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Reality Therapy

C6436 Individual Counseling

Theory and Practice

James J. Messina, Ph.D.

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William Glasser 1925-

Bachelors Degree-Chemical Engineering-

Case Western Reserve-Cleveland Ohio

MA Clinical Psychology 1948 MD Psychiatry 1957-Board Certified 1961

Created Reality Therapy by 1962-essence

we are all responsible for what we choose

to do

By 1998-2000 change to Choice Theory

which is now part of Reality Therapy

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Underlying Problem for all Clients

They are either involved in a present

unsatisfying relationship or lack what

could even be called a relationship. If therapy is to be successful, the therapist

must guide the client to a satisfying

relationship & teach client to behave inmore effective ways

Clients find out their problems are the way

they chose to behave

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Innate Needs of Humans

All humans are born with five genetically codedneeds which they have at varying levels in eachone of them

Survival Love & Belonging-Primary Need Power 

Freedom Fun

Our brain functions as a control system to get uswhat we want

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We do not satisfy need directly

In our Brain is our Quality World  People we are closest to & enjoy most

People we imagine it would be nice to bewith

Things we own or would like to own

Beautiful things in nature important to use.g. sunsets

Systems of beliefs that give us pleasure,

religious, political, personal

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Art of Reality Therapy

Therapist must be a person client would

consider putting in quality world 

It is from this relationship with therapistthat client begins to learn how to get close

to the people they need

People who enter therapy typically haveno people in their quality world 

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Reality Therapy Concept of 

Behavior 

Behavior is purposeful because it isdestined to close the gap between what

we want and what we perceive we aregetting All behavior has four components

Acting Thinking Feeling

Physiology 

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Reasons why People choose to

Suffer 

1. If in a frustrating relationship it is normal tochoose anger. From angering it is easy to lashout and hurt someone. Depressing & other 

symptoms can immobilize to restrain anger 2. Depressing is most common way people use

to ask for help without begging. When wesuffer people reach out to us.

3. Depressing and all other forms of what arecalled mental illness allow us to avoid doingwhat we are afraid to do for fear of thepossible negative consequences involved

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Key Reality Therapist Statement

“There is no guarantee that life is fair. The onlyguarantee is that your are the only person whomyou know you can change. Complaining may

feel good for a short time, but it is completelyineffective behavior. If complaining wereeffective, there would be a lot more happypeople in the world.”

Complaining, blaming & criticizing are self-defeating total behaviors which are mostineffective behaviors so not listened to in realitytherapy

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Reality Therapy Basic Beliefs

Emphasis is on responsibility Rejection of Transference-welcome responsible

involvement with clients Therapist’s function is to keep therapy focusedon the present

Avoid focusing on symptoms

We often mistakenly choose misery in our bestattempt to meet our needs

We act responsibly when we meet our needswithout keeping others from meeting their needs

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Goals in Reality Therapy

Help clients to get connected or reconnected with people they have

chosen to place in their quality world To teach clients choice theory Help people extremely resistant to therapy

to get involved-disconnected pleasureseeking people-goal is to get therapistconnected with these people

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Therapist’s Function & Role

Assist client in dealing with present

“ Are the total behaviors you are choosing getting 

you what you need? Is this choice realistic? Is it getting you closer to people you need or want to

get to know?” 

Establish satisfying therapist/client relationship

Be role model of a human who knows what life

is all about & successful in dealing with life & not

afraid to discuss any subject with their clients

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Relationship between Therapist &

Client Therapy is a mentoring process-therapist

teacher & client student Therapists capable of relating to wide range of 

people most of whom would not have normallybeen a part of their lives Sense of paradox Ability to reframe the reality

Ability to communicate hope Ability to define problem in solvable terms Ability to use metaphors

Being ethical and culturally sensitive

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Reality Therapy Cycle of 

Counseling

1. Creating the counseling environment

2. Implementing specific procedures that

lead to changes in behaviors3. Clients led to evaluate their lives &

decide to move in more effectivedirections-make plans to change

4. Following up on how well clients aredoing & offering further consultation

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The Counseling Environment

Coercion free – neither client or therapist

coerces or controls the other 

Clients free to be creative & try newbehaviors or renew past successful ones

Confronting yet always noncriticizing,

nonblaming, noncomplaining, caringenvironment which leads to create new

satisfying environments that lead to

successful relationships

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Procedures that Lead to Change

Identification of major unsatisfying relationship inlife of client-root of problem

In that relationship: “Whose behavior can youcontrol?”

Once accept can only change self, focus on howclient can make better choices

Explore tenets of Choice Theory model Identify basic needs Discover client’s quality world Help client understand they choose total behaviors

that are their symptoms

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The “WDEP” System-Promotes

Change

W Wants: What do you want to be anddo? Your “picture album”

D Doing and Direction: What are youdoing? Where do you want to go?

E Evaluation: Does your presentbehavior have a reasonable chance of getting you what you want?

P Planning  – “SAMIC”

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Planning For Change-SAMIC

S Simple: Easy to understand, specific andconcrete

A  Attainable: Within the capacities andmotivation of the client

M Measurable: Are the changes observableand helpful?

I Immediate & Involved : What can be donetoday? What can you do? C Controlled : Can you do this by yourself or 

will you be dependent on others?

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Qualities of a Good Change Plan

Flexible & open to modification

Stated positively in terms client willing to do

Plan capable of being done independent of 

others help or assistance

Repetitive & performed daily

Carried out as soon as possible

Plans contain process-centered activities Evaluate plan if realistic & attainable & if relates

to what client needs & wants

Firm plan up in writing to help client commit to it

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Total Behavior: Our Best Attempt

to Satisfy Our Needs

DOING ~ active behaviors

THINKING ~ thoughts, self-statements FEELINGS ~ anger, joy, pain, anxiety

PHYSIOLOGY ~ bodily reactions