Reality Therapy

In today’s podcast we will look at Reality Therapy, developed by Dr. William Glasser. We briefly review the assumptions of choice theory and how those assumptions are translated into Reality Therapy. The majority of today’s short podcast comes from the Gerald Corey text, Theory and Practice of Counseling and Psychotherapy. 

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Transcript

Hello and welcome.  You found The Social Work Podcast.  My name is Jonathan Singer and I'll be your host as we explore all things social work.

 

Today we're talking about reality therapy.  Reality therapy was developed by Dr. William Glasser.  Like Carl Rogers, developer of person-centered therapy, Albert Ellis and Aaron Beck, both of whom developed cognitive behavioral therapies, Glasser started his career as a psychoanalyst but quickly became convinced that the psychoanalytic emphasis on symptoms, childhood experiences and unconscious content actually worked against the change that psychoanalysts were trying to make with their clients.

 

Glasser came to believe that rather than being driven by unconscious choices, our situations were largely the product of conscious choice.  Although reality therapy was originally not associated with the theory, Glasser recognized that control theory provided a congruent theoretical basis for his approach to treatment.  After two decades of modifying control theory, Glasser believed that his theoretical basis was sufficiently different to rename control theory into choice theory.

 

These days reality therapy is grounded in Glasser’s choice theory and clinicians are taught choice theory as a part of their training to become certified reality therapists.  In today’s podcast, we'll briefly review the assumptions of choice theory and look at how they're applied in reality therapy.  Now one disclaimer, I'm not a certified reality therapist.  Most of the information that I've gathered for this lecture comes from Gerald Corey’s chapter on reality therapy in the 7th Edition of his text Theory and Practice of Counseling in Psychotherapy.

 

Choice theory states that people choose their behaviors and that these choices are made to satisfy five basic needs: survival, love and belonging, power, freedom and fun.  Now just as a side note, it's not often that you find a theoretical model that assumes that fun is a basic need.  So right off the bat, reality therapy has something going for it that almost no other therapy model has.  Now the most important of these basic needs is love and belonging.  Love and belonging are the most important needs because they're the basis for forming relationships and relationships are the core of satisfying the other needs.

 

So let's take a brief look at the five basic areas of survival, belonging, power or achievement, freedom or independence and fun or enjoyment.  One way of getting to this issue of survival, this basic need of survival is you can ask yourself to what degree are you maintaining vitality and good health rather than merely surviving.  In order to get at the basic need of belonging, you can ask in what ways do you feel a sense of belonging or what do you do to meet your needs for meaningful relationships.

 

In terms of power or achievement, you can ask when do you feel a sense of power, in what areas of your life are you making significant achievements and when do you feel recognized by others.  For freedom or independence, you can ask to what degree do you feel that you were in charge of your life and are moving in the direction that you want.  And finally for fun or enjoyment, you can ask what are those activities that you do for fun and do you have as much fun as you would like.

 

If you go see a reality therapist, it's likely that he or she will assume that the underlying problem is either that your relationships are unsatisfying or that in fact you lack relationships to begin with?  The basic goal of treatment would be to help you develop behaviors that result in new or behaviors that improve existing connections with others.  Because of this emphasis on relationships, the reality therapist uses the client-therapist relationship as a model for developing satisfying connections with others.

 

The therapist will work very hard to keep the focus on the present.  And this serves two purposes:  First, it keeps you focused on the choices that you're making moment to moment to satisfy your basic needs.  And second, it reinforces the importance of relationships in ultimate happiness.  So how come it is that we make choices that end up hurting us.  Wouldn’t it make sense that we would choose behaviors that would get us what we want?  Why would we intentionally choose behaviors that would make us miserable instead of making us happy?

