Reality therapy


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Reality therapy

  1. 1. William Glasser • “. . . it is what you choose to do in a Reality Therapy relationship, not what others choose to do, that is the heart of reality Chapter 11 therapy.” Dr. Sheila K. Grant Biography of Biography of William Glasser William Glasser• Born 1925 & educated at Case Western • Glassers path a continuing progression from Reserve University (Cleveland, Ohio). private practice to lecturing & writing, ultimately culminating in publication of 20+• Initial training in chemical engineering, books then master’s in clinical psychology • After writing counseling book, Reality Therapy• Attended UCLA medical school & (1965), published his first book on education, became a board certified psychiatrist in Schools without Failure (1969), greatly 1961 expanded understanding of motivation & behavior with Choice Theory (1998), & finally added, Warning: Psychiatry Can Be Hazardous to Your Mental Health (2003), to help people improve their mental health and happiness Philosophy of Philosophy of William Glasser William Glasser• People should not be labeled with mental • People choose to be depressing, anxious, illness unless they have a true brain panicky, angering, behaving in a way disorder such as Alzheimer’s disease, that others say they have a psychosis, epilepsy, head trauma & brain infections etc. in order to avoid other more painful (they should all be treated by experiences or to reach out for help neurologists) • They are coping in best way they know• Otherwise, categories of DSM-IV-TR are how for given situation, which is usually not mental disorders or illness caused either by relationship problem or• Psychologists & psychiatrists should only a lack of a relationship at all use DSM categories to satisfy requirements of insurance companies to receive payments 1
  2. 2. Philosophy of Choice Theory: William Glasser Need for a new Psychology• The brain reacts to actions & thinking processes • Past 100 years, technology has progressed of individual, rather than individual reacting as drastically, but human progress has been at a result of an “imbalance in brain chemistry” as is standstill popularly thought – Still wars, divorces, suicides, murder, poor productivity in schools & workplace & unhappy people• As a result, people do not need psychotropic or “brain” drugs such as Prozac • Two groups of people of unhappy people: – Those who try to find their way back to pleasurable• Rather, they need psychotherapy to help them relationships w/happy people with their relationships – Those who have given up on relationships & try to feel• Society should be in a more preventive mode good by other means (drugs, alcohol, violence, sex, abusing rather than a reactive mode for psychological food, etc.) behaviors, just as communities are for medical • Once this group can find meaningful relationships through AA or other professional or nonprofessional counselors & teachers, illness they too can find happiness again Choice Theory: Choice Theory: Need for a new Psychology Need for a new Psychology• Glasser believes problem is external • Need to change our “7 Deadly Habits of External Control” mindset of our society – Criticizing – Blaming – “You must do what I want or be the way I – Complaining Nagging want you to be!” – Threatening – Punishing• Rather than letting us both decide what is – Bribing or rewarding to control best for us in our relationship & then work • To the “7 Caring Habits of Choice Theory)” together to make it happen – Respecting• Glasser feels that society should move – Supporting – Encouraging Listening more towards internal locus of control – Accepting – Trusting – Negotiating differences to a Win/Win situation Choice Theory: Choice Theory: Need for a new Psychology Basic Needs and Feelings • Similar idea as Maslow’s hierarchy of needs• Difficult to retrain our thinking & communication (Survival,Love/Belonging, Power, Freedom, & Fun) because we are so engrained in the external control – Different in that only Survival & Love/Belonging are in system both sets• Three Beliefs of External Control Psychology: – Choice Theory needs are NOT in a hierarchy – 1) My behavior is caused by something that occurs outside of myself (e.g., “I answer the phone because it rings”) • Rather they are analogous to the legs of a chair -- – 2) I can make you do what I want you to do or we can if all legs are balanced, the chair functions better control each other by what we say or do • Glasser believes that we are genetically – 3) I know what’s right for you & if you don’t do it, I should & programmed to satisfy all five basic needs must control you because it is the right thing to do – Strongly Agree, Agree, Unsure, Disagree, Strongly Disagree • Negotiation is necessary to balance the needs of Where are you on this continuum of beliefs both parties of a relationship for #1, 2, & 3 • One party may need more of one need than the other 2
