Reality Therapy

Introduction
Key Concepts

The Therapeutic Process

The Practice of Reality Therapy The WDEP System Contributions and Limitations A Multicultural Perspective Summary

Introduction

Developed by William Glasser

Based on choice theory

Basic premise and assumptions:

People strive to control their lives to fulfill their needs

We are responsible for what we choose to do

Problem arise from lack of satisfying present relationship

Most mental illnesses are ineffective behaviours chosen

Introduction
Roles and Functions of Reality Therapists:
Establishing a working relationship Teaching clients choice theory Helping them make more effective choices in lives

Introduction
Its use in a variety of settings
schools, correctional institutions, general hospitals, state mental hospital, and substance abuse centers

Reality therapy approach is applicable to : counseling, social work, education, crisis intervention, institutional management, community development, corrections and rehabilitatin

Views of Human Nature

Five innate needs
Survival Love and belonging Power or achievement

Freedom or independence
Fun

Human behaviour is purposeful and driven by needs

Views of Human Nature

Needs, wants and perceived ways to satisfy them are stored in our quality world

Quality world is our personal Shangri-La

People are driven to satisfy the pictures through their behaviour

People are the most important component in one's quality world.

Choice Theory Explanation of Total Behaviour Choice Theory Explanation of Total Behaviour

Choice Theory Explanation of Total Behaviour

Choice Theory Explanation of Total Behaviour

Components of Total Behaviour
Acting Thinking Feeling Physiology

Behaviours are purposeful and chosen

People are responsible for their total behaviour Depressing, headaching, angering, etc

Characteristics of Reality Therapy

Stresses choices and responsibilities
as if people have choices We choose all we do

We must be responsible for what we choose

Focus on conscious behaviours that can be more easily and directly controlled Transference seen as refusing ownership and responsibility over one's behaviours Therapists firmly yet gently reject transference

Reject transference

Characteristics of Reality Therapy

Keep the Therapy in the Present
We may be products of our past but we are not victims of our past, unless we choose to be. It is the present that we can control Avoid dwelling on clients' past, especially past failure. Symptoms are results of the frustration of needs

Avoid Focusing on Symptoms

Symptoms will disappear once needs are met

Characteristics of Reality Therapy

Challenge Traditional Views of Mental Illness

Diagnosis attributes illness to brain pathology, discouraging psychotherapy & responsibilities Psychiatric drugs have negative side effets, physically and psychologically. Mental illness: people choose ineffective total behaviour

The Therapeutic Process

Therapeutic Goals
Help clients choose better ways in fulfilling needs, and connect with significant others For resistant and pleasure-seeking clients, the only goal is to connect with them first.

Therapists' Functions and Roles

ii. teach clients to self evaluate

i. establish good realtionship with clients

Iii. Instill hope that they are not alone and change is possible

The Therapeutic Process

Clients' Experience in Therapy
Find therapists gently, but firmly confronting May feel a sense of urgency Prompted to explore and self-evaluate

Focus on the present and controllable behaviours

Client decide to take responsibilities over choices Should feel motivated and confident to change

The Therapeutic Process

Relationship between Therapists and Clients
A teacher and the student in mentoring process Sincere, understanding, involved, supportive Good personal qualities of therapists: warmth, congruence, understanding, acceptance, concern, respect for the client, openness, persistence Therapists should be sincere and comfortable with their own individual styles

The Practice of Reality Therapy

1. Creating the counseling environment
Fair, friendly, supportive, caring, accepting, trusting, noncoercive choice environment Gently yet firmly confontative Therapists' involvement is promoted through:
Attending behaviour Appropriate humour Facilitative self-disclosure Summarizing and focusing Listening for themes

The Practice of Reality Therapy

2. Procedures that Lead to Change
People are motivated to change (i) when convinced present behaviour is not getting them what they want and (ii) when they believe they can choose other behaviours that will bring them what they want

A Cycle of counseling consisting of several steps

Intensive use of skillful questioning and confrontation

Paradoxical techniques, being positive, using clients' metaphors

The WDEP System

Developed by Wubbolding(2000, 2001, 2002)

Useful in teaching choice theory and traning therapists Skillful questioning as the basic technique W= Wants, needs, and perceptions

D= Direction and Doing

E= Self-evaluation

P= Planning and Action

1.Wants and Needs in WDEP

Explore wants, needs, perceptions,hopes, dreams, expectations of oneself and others, of clients in a conducive counseling environment
Define expectation of clients of themselves and of the therapy Continuous What do you want? What is it you want that you don't seem to be getting from life?

2. Direction and Doing in WDEP

Explore and describe total behaviour

Focus on the present

Emphasizes thinking and doing Link feelings and physiological reactions to thinking and doing/acting The choices and responsibilities of clients for total behaviours are emphasized What are you doing now?

3. Evaluation in WDEP

Confront clients with the consequences of their chosen behaviour

Lead them to judge the quality of their choices Cornerstone of reality therapy to drive change Is what you are doing helping or hurting you? Does what you are doing stand a good chance in bringing you what you want? Self evalution, except for certain groups of clients, eg: alcoholics or alcoholics' children

4. Planning and Action in WDEP

(i)
(ii)

Exploring possible new choices

Formulating action plans
Help clients come up with a good plan Assess commitment to carry out plan

(iii) Committing to action plans

Help clients explore and express fear in failing

Firm up commitment in writing Do not accept excuses, nonjudmental, convey belief

(iv) Devise a new plan if necessary

4. Planning and Action in WDEP

The importance of formulating a good plan

Essence of a good plan: SAMIC by Wubbolding

Simple

Attainable
Measurable Immediate, Involved

Controlled by planner, committed to, continuously done

Contributions of Reality Therapy

Short-term focus, thus less time consuming and more cost efficient Development of therapeutic processes that strongly support behavioural changes

Phenomenological stand
Existential orientation
People are choosing own goals and responsible for the world they create

Limitations and Criticisms

Neglect unconscious struggles and drives

Repressed conflicts, defense mechanisme One's past and traumatic experiences have tremendous influence Dreams reveal internal conflicts, wants, needs, hopes, fear and visions of the future

Focus on the present

Do not make use of dreams

Limitations and Criticisms

Reject transference
Transference reflects past interpersonal influence

Insights brought on by transference can improve present relationships

Simplistic views of psychological disorders
There are biochemical and genetical factors Causes additional guilt in patients

May affect growth & autonomy if used by manipulative therapists

Contribution to Multicultural Counseling

A nonjudmental, accepting counseling environment Demonstrate respect for clients' personal values through encouraging clients' self evaluation and own decision Helping clients to formulate and execute plans that are consistent with clients' cultural values

Specificity and direction of effective action plans

Limitations for Multicultural Counseling

Wubbolding(2000) expanded practice to multicultural situations: Japan, taiwan, Hong Kong, Singapore, Korea, India, Kuwait, Australia, Columbia, Slovenia, Croatia etc Differences in various issues
Collectivism vs Individualism Assertiveness and Communication Style

Concept translation
Discrimination and racism

Adaptations for Multicultural Counseling

Therapists must be aware and flexible
Accepting clients' priorities in innate needs Accepting a wide range of acceptable ways to satisfy needs Make adaptations tailored to each client's needs

Summary

Reality therapists fucntion as teachers and role models

Therapists create a caring, accepting, involved, supportive and noncoercive environment Following specific procedures and through skillful questioning, clients make better choices
Explore wants, needs, & perceptions Evaluate total behaviour Self evalution and decision Planning, commitment and action