 

Well, Glasser would say that in fact we mistakenly choose misery in our best attempts to meet our needs.  This mistake is caused by a gap in what we really want and what we think or perceive that we want.  See, we have an ideal world referred to in choice theory as a quality world that reflects what we want.  We often confuse what we want with what we need.  In doing so, we confuse our ideal world with reality.  For example, I don’t need that second piece of cake.  If I tell myself that I need it then I'll choose behaviors that will help me satisfy that need even if those behaviors will ultimately end up in me feeling worse not better.

 

If however I tell myself that I want a piece of cake then I acknowledge that having that second piece is a choice.  Now, getting a second piece of cake is pretty tame.  Confusing the want of cake with the need of cake seems pretty obvious and you wouldn’t imagine that somebody would go in for therapy just for that.  Well, cake can be cake and it be a serious issue for folks with eating disorders, but let's imagine what if instead of cake I told myself that I needed to score some crystal meth or that I needed to revenge the death of my brother.  Well, there's a world of difference between wanting crystal meth and needing crystal meth and wanting to avenge the death of my brother and needing to.

 

You see the difference?  You see the qualitative difference between wanting something and needing something?  When we tell ourselves that we need something, it makes it an imperative.  It says I need this just like I need air, just like I need to breathe, just like I need food to sustain myself.  It's not a want, it's a need and because it's something that is basic to my survival I will stop at nothing to get it.  Well, Glasser would say that in fact most of the things that we think of as needs are in fact wants.  We want these things.  We don’t need them.

 

So, our behaviors are geared towards getting what we want.  In reality therapy, behavior is not just a physical act.  Choice theory says that doing, thinking, feeling and physiology comprise what they call total behavior.  Now doing is active behaviors.  Thinking, those are thoughts and self statements, the things that we tell ourselves like I need that second piece of cake.  That’s a self statement.  Feelings are just what you would think of as feelings, anger, joy, pain, anxiety and physiology is bodily reactions.

 

Ultimately, behavior is purposeful because it is designed to close the gap between what we want and what we perceive we are getting.  So what do these ideas look like in a therapy context?  Well, Gerry Corey illustrates the practice of reality therapy by using the WDEP system developed by Dr. Wubbolding.  So let's take a minute to talk about this approach to reality therapy.

 

The WDEP system, W stands for wants.  What do we want to be and what do we want to do with our lives?  The D stands for doing and direction.  Where are we going?  What are we doing?  The E stands for evaluation.  Does your present behavior have a reasonable chance of getting you what you actually want?  And the P in the WDEP system stands for planning.  And there's a nice little acronym that the good doctor has come up with to help us remember the stages of planning and that’s SAMIC3 or SAMIC.

 

So, S stands for simple.  When you plan something, it has to be simple.  It has to be easy to understand, specific and concrete.  A is attainable and by attainable I mean that whatever it is that you're setting out to do has to be within your capacity and motivation to actually attain.  So you can say that you want to become the president of the United States, but if that’s not within your capacity and you're not motivated to do all that you need to do to become the president then that’s not a reasonably attainable part of your plan.  It has to be measurable.  Are the changes observable and are they helpful?

 

The I in SAMIC stands for immediate and involved.  What can be done today?  What can you do today to make this change?  This idea is really helpful because when you work with a therapy client it's possible that they might not come back for a second session and so the session that you have is the session that you have the opportunity to actually make some differences.  So what is it that your client is doing today?  What is immediate and what is it that you can do to be involved?

 

And the C stands for control.  Can you do this by yourself or will you be dependent on others?  I want to say one thing about this last part.  Being dependent on others does not mean that you are not in relation with others.  Obviously, the core belief in reality therapy is that our problems arise when we are not relationships or relationships are not satisfying.  So it wouldn’t make any sense to have part of the plan for getting us what we want to be in isolation.

 

The C in the SAMIC planning part, can you do this by yourself or will you be dependent on others, refers to this idea that if you are going for something but getting that will ultimately depend on somebody else, it means that you might be setting yourself up for failure.  Take for example a job.  What if you wanted to get a position that was somewhat out of your control, that by doing all that you could do you might still end up not getting this job.