  3. 3. Choice Theory: Choice Theory: Basic Needs and Feelings Basic Needs and Feelings • 1) Survival - Physiological Need• There may also be an internal conflict to – All living creatures struggle to survive & reproduce the species satisfy multiple needs at same time – Also, humans look beyond present survival needs & – e.g., you want to be responsible & gain make an effort to live in ways that lead to longevity respect of others but also want freedom & (exercise & eating healthy) fun – Survival comes from the “old brain” – base of the• McNamara (1997) also added intraneed brain As humans developed, cerebral cortex or “new brain” allows us to have needs beyond conflicts (e.g., survival – “the need for survival can include the – If survival was our only need, there would be no motivation to be safe & the urge toward anorexia or suicide growth”) – Also getting along better with each other would result in more survival & less death Choice Theory: Choice Theory: Basic Needs and Feelings• 2) Love & Belonging - Psychological Need Basic Needs and Feelings – It’s a 2-way street • 3) Power – Psychological Need • “I need to receive love, be involved & feel like I belong” – Distinctive human need • “I feel better if I am able to give love & acceptance to others” – Includes feeling of accomplishment, success, – Most of psychotherapy in countries where survival needs recognition, respect & being heard are primarily met revolve around this need – For some, the need is insatiable – Either lack of love or deteriorating love are associated – For others, they are satisfied with the amount they with have • Suicide – For some, it comes at the expense of their • Mental Illness relationships with others (greed, external control • Infidelity over others) • Murder – But for some, it may work for the common good • Feelings of jealousy, abandonment, revenge & despair (saving lives or developing new treatments) – External control is used extensively here – We need to strive for the latter rather than the former Choice Theory: Choice Theory: Basic Needs and Feelings Basic Needs and Feelings• 4) Freedom to express ideas, choices & ability • 5) Fun – Psychological Need to be constructively creativity – Psychological Need – The genetic reward for learning – It concerns us most when we perceive that our – We play all our lives & as a result we learn all freedom is threatened our lives – Need balance between “your need to try to force me to live my life the way you want & my need to be free – “Fun is best defined by laughter” of that force – “People who fall in love are learning a lot – This balance is best expressed by the golden rule “Do about each other, & they find themselves unto others as you would have others do unto you” – External control is the enemy of freedom laughing almost continually” – When we loose freedom, we loose a defining human – “Laughing & learning are the foundation of characteristic (creativity) all successful long-term relationships” 3
  4. 4. Choice Theory Choice Theory (Quality World) (Quality World) • As people grow up & interact with • It is dynamic as our experiences environment, they find some parts of world satisfy their needs & make them grow feel good & other parts do not • Anytime we feel good, we are • They take this information & build into choosing to behave so that their memory pictures of people, things, something or someone in our real beliefs or situations which seem to be the best ways to satisfy one or more of the world comes close to matching the basic needs image in our quality world • The conglomerate of these wants is the world in which we would like to live & is called our Quality World Choice Theory Choice Theory (Quality World) (Quality World) • Everyone has their own unique quality world • Besides being in conflict with other’s quality world • Total objectivity is a myth wants, our own quality world wants can be in • It could only exist if we all had exactly the same conflict with each other and/or they can be linked quality worlds together • It’s just like jury trials – everyone sees things from • Advertises hope that consumers will put their a different perspective product into their quality world & link them to the • Only things that are not important to us can be images the consumers already have in their minds seen as they truly are (heroes, beauty, power, wealth, etc.) • Luckily, there are enough of these unimportant • Pictures or wants exist in a priority & often it is the things to almost all of us that we can agree that therapist’s job to help clients to determine priorities what is out there is REALITY about what is need satisfying in the long term & not just for the moment Choice Theory Choice Theory (Quality World) (Total Behavior)• Besides being in conflict with other’s quality world • Behavior generated to fulfill quality world wants is wants, our own quality world wants can be in always composed of four elements: actions, conflict with each other and/or they can be linked thinking, feeling, & physiology together • All behaviors have all 4 components, so it is called• Advertises hope that consumers will put their product into their quality world & link them to the Total Behavior images the consumers already have in their minds • Other psychotherapy theories emphasize one or two (heros, beauty, power, wealth, etc.) of these components whereas Reality Therapy• Pictures or wants exist in a priority & often it is the emphasizes all four of them therapist’s job to help clients to determine priorities • However, we only have direct control over two of about what is need satisfying in the long term & not just for the moment them: Actions & Thinking 4
