Reality Therapy

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Reality Therapy

• EDCE 655
• Theories Techniques II

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Reality Therapy Founder William Glasser

• Graduated High School at Cleveland Heights High
  School
• Did not talk much about his childhood
• Keeping consistent with not dwelling in the past
• 1948 Received his MA in Clinical Psych.
• Worked on Ph.D. but advisors rejected his
  dissertation
• 1953 Graduated from Med School Case Western
  Reserve
• Psychiatric Training - UCLA
• While working here Glasser noted a discrepancy
  between what was being taught (Freudian Model)
  what seemed to work in clinical practice

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Significant Works by Glasser

• 1969 Schools without failure
• Focuses on helping children gain adequate control
  of their education to avoid failure
• 1973 Behavior The Control of Perception
• Presents the theoretical basis for the brain as
  an inupt control system
• 1976 Positive Addictions
• Depicts how powerful meditations can become both
  strengthening addicting
• Confirmations of this observation spurred Glasser
  to find out how our brain functions led to the
  control systems theory
• 1981 Stations of the Mind
• Relates control theory to the clinical practice
  of reality therapy

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Reality Therapy Basic Underlying Assumptions

• Individuals are responsible for what they do
• Responsible behavior satisfies ones needs
  without preventing others from satisfying theirs
• The brain works like a control system, acting
  upon itself or the outside world to fulfill some
  intrinsic purpose of the system
• All behavior is generated internally to fulfill
  needs built into the genetic structure of the
  system
• People with psychological disorders fail to
  control the world enough to satisfy what they
  want right now
• People have basic needs
• To say alive reproduce
• To belong, socialize, cooperate, love
• To have power, self-worth, recognition
• To have fun freedom
• There are only 2 fundamental ways to control the
  world
• Perceive (throught the senses) what could satisfy
  needs
• Act upon or control what one perceives will
  satisfy needs

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Major Areas of Focus Emphasis

• Rejection of traditional concepts of mental
  illness
• Focus on present but will look to the past for
  successful behaviors that might be currently
  useful
• Deals with clients present level of awareness
  strives to increase awareness

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Reality Therapy Key Concepts

• RT attempts to help people control the world
  around them more effectively responsibly to
  better satisfy their needs
• Counselors ask clients to assess effectiveness of
  current behavior in getting what clients desire
• Motivation to change comes only from the clients
  judgment that current behavior is not effective
• Teaches better ways or better behaviors to deal
  with the world
• All counseling is teaching to the extent that
  teaching leads to fulfillment, it is successful

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RT Theory of Personality Dev.

• Personality is the characteristic way in which we
  attempt to control the world to satisfy what we
  desire
• Fundamental needs which must be satisfied are
  built into the genetic structure
• A responsible personality satisfies wants without
  interfering with the ability of others to satisfy
  theirs
• We compare what we want with what we perceive is
  available for need fulfillment
• We generate behaviors (mixtures of feeling,
  thinking, doing) to control events get needs
  satisfied

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RT Theory of Personality Constructs

• Clients must be taught to understand people
  around them do not necessarily perceive the world
  the way they do
• We cannot control anyone who does not want to be
  controlled
• One must not let others control them through
  painful feeling behaviors
• We can help others fulfill their needs congruent
  with our own needs

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Process of Psychotherapy

• Role of Counselor
• To persevere with the client
• Verbally active sets limits
• Emphasizes the positive but focuses on
  responsible specific goals
• Role of Client
• To accept responsibility for what they do
• Nature of Interaction
• Caring
• Verbally active dialogue
• Confrontations are used frequently
• Optimal Conditions / Clients
• Individuals with any sort of problem from mild
  emotional upset to complete psychotic withdrawal
• Used successfully in schools, correctional
  facilities, mental hospitals, businesses

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Mechanisms of Reality Therapy

• Focus is on individuals behavioral strengths,
  attributes, potentials experiences, current
  attempts to succeed at life
• Improvement occurs when clients learn to use
  behaviors that are effective feel good
  essentially when they learn to take more
  effective control of their lives
• Presenting complaint is not significant it is
  an example of the clients attempt to deal with
  the world

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Procedures that Lead to Change

• Client is convinced that their present behavior
  is not getting them what they want
• Client believes that they can choose other
  behaviors that will get them closer to what they
  want
• WDEP the cluster of strategies developed by
  Glasser Wubbolding
• W - Wants
• Explore what the clients wants, needs
  perceptions
• D - Direction Doing
• Deal with what client is doing in the present
  explore direction of life
• E - Evaluation
• Is the behavior getting client where they want to
  go
• P - Planning Commitment
• Explore other possible behaviors formulate an
  action plan

