Reality Therapy
William Glasser Robert Wubbolding
Development of Reality Therapy
Glasser labeled reality, responsibility, and right and wrong. He believed that all people have two basic and intertwined human needs: relatedness (to love and be loved) and respect (to feel worthwhile to oneself and others). To feel self-worth, one needs to appreciate their own needs and the needs of others. There is an appreciation of individual differences and the importance of right and wrong is part of the therapeutic process. This therapy will also identify the causes and treatment for emotional difficulties
(Glasser, 1965).
Eights steps for clinicians in reality therapy
1. Build rapport with clients.
2. Ask "What are you doing?"
3. Collaborate with clients in evaluating their behavior
4. Help people make a plan to do better
5. Help clients commit to the plan
6. Do not accept excuses
7. Do not interfere with reasonable consequences
8. Do not give up!
(Evans, 1982)
Control Theory
Glasser "conceptualized people as driven by inner control systems in the brain that guide behaviors and emotions so that they are instrumental in moving people in directions that seem likely to fulfill their needs." To modify our control systems, awareness and assessment are key to improving our lives. People need to be aware of what they need and want. Then, we can decide what our goals are and whether or not there needs to be a chance in behavior.
(Glasser, 1984)
Choice Theory
The choices we make affect the quality of life and the main goal is to help people improve their lives.
Important Theoretical Concepts
Human Development
In reality therapy, the way to have emotionally healthy children is to provide them with experiences to feel powerful and free so that they can learn to be responsible. This helps children to believe in themselves and show them that they are able to meet their needs. This therapy also believes that people have the ability to overcome difficulties and doesn't focus on the past. The past is not a focus because it's believed that past issues manifest themselves in the present.
Five Basic Needs
1. Belonging : Loving and being loved; having contact, connections, interactions, and relationships with people
2. Power/achievement : Feelings of accomplishment and competence, self-esteem, success, and control over one's own life
3. Fun/enjoyment : Pleasure; the ability to make choices; to live without excessive and unnecessary limits or constraints
4. Freedom/independence : The ability to make choices; to live without excessive and unnecessary limits of constraints
5. Survival : The essentials of life, including good health, food, air, shelter, safety, security, and physical comfort
Because the needs overlap, fulfillment of one need may expedite fulfillment of another need. Even though everyone has these basic needs, they differ in the way they manifest themselves in individuals.
(Wubbolding, 1991)
Concept of Mental Illness
It's believed that mental illness doesn't come from something wrong with the brain. The symptoms are there and can be taken care of with choice therapy. Mental Illness, according to reality therapy, is actually people's failure to meet their five needs in responsible and effective ways - overemphasizing some needs while neglecting others (Seligman & Reichenberg, 2014, p. 372). Glasser believes that people pick their symptoms due to their lack of control of their reality. Rather than medication, people are encouraged to connect with others and do no harm (Glasser, 1998a).
Common symptoms of emotional difficulties
1. Loneliness (rather than belonging)
2. Loss of control (rather than empowerment)
3. Boredom and depression (rather than fun)
4. Frustration, inhibition, or rebelliousness (rather than freedom)
5. Illness or deprivation (rather than safety and security)
(Seligman & Reichenberg, 2014, p. 373)
Concept of Mental Health
Healthy people are those who are "successful in meeting their five basic needs. Emotionally healthy people choose thoughts, feelings, and behaviors wisely. Their choices help them meet their needs while respecting the right of other people to fulfill their own needs." Setbacks are a part of life and when they occur, they challenge people to make better choices. They are also improving themselves as well as the world as they have a positive self-image (Seligman & Reichenberg, 2014, p. 373).
Total Behavior Motivation
"All aspects are linked to behavior. He calls people's overall functioning total behavior, which is composed of four inseparable components: acting, thinking, feeling, and physiology. Reality therapists believe that all behavior is chosen, that people can directly control the acting and thinking components and thereby gain indirect control over feelings and physiology" (Glasser, 1988a). Behaviors have a purpose and actions are the first thing that need to change; then, thoughts will change. When a person wants to change a certain behavior, he/she first needs to change his/her actions because these are the easiest to control.
Quality Worlds
People have ideas in their heads of what their ideal world would look like. This ideal world helps people to try and satisfy their needs. If people have an unrealistic ideal world, this will lead to frustration; if they have a realistic world, this will lead to better choices and more control.
WDEP System
Four main elements
- Wants
- Direction and doing
- Evaluation
- Planning
(Seligman & Reichenberg, 2014, p. 374)
W : Wants
Therapists look at the client's world and figure out what the client is getting versus what the client is not getting. "Helping people to realize that some wants an unrealistic or unreasonable, while others can be helpful to the establishment of interpersonal relationships, and the recovery process, is an important role of the reality therapy counselor" (Wubbolding, 2011). Perceptions are another thing that affects behavior. There are two filters that perceptions pass through: total knowledge filter (recognizes and labels perceptions; the upper-level filter) and the valuing filter (evaluates perceptions) (Seligman & Reichenberg, 2014, 9. 374).
5 levels of client commitment to change
1. I don't want to be here.
2. I want the outcome but not the effort.
3. I'll try; I might.
4. I will do my best.
5. I will do whatever it takes.
(Wubbolding, 2007b, p. 303)
D: Direction and Doing
It's important to look at people's total behavior to explain and list the impacts of that behavior. The aim is to know what people are doing rather than why they act a certain way.
