REALITY THERAPY:Role of the Counselor, Strengths, Limitations

<< BEHAVIORAL APPROACHES:Use of reinforcers, Maintenance, Extinction

GROUPS IN COUNSELING:Major benefits, Traditional & Historical Groups >>

Theory and Practice of Counseling - PSY632

Lesson 37

REALITY THERAPY

Behavioral Approaches (Link to previous lecture)

Evaluation: Strengths

Effectiveness: This approach has variety of techniques effective to deal with various problems.

Efficiency: The technique is shorter, and also requires less training on the part of the administrator.

Empirically supported techniques

Breadth of application: Behavioral approaches are effective for different types of patients, and

applicable to different situations. For Example, it is used effectively with ADHD, conduct disorder,

eating disorders, substance abuse, phobia, impulse control, psychosexual dysfunction, etc.

Critics of Behavior Modification

The approach is criticized to be dehumanizing and overly controlling. One question is often raised

whether it is ethical for one human to control another's behavior?

Reinforcement and real life?

Another question is that what happens when the reinforcers stop, for example, when the person

leaves the mental hospital or clinic? The person may become so dependent on extrinsic rewards

that the appropriate behaviors quickly disappear.

Does not deal with the total person.

The approach does not promote any inner growth; just relieves symptoms or provides a few skills.

Also it is not beneficial for nonspecific or existential problems.

Best demonstrated only under controlled conditions.

Does not consider developmental stages:

Skinner and others believe that acquisition of learning has universal characteristics, and do not pay

much attention to developmental stages.

REALITY THERAPY

What is Reality Therapy?

Reality Therapy is a relatively new counseling theory that emphasizes change people can make in

their actions and thoughts.

It has a phenomenological base and an existential heart, which maintains that people's inner words

will determine what behaviors they choose.

It is action oriented, concrete, didactic, directive, behavioral and cognitive.

Overall, reality therapy emphasizes the fulfillment of psychological needs and is preventive in

nature.

Developed by Dr. William Glasser in 1965.

William Glasser

William Glasser was born in Cleveland, Ohio, USA, in 1925; the third and youngest child in a close-

knit family. He played the band, and had a strong interest in sports.

158

Theory and Practice of Counseling - PSY632

He finished work for a Master's degree in 1948, but his doctoral dissertation was rejected. He then

entered medical school at Western Reserve University, graduating with a medical degree in 1953.

After obtaining a medical degree, he finished his psychiatric residency from UCLA, USA, in 1957.

He had doubts about psychoanalysis. His faculty supervisor Harrington helped him develop some

concepts of reality therapy. In the 1960s he began to formalize his approach to counseling. He

indