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Choice Theory/Reality Therapy/PTSD
Choice Theory/Reality Therapy is a counseling method developed by William Glasser that focuses on internal control and meeting basic human needs. It teaches clients choice theory and uses the WDEP process - defining wants, examining behavior, evaluating plans, and creating positive plans. The theory promotes problem-solving skills and mutual respect over criticism. It views mental health as fulfilling the five basic needs of survival, love, power, freedom and fun. PTSD involves exposure to trauma and symptoms of intrusive memories, avoidance, mood changes and hyperarousal according to the DSM-V. It can cause problems with memory and emotions that increase suicide risk.
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Choice Theory/Reality Therapy/PTSD
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- 2. Choice Theory/Reality Therapy ChoiceTheory/Reality Therapy is a method of counseling and psychotherapy that was developed by William Glasser. William Glasser promotes the teaching of reality therapy applied to psychotherapy, counseling, schools, agencies, and management.
- 3. Choice Theory/Reality Therapy Beginnings •Psychoanalytic-Behavior • G.L. Harrington • Unhappiness • Relationships *Responsibility is the ability to fulfill one’s needs, and to do so in a way that does not deprive others of the ability to fulfill their needs.
- 4. Concepts • Humanistic-Existential Theory •Therapist is the Teacher, Client is the Student *Choice Theory is Taught to Clients • Multi-Cultural *Dreams are not explored or mentioned. Time spent on dreams is time wasted. Choice Theory/Reality Therapy
- 5. Choice Theory/Reality Therapy Glasserstates, “Therapy is not perfect. Psychiatrists make mistakes by admitting it and learning something from it.”
- 6. Glasser believes, “thatthe current accepted concept that clients are the victims of mental illness caused by neurochemical imbalance over which they have no control is wrong…The brain is not defective, its chemistry is normal for the behaviors clients choose.” *Verbs are used, not nouns or adjectives. *Medications are ineffective. Choice Theory/Reality Therapy
- 7. Choice Theory/Reality Therapy VenturaSchool of the Girls Glasser stated, “No matter how lonely and isolated someone may be, if the therapist adheres to the present and points to a hopeful future and, expands initial involvement into a series of involvements as soon as possible, great changes can take place.” *Maria
- 8. External Control Glasser, “Thesimple operational premise of the external control psychology the world uses is: Punish the people who are doing wrong, so they will do what we say is right; then reward them, so they keep doing what we want them to do. This premise dominates the thinking of most people on Earth.” Choice Theory/Reality Therapy
- 9. Internal Control The reasoninternal control psychology can make us happy is this: If we understand the principles of internal control, we will stop trying to control others and recognize we can only control our own behavior. This shift in thinking will help people meet their basic human needs in more direct, healthy, and adaptive ways. Choice Theory/Reality Therapy
- 10. Building the Relationship •Supporting • Encouraging • Listening • Accepting • Trusting • Respecting • Negotiating Differences Choice Theory/Reality Therapy
- 11. Hurts the Relationship •Criticizing • Blaming • Complaining • Nagging • Threatening • Punishing • Bribing or rewarding to control Choice Theory/Reality Therapy
- 13. Robert Wubbolding Wubbolding isa counselor, psychologist, and university professor. He urges students to adapt reality therapy to their own personality.
- 14. Plans are encouragedto be: SAMIC • Simple • Attainable • Measurable • Immediate • Controlled • Committed • Continuous Choice Theory/Reality Therapy
- 15. WDEP • The proceduresof reality therapy are summarized in the WDEP system • Helping clients, students, employees define and clarify their wants (W), • Examining their total behavior: feelings, effective or ineffective self-talk, and especially their actions (D). • A searching and even at times uncomfortable self-evaluation (E) • Culminating in specific and attainable positive plans (P) for improvement
- 16. Wants What do youwant? What do you want instead of the problem? What is your picture of a quality life, relationship, etc? What do your family/friends want for you? What do you want from counselling? Doing What are you doing? (acting, thinking, feeling, physiology) When you act this way, what are you thinking? When you think/act this way, how are you feeling? How do your thoughts/actions affect your health? Evaluate Is what you are doing, helping you get what you want? Is it taking you in the direction you want to go? Is what you want achievable? Does it help you to look at it in that way? How hard are you prepared to work at this? Is your current level of commitment working in your favor? Is it a helpful plan? Plan What are you prepared to do/think differently that will take you in the direction you want to go? Are you clear about what you are going to do? Is it achievable? How will you know you have done it? Can you start doing it immediately? Is it in your control? Are you committed to doing it?