(Seligman & Reichenberg, 2014, p. 375)
E: Evaluation
Clients need to evaluate whether their behaviors and perceptions are realistic rather than being judgmental. Again, the main focus is on the present and will stress the successes in one's life rather than the impact of the past on the present.
P: Planning
People need to have long-term plans and goals that they can break down into smaller, more manageable short-term items. These plans should mirror the changes wanted for total behavior.
Eight qualities of viable plans
- Simple, clear, and understandable
- Attainable; able to be accomplished by the client
- Measurable via inventories, diaries, and other methods of recording progress
- Immediate; implementation can start right away
- Involving the clinician in appropriate ways such as giving feedback, serving as a sounding board
- Controlled by the client rather than someone else
- In keeping with the client's commitment to change and recognition that this change is important
- Reflecting consistent and repeated changes in behavior
(Wubbolding, 2007b, p. 305)
Even though changing actions and improving is key, thoughts may help people to see how choosing different actions will be advantageous for them. If a person can change actions and behaviors, their feelings and emotions will follow suit. Making better choices is a goal of planning.
Importance of Relationships
Relationships are essential to have a fulfilling life. Marriages are most successful when the two people have similar personalities and when they have a need for fun rather than having power. Furthermore, it's important for parents to love their children unconditionally. Even though, as parents, we don't agree with all of our children's behavior, it's alright to let them know that while ensuring that they still know we love them.
Treatment Using Reality Therapy
Goals
"The fundamental goal of reality therapy is to enable people to have great control over their lives by making better choices" (Seligman & Reichenberg, 2014, p. 376).
Three criteria for wise choices
1. They help people meet their innate needs and their specific wants, reflected by the pictures in their quality world.
2. The choices are responsible; they not only help the person making the choices but also respect the rights of other people and contribute to their efforts to make wise choices.
3. The choices are realistic and are likely to be attained through sound planning.
(Seligman & Reichenberg, 2014, p. 376).
Therapeutic Alliance
Reality therapists need to have a positive relationship with their client and the relationship is more friendly than other theories. The therapist is friendly and the alliance is on a more personal level. Even though it's a collaborative relationship, the client must take responsibility for the success of his/her treatment. The therapist will support and encourage the client and help the client with his/her plans. In addition, therapists will use language that enhance the therapeutic alliance and will use compassion when necessary.
Strategies
Creativity and understanding are what guides therapists to encourage the client to be an active part of the intervention.
Metaphors
"Reality therapists use metaphors, similes, images, analogies, and anecdotes to give clients a powerful message in a creative way"
Example : A client whose hobby was fishing that his efforts to meet his goals seemed like fishing without bait in a lake with few fish
(Wubbolding, 2011).
Relationships
Relationships help make live more rewarding and fulfilling. Via counseling, the therapist helps the client to make the relationships they have formed more meaningful. To have a strong basis for a relationship, the people must spend time together.
Example : He suggests taking frequent and regular walks with a friend as a way to build closeness
(Wubbolding, 1991)
Questions
People need to look at their lives to figure out what is working and what's not working. The therapist does not give the client that information but rather asks the client questions so that they can figure out what's working and what's not.
WDEP and SAMI2C3
"WDEP reflects the process of moving toward change by evaluating wants and direction and formulating plans. SAMI2C3 represents the elements that maximize the success of plans: simple, attainable, measurable, immediate, involving, controlled, consistent, and committed" (Seligman & Reichenberg, 2014, p. 378).
Positive Addictions
To reduce negative behaviors, people need to form positive addictions. "These are the behaviors that provide mental strength and alertness, creativity, energy, confidence, and focus, but do not dominate or control people's lives" (Seigman & Reichenberg, 2014, p. 378). Exercise is an example of a positive addiction. Positive addictions take six to two years of regular practice at 45 to 60 minutes/time (Seigman & Reichenberg, 2014, p. 378).
Guidelines for choosing and nurturing positive behavioral patterns
- The behavior should be noncompetitive and capable of being done alone.
- The behavior can be accomplished without inordinate mental or physical effort.
- The behavior should have value to you.
- The behavior should be one that you believe will lead you to improve in some way if you persist in it.
- The behavior should be one that you can perform without criticizing yourself.
(Glasser, 1976)
Using Verbs and "ING" Words
Therapists show people the control that they have over their lives and their behaviors. To do this, active verbs are used.
Reasonable Consequences
People should be responsible for their actions; therefore, they need to suffer the consequences of their actions. Consequence help people to see what they did wrong and what they can do differently next time. They do not focus on what the person did wrong.
Renegotiation
In counseling, a client will not always be successful. There will be setbacks and when they do occur, counselors need to help the client fix their plans so that they can be more successful in the future.
Paradoxical Interventions
These individuals help people take responsibility.
Two forms of Paradoxical Interventions
1. They relabel or reframe to promote choice and control. People might be viewed as lacking in skills rather than psychotic. Disappointments might be referred to as learning experiences rather than failures.
2. They involve paradoxical prescriptions. Reality therapists might encourage people to imagine the worst that could happen and find ways to cope with that, to choose their symptoms rather than fight them, to do the opposite of what is not working, or to schedule a relapse. Of course, suggestions always reflect accepted ethical standards.
(Wubbolding, 1988)
Skill Development
Education is important. "Clinicians help people develop skills to help them fulfill their needs and wants in responsible ways. Reality therapists might teach people assertiveness, rational thinking, development of positive addictions, planning, and other skills that promote growth and responsibility" (Seligman & Reichenberg, 2014, p. 379).