  5. 5. Reality Therapy Reality Therapy (Characteristics) (Characteristics) • It is important to keep the therapy in the present & not dwell on the past • Reality therapy focuses on what clients can • Glasser admits that we are products of the past & control in a relationship, rather than finding the therapist can listen to past experiences briefly, fault or talking about what they can’t but we are not victims of the past unless we control choose to be • It is crucial for client to understand they • Also, it is important not to focus on the symptoms can only control their own actions & because they are just the body’s way of warning behavior, & they can control all of them client that behavior they are choosing is not • Reality therapists strive to be themselves in satisfying a basic need order to build relationships with client & • Glasser believes that if client believes therapist teach them how to relate to others wants to hear symptoms or past, they will comply • Therefore, transference is rejected in this & result will be therapy that lasts longer than it therapy needs to Reality Therapy Family Therapy (Therapeutic Process) (Application: Therapeutic Techniques & Procedures)• Basic goal is to help clients learn better ways to fulfill all of their basic needs & connect with the • Practice of reality therapy is conceptualized people that they have chosen to put into their quality world as the “cycle of counseling” consisting of two• If client has not voluntarily come to therapy, it is key components: for therapist to focus on connecting with client – 1) Creating the counseling environment before doing anything else – 2) Implementing specific procedures that lead to• Often these clients have not had any positive changes relationships in past with adults (teachers, parents, school counselors, etc.) • Cycle begins by establishing a working• Therapist’s role is not to judge or evaluate client but relationship with client & proceeds through an act as an advocate to help & support, as a teacher exploration of client wants, needs & or mentor to client & to encourage them that there perceptions is hope Family Therapy (Application: Therapeutic Reality Therapy From a Techniques & Procedures) Multicultural Perspective• Clients explore their total behavior & make • It is essential that cross-cultural therapists their own self-evaluations respect differences between their own quality world & that of their clients• If they decide to try a new behavior, they make plans & commit themselves to plan & • Counselor can work with client to help them develop relationships as they are there is a follow-up on how well client is doing meaningful to them in their culture• Reality therapy is an art form, not just • In some cultures, the procedures need to following procedures be modified such as not asking direct• Each client is different with different needs questions o accepting “I’ll try” when asked to make plans with Japanese clients 5
  6. 6. Reality Therapy Reality Therapy (Contributions) (Limitations and Criticisms)• It has a short-term focus • Corey believes that for some cultures, clients may be reluctant to voice their• Existentialism exist in the theory as needs, & that discrimination & racism may well as cognitive-behaviorism impede clients from obtaining what they want in life• There is no hidden agenda by the • The result would be that client may feel therapist, it is client focused misunderstood• Client is encouraged to decide if • Corey also believes that the what they are doing is working or psychoanalytic aspects of counseling (unconscious, dreams, transference & not past childhood experiences) are not given adequate emphasis in influencing our behavior Reality Therapy Reality Therapy in Summary (Limitations and Criticisms) • Reality therapy is best characterized as a• Counselors need to ensure that their form of cognitive behavioral therapy own values & need to give advise • In Reality Therapy: – Therapy is a didactic process does not pervert the basic concepts – Clients must make commitments of choice theory – Punishment is eliminated• Many people disagree with Glasser – Therapists do not accept excuses or blaming that all psychological disorders are • Goals: – Clients are taught Choice Theory behavioral choices & there are no – Clients are helped to get connected or biochemical or genetic influences reconnected with people they have chosen to put in their quality world – Assist clients in dealing with the present Reality Therapy in SummaryReality Therapy in Summary • Functions of Reality Therapists:• Emphasis is on choice & responsibility – Setting limits in the therapeutic setting• Therapist establishes involvement with the – Getting clients to be specific about how they will client make desired changes• Focus is on client’s strengths – Confronting clients by not accepting their excuses – Helping clients reformulate their plans, if necessary• Planning & commitment are essential• Methods of Reality Therapy: • Reality Therapists deal with the following: – What client is currently doing – Behavior-oriented methods – What clients are thinking & feeling, when this relates – Contract method to what they are doing – Role-playing – A client’s relationships with significant others – Confrontation of client – Assisting clients in developing an action plan geared for change 6