- 17. Choice Theory/Reality Therapy Promotes •Problem-solving skills • Self-evaluation • Mutual respect • Cooperation and collaboration
- 18. Five Basic Needs •Survival •Loveand Belonging •Power or Achievement •Freedom or Independence •Fun “Choice Theory is the Train Track and Reality Therapy is the Train.” Choice Theory/Reality Therapy
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- 22. PTSD involves: • Exposureto actual or threatened death, serious injury, or sexual violence • Presence of intrusion symptoms associated with traumatic event(s), beginning after the traumatic event(s) • Persistent avoidance in stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred • Negative alterations in cognitions and mood associated with the traumatic event(s) beginning or worsening after the traumatic event(s) occurred • Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred (DSM-V) PTSD
- 23. PTSD Significant Problems ofPTSD: • Having problems with memory • Having a distorted sense of blame • Being in a cycle of negative emotions • Feeling detached, disconnected or isolated from others • Somatic symptoms (heat sensations, shortness of breath, etc.) (DSM-V)
- 24. PTSD Other Factors: • Femalesare at higher risk • Increased suicide risk • 80% more likely to have other mental illness involved • Traumatic Brain Injury can cause mis-diagnosis • Karen’s onset from culture shock and often co- morbid *Bi-polar Disorder (DSM-V)
- 26. Conclusion Glasser, “When therapyseems finished there is often a problem of when and how to bring it to a close. Although termination is always difficult because of the involvement, as the patient grows stronger he is able to make more permanent involvements to replace the therapist. The therapist must take the initiative if the patient hesitates, but usually termination just happens. To quote G.L. Harrington, when I asked him when he believes a patient is ready to have therapy terminated, ‘When, after a long period of treatment, he begins to talk about how much more he needs a new car and how much less he needs you,’.”
- 27. Diagnostic and StatisticalManual of Mental Disorders: DSM-5. (2013). (5th ed.). (pp. 271-280). Arlington,VA: American PsychiatricAssociation Glasser, W.(2000) Counseling with Choice Theory The New Reality Therapy. (1st ed.). (pp. 22-26). New York. Harper. Glasser, W. (1990) Reality Therapy A new Approach to Psychiatry. (1st ed.). (pp. 80-82, 153). New York. Perennial Library. Glasser, W. & Wubbolding, R. Reality Therapy. Retrieved on October 19, 2018, from http://www.cengage.com/resource_uploads/downloads/0495097144_81298.pdf Hale, J. V., & Sindlinger, J. (2017). Re-Envisioning Reflective Supervision: A Choice Theory/Reality Therapy Application Using Reflecting Teams. International Journal of Choice Theory & Reality Therapy, 37(1), 56– 65 Mason, C. P., & Dye, L. (2017). ATTENDING to BASIC NEEDS: IMPLEMENTING REALITY THERAPY IN SCHOOL COUNSELING PROGRAMS to ENHANCE ACADEMIC ACHIEVEMENT and CAREER DECISION-MAKING SKILLS. International Journal of Choice Theory & Reality Therapy, 37(1), 46– 55. PTSD, N. (2016). Types of PTSD. Psych Central. Retrieved on October 29, 2018, from https://psychcentral,com/lib/types-of-ptsd/ Sommers-Flanagan, J. & Sommers-Flanagan, R. (2015). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques (2nd ed.). (pp. 301-330). Hoboken, NJ: John Wiley & Sons, Inc. References