 

And you wouldn’t get this job because it was dependent on somebody else deciding that you were the best person for this job.  Well, having any part of your plan be dependent on somebody else for success is ultimately going to end up in failure.  So the idea is to identify what it is that you can control in terms of this plan.  Remember earlier when we're talking about basic needs, the five basic needs?  Well, the way that it's used in therapy is that you identify what somebody is looking for, what they want, the W in the WDEP model and you ask them to look at an area in their life.

 

It could be what they want from their self, friends, spouses, religion, spirituality, work or the larger world around them and then they select one of these targets for further exploration.  And then you ask three questions of those particular areas.  The first is what are you doing now to get what you say you want?  How much effort are you devoting to getting what you want?  The second question is how do you perceive yourself and significant others in your life? And then finally how are you meeting the basic needs?

 

So, at that point you come into these issues of basic needs and you ask your client to rank their basic needs.  So it could be that for them this issue of belonging, the love and the relationships is the most significant need that they have right now.  Then what you do is you ask them well what are you willing to do to change this aspect of your life and that’s where the reality therapy really starts coming in.  That’s where people get down to brass tacks about what it is that they're doing, the choices they have made, the situation that they have created for themselves and acknowledge that that situation is in part because of their own doing.

 

Now, what's true is that there are some situations where there are things that are somewhat out of our control.  For example, if you are in a job and it is not your choice whether or not you get a promotion then that is out of your control.  However, it could be argued that you have made choices along the way to get yourself in a job where you have less control over your career than if you had been in another job.  So at that point you say well what is it that you're willing to do to change this aspect of your life?

 

Choices aren't necessarily easy nor are they necessarily fun.  But reality therapy would argue that by making choices and being aware of the fact that you have choice that you're that much closer to actually satisfying your basic needs and ultimately feeling fulfilled.  So if we think about some of the strengths of reality therapy, we have to acknowledge that it's a practical approach to identifying what is within the control of the client.  Its focus is on relationships which is a big strength because relationships are universal experience.

 

It has a short-term and focused approach and it works well in many social work settings such as criminal justice, psychiatric hospital, substance abuse and residential treatment centers.  Some of the limitations are that reality therapy really rejects the medical model.  It rejects exploration of the past, of dreams, of dwelling on feelings or insight, transference in the unconscious.  Now, these are limitations only if those things are necessary and are important for your treatment.

 

It also has the limitation of being very direct in terms of questioning and holding people to choices.  And these can be limitations when you're working with culturally diverse clients for whom making the statement “yes I will make this change” is actually incongruent with their cultural upbringing.  So for example, if you ask me as a middle class white male Jonathan, will you do this and I said, “Well yeah, I'll try to do it.” Well, that’s not me making a firm commitment.

 

However, if I was talking to a traditional Japanese father and I said will you do this and he says, “Yes, I will try.” Then culturally that would be the same degree of commitment as for me saying yes, I will do that.  So it's important to take these into consideration.  And finally, as we were alluding to a few minutes ago personal choice is sometimes not a sufficient condition for change in a culture where discrimination and racism are a reality.  So to sum up, reality therapy is a treatment model grounded in choice theory that emphasizes personal responsibility and personal choice.  Responsible behavior enables us to meet our needs without keeping others from meeting their needs.

 

So, I'm Jonathan Singer.  Thanks for being with me today for this episode of The Social Work Podcast.  If you missed an episode, visit our website at https://www.socialworkpodcast.com.  If you have suggestions for future podcasts, please email me.  And to all the social workers out there, keep up the good work.  We'll see you back here next time at The Social Work Podcast.

 

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References  

Corey, G. (2005). Theory and practice of counseling and psychotherapy (7th ed). Belmont, CA: Wadsworth/Thomson.  

APA 7th edition

Singer, J. B. (Producer). (2007, March 26). #15 - Reality therapy. Social Work Podcast [Audio podcast]. Retrieved from http://socialworkpodcast.com/2007/03/reality-therapy.html