction, specific actions, wants,
perceptions, new directions, and plans.
 planning and action: Much of the significant work of the therapeutic process involves
helping clients identify specific ways to fulfil their wants and needs. Once clients
determine what they want to change, they are generally ready to explore other
possible behaviors and formulate an action plan. The key question is, “What is your
plan?” The process of creating and carrying out plans enables people to begin to gain
effective control over their lives. If the plan does not work, for whatever reason, the
therapist and client work together to devise a different plan. The plan gives the client
 a starting point, a toehold on life, but plans can be modified as needed. Throughout
this planning phase, the therapist continually urges the client to be willing to accept
the consequences for his or her own choices and actions. Not only are plans discussed
in light of how they can help the client personally, but plans are also designed in
terms of how they are likely to affect others in the client’s life
Characteristics of Reality Therapy

Emphasize choice and responsibility: If we choose all we do, we must be responsible for
what we choose. This does not mean we should be blamed or punished, unless we break the
law, but it does mean the therapist should never lose sight of the fact that clients are
responsible for what they do. Choice theory changes the focus of responsibility to choose and
choosing.
Reality therapists deal with people “as if” they have choices. Therapists focus on those areas
where clients have choice, for doing so gets them closer to the people they need. For
example, being involved in meaningful activities, such as work, is a good way to gain the
respect of other people, and work can help clients fulfil their need for power.
Reject transference: Reality therapists strive to be themselves in their professional work. By
being themselves, therapists can use the relationship to teach clients how to relate to others in
their lives. Glasser contends that transference is a way that both therapist and client avoid
being who they are and owning what they are doing right now. It is unrealistic for therapists
to go along with the idea that they are anyone but themselves.
Keep the therapy in the present: An axiom of choice theory is that the past may have
contributed to a current problem but that the past is never the problem. To function
effectively, people need to live and plan in the present and take steps to create a better future.
We can only satisfy our needs in the present. The reality therapist does not totally reject the
past. If the client wants to talk about past successes or good relationships in the past, the
therapist will listen because these may be repeated in the present. Reality therapists will
devote only enough time to past failures to assure clients that they are not rejecting them.

Avoid focusing on symptoms: In traditional therapy a great deal of time is spent focusing on
symptoms by asking clients how they feel and why they are obsessing. Focusing on the past
“protects” clients from facing the reality of unsatisfying present relationships, and focusing
on symptoms does the same thing. Glasser (2003) contends that people who have symptoms
believe that if they could only be symptom-free they would fifi nd happiness. Whether people
are depressing or paining, they tend to think that what they are experiencing is happening to
them. They are reluctant to accept the reality that their suffering is due to the total behavior
they are choosing. Their symptoms can be viewed as the body’s way of warning them that the
behavior they are choosing is not satisfying their basic needs. The reality therapist spends as
little time as he or she can on the symptoms because they will last only as long as they are
needed to deal with an unsatisfying relationship or the frustration of basic needs.

The therapeutic process

Therapeutic Goals
A primary goal of contemporary reality therapy is to help clients get connected or
reconnected with the people they have chosen to put in their quality world. In addition to
fulfilling this need for love and belonging, a basic goal of reality therapy is to help clients
learn better ways of fulfilling all of their needs, including achievement, power or inner
control, freedom or independence, and fun. The basic human needs serve to focus treatment
planning and setting both short- and long-term goals. Reality therapists assist clients in
making more effective and responsible choices related to their wants and needs.
Another goal entails working with an increasing number of involuntary clients who
may actively resist the therapist and the therapy process. These individuals often engage in
violent behavior, addictions, and other kinds of antisocial behaviors. It is essential for
therapists to do whatever they can to get connected with involuntary clients. If the therapist is
unable to make a connection, there is no possibility of providing significant help. If the
therapist can make a connection, the goal of teaching the client how to fulfil his or her needs
can slowly begin