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Basic Human Needs Motivate Behavior
Acting
Feeling
Basic Needs
Wants
Thinking
Physiology
Basic Needs Belonging Caring Cooperation
Power Gaining recognition, Competing,
Achieving Freedom Choosing Moving
Fun Learning Playing
Survival Feeling Safe
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2 Lesson of Control Theory

• Your pictures are yours. You put them in you
  can exchange them, remove them, add new
  pictures. You can also choose to concentrate on
  ones you can satisfy, allot little time
  energy to those you cant satisfy but are not yet
  ready to take out of your head.
• Whether you directly choose a behavior, such as
  depressing, or make an indirect creative choice,
  such as a psychosomatic illness, you always have
  the option to do or think something more
  satisfying. You have to breathe, but this is ALL
  you absolutely must do. The rest of what you
  choose is up to you whether you feel like it or
  not.

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Reality Therapy

• Establish Relationship
• What do you want?
• Focus on Current Behavior
• What are you doing now?
• Are Current Choices Working
• Are you getting..?
• Is what you are doing getting you what you want?
• Make a Plan (to do better)
• Get a Commitment
• Allow No Excuses
• Reasons for ineffective miserable behavior are
  not accepted
• No Punishment but permit 2 temporary reasonable
  consequences for behavior
• Temporarily restrict freedom
• Temporarily remove privileges
• Never Give Up

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Enhancing Efficacy Self Worth

• What is Self-Efficacy?
• Way is Self-Efficacy so important in the helping
  relationship?
• How does Self-Efficacy, Self-Esteem,
  Self-Concept, Self-Worth all fit together?
• How why does Cognitive approaches work
  effectively in this area?
• What is the concept of Learned Helplessness,
  what can counselors do about it?

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Glassers 8 Steps of Reality Therapy

• Make Friends! Ask What do you want? What do you
  really want?
• Ask What are you doing now? What are you
  choosing to do now?
• Ask Is it helping or Is it against the rules?
• Make a plan to get what you want or what you
  really want
• Get a commitment!
• Dont accept excuses!
• Dont punish dont interfere with reasonable
  consequences. Dont criticize!
• Never give up! Do not confirm the failure
  identity!

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Janet A Substance Abuser

• Janet reports that she has always had difficulty
  handling her family her personal life. She says
  that she had a relatively stable marriage until
  she found out her old man was running around
  with other girls. Although she filed for a
  divorce from him, she never appeared in court, so
  she is uncertain about her marital status. She
  reports that after the separation he
  disappeared until quite recently, when he
  reappeared out of nowhere took their son (now
  15) to live with him. She also has 2 girls, ages
  8 10, who still live with her. The client says
  that, once her husband had left, she was forced
  to resort to stealing to support the family her
  drug habit.
• Janet has been addicted to cocaine for 4 years.
  During this period she has had behavioral
  problems with her 2 daughters, as well as the
  son. Eventually she moved in with her current
  boyfriend, the behavioral problems with the
  children escalated. She reports that she is on
  parole for a theft charge is afraid that she
  will have to go back to prison for parole
  violation because of her drug use.
• Janet lets her parole officer know that she has
  seen you that she wants to get some help to
  get her life together. A few days later her
  parole officer calls says that her urine test
  is dirty, showing traces of several drugs. The
  parole officer asks about your Tx plan for
  therapy requests that you write your opinion on
  whether the client should be back in prison.

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Questions for Reflection (Janet A Substance
Abuser)

• What ethical legal implications does this case
  have?
• What referrals might you need to make?
• What type of info. would you provide to the
  parole officer?
• If Janet wanted to remain in counseling, what
  goals would you see as being important?
• How would you apply the steps of RT to this case?
• What interventions would you make why?
• How would you work with Janet if she avoided
  making an evaluation of her behavior?
• Do you think you could work with her effectively
  given the fact that she has come to you as a
  stipulation of her parole? Why or why not? How
  could you tie this requirement into a RT
  perspective?
• Besides RT, what theoretical framework would be
  helpful to you in this case? Are there any
  theoretical approaches that you think would not
  be particularly helpful?
• Show how your approach in working with Janet form
  a RT perspective would differ from your work with
  her from a person-centered framework.
• How might you deal with possible manipulation by
  the client? What would you do if you suspected
  that she was using you simply to meet the
  requirement for parole that she was not really
  involved in her counseling?
• Do you see her as a candidate for
  hospitalization? In your opinion, is Janet a
  suitable candidate for conventional
  psychotherapy? Explain.