Reality therapy (RT) is an approach to psychotherapy and counseling developed by William Glasser in the 1960s. It 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 mental disorders. Reality therapy maintains that most people suffer from socially universal human conditions rather than individual mental illnesses, and that failure to attain basic needs leads to a person's behavior moving away from the norm. Since fulfilling essential needs is part of a person's present life, reality therapy does not concern itself with a person's past. Neither does this type of therapy deal with unconscious mental processes.
The reality therapy approach to counseling and problem-solving focuses on here-and-now actions and the ability to create and choose a better future. Typically, counseled people 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 overlooked in the rush to label the population as sick or mentally ill. If a social problem causes distress to a person, it is not always because of a labelled sickness, it may sometimes just be the inability to satisfy one's psychological needs. Reality therapy attempts to separate the person from their behavior.
History
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 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 at the 1995 IRTI Conference in Waterford, Ireland and subsequently adopted by Glasser . The practice of reality therapy remains a cornerstone of the larger body of his work. Choice theory asserts that each of us is a self-determining being who can choose (many of our) future behaviors and hold ourselves consciously responsible for how we are acting, thinking, feeling, and also for our physiological states. Choice theory attempts to explain, or give an account of, how each of us attempts to control our world and those within that world.
In 2007, reality therapy was recognised as a legitimate psychotherapeutic approach in Europe, recognised by the European Association for Psychotherapy (EAP), thanks to the publication Scientific Argument for Reality Therapy by Leon Lojk, a Slovenian psychologist and psychotherapist.
Approach
According to Glasser, human beings have four basic psychological needs after survival: the most important need being to love and be loved by another person or group for a feeling of belonging; the need for power, through learning, achieving, feeling worthwhile, winning and through being competent; the need for freedom, including independence and autonomy while simultaneously exercising personal responsibility; the need for fun, pleasure seeking enjoyment and relaxation is also a very important need for good psychological health.
One of the core principles of reality therapy is that, whether people are aware of it or not, they are always trying to meet these essential human needs. These needs must all be balanced and met for a person to function most effectively. However, people don't necessarily act effectively at achieving these goals. Socializing with others is one effective way of meeting the need to belong. But how a person chooses to interact with and gain attention and love from others is most often at the root of their psychological dismay. Reality therapy stresses one major point—people are in control of what they are currently doing in their lives whether or not it is working in their favor toward meeting their basic psychological needs for power, belonging, fun and freedom. And it is through an individual's choices that he or she makes change happen for the better or worse.
Core ideas
Action
Glasser believes that there are five basic needs of all human beings: survival, love and belonging, power, freedom or independence, and fun/pleasure. Reality therapy maintains that the main reason a person is in pain and acting out is because he/she lacks that one important 'other being' to connect with, or lacks another basic need for survival. Glasser believes the need for love and belonging is the most primary need because we all need other people in our lives in order to satisfy the rest of our needs.
Commitment to the plan
The participant must make a commitment to carry out the plan. This is important because many clients will do things for the therapist that they would not do just for themselves. In some cases it can be helpful to make the commitment in writing.
"No Excuses, No Punishment, Never Give Up"
If there is no punishment, then there is no reason to accept excuses (note that punishment can be ineffective with clients who expect to fail, see Learned helplessness). The therapist insists that the client either carries out the plan, or comes up with a more feasible plan. If the therapist maintains a good relationship with the client, it can be very hard to resist carrying out a plan that the client has agreed would be feasible. If the plan is too ambitious for the client's current abilities, then the therapist and the client work out a different plan. Cynthia Palmer Mason and Jill Duba, professors at Western Kentucky University, have proposed reality therapy techniques be applied to school counseling programs. They propose using reality therapy methods will help school counselors develop positive therapeutic relationships and improve students' self esteem. Many at risk and alternative schools across the nation have implemented reality therapy techniques and methods to improve school functioning and the learning and social environment. According to Klug, reality therapy in coaching helps build relationships, a healthy teaching environment and brings a definitive purpose to goal setting. It is suggested that applied reality therapy methods may help children evaluate their eating behaviors, set realistic goals and integrate effective self-evaluation.
Criticisms
The main limitation regarding reality therapy is that it primarily and exclusively deals with the current and the present problems of the individuals. Not looking to unlock trauma or recurring dreams, reality therapy's only workable arena is the present and going forward in the best possible way, while remembering the importance of taking responsibility for one's own actions and realizing that the only person one can control is oneself. In that realization of personal responsibility, one is given great freedom and happiness. Some people find fault with Glasser's notion that people chose the behaviors that afflict them by choosing chronic depressive thought patterns and choosing profound psychosis. Apart from specific brain pathology, Glasser argues that mental illness is a result of unsatisfying present relationships or general unhappiness.