Therapist’s Function and Role

Therapy is often considered as a mentoring process in which the therapist is the teacher and
the client is the student. Reality therapists teach clients how to engage in self-evaluation,
which is done by raising the question, “Is what you are choosing to do getting you what you
want and need?”
The role of the reality therapist is not to make the evaluation for clients but to challenge
clients to examine what they are doing. Reality therapists assist clients in evaluating their
own behavioral direction, specific actions, wants, perceptions, level of commitment,
possibilities for new directions, and action plans. Clients then decide what to change and
formulate a plan to facilitate the desired changes.
The outcome is better relationships, increased happiness, and a sense of inner control of their
lives (Wubbolding, 2011b). It is the job of therapists to convey the idea that no matter how
bad things are there is hope. If therapists are able to instil this sense of hope, clients feel that
they are no longer alone and that change is possible. The therapist functions as an advocate,
or someone who is on the client’s side. Together they can creatively address a range of
concerns and options.
Relationship Between Therapist and Client
Reality therapy emphasizes an understanding and supportive relationship, or therapeutic
alliance, which is the foundation for effective outcomes (Wubbolding & Brickell, 2005;
Wubbolding, Robey, & Brickell, 2010). The therapist’s skill in establishing a trusting
relationship is critical. It is also important that the client perceives the therapist as being
skilled and knowledgeable. Although the therapeutic relationship is paramount, it is not an
end in itself, and it is not automatically curative or healing

Therapeutic techniques and procedures

Reality therapy is not a technique-focused psychotherapy system. reality therapists do tend to

use certain psychotherapeutic techniques more than others (Wubbolding & Brickell, 1998).
The ones that are more commonly used are described here: questions, being positive,
metaphors, humor, confrontation, and paradoxical
intention.

Questioning

Questions play an important role in exploring total behavior, evaluating what people are
doing, and making specific plans. Wubbolding(1988) suggests that questions can be useful to
reality therapists in four ways: to enter the inner world of clients, to gather information, to
give information, and to help clients take more effective control. When reality therapists help
clients explore their wants, needs, and perceptions, they do so by asking clients what they
want and follow the question with more questions to determine what they really want. They
also ask clients what they are doing and what their plans are. These questions help the reality
therapist understand the inner world (the wants, needs, and perceptions) of clients. Questions
give clients choice and, through choice, control over how they are to change their lives. It
should be noted that therapists should not overuse questions but integrate them with reflective
and active listening, sharing of perceptions, and other statements.
Being positive. The reality therapist focuses on what the client can do. Opportunities are
taken to reinforce positive actions and constructive planning. Positive statements are made to
statements of misery and complaint. For example, if a client says, “I am angry about what
Mary said to me today,” the reality therapist does not respond, “Has this been happening to
you for a long time?” or “You’re feeling angry that Mary doesn’t treat you well.” The reality
therapist might respond, “What are you going to do so that you will not choose to anger at
Mary?” The emphasis of the counselor’s questions is on positive actions.
Metaphors. Attending to and using the client’s language can be helpful in communicating
understanding to a client through use of her language. In this technique, the therapist is
talking in a way that is congruent with the client’s personal perceptions.
Humor. Because of the friendly involvement that reality therapists try to develop with their
clients, humor fits in rather naturally. Therapists sometimes have the opportunity to laugh at
themselves, which encourages clients to do the same (Glasser & Zunin, 1979). This can take
the pressure off client disappointment if plans are not realized. Because fun is a basic need,
according to reality therapy, it can sometimes be met to a small degree in the therapy session
itself. When the therapist and client can share a joke, there is an equalizing of power and a
sharing of a need (fun). To the extent that humor can create a greater sense of friendly
involvement, it also helps to meet the client’s need for belongingness.
Confrontation. Because reality therapists do not accept client excuses and do not give up
easily in their work, confrontation is inevitable. Helping clients to make plans and to commit
to plans for behaviors that are difficult to change means that often plans are not carried out as
desired. In confronting, the therapist can still be positive in dealing with client excuses. Not
accepting them is a form of confrontation. The therapist does not criticize or argue with the
client but rather continues to
work to explore total behavior and to make effective plans.
Paradoxical techniques. Paradoxical techniques are those that give contradictory
instructions to the client. Reframing and prescriptions are two paradoxical techniques. These
paradoxical instructions help clients feel that they are in control and that they choose their
behavior. To choose to feel more depressed means that an individual can also choose to feel
less depressed.
Reframing helps individuals change the way they think about a topic. Reframing can help a
client see a behavior that was previously undesirable as desirable. If a young man says that he
is upset because a young woman refused his invitation to dinner, this can be reframed by
commenting on the young man’s strength in asking the woman out for dinner and for
weathering rejection. Reframing helps individuals look at their behavior as a choice. This
leads to a greater sense of control.
Paradoxical prescriptions refer to instructing the client to choose a symptom. For example, if
a person is concerned about blushing, he can tell others how much he blushes and how often.
If a person is choosing to depress, she can be told to schedule the depression—to depress at
certain times. These instructions give individuals a means of controlling their behavior, an
important aspect of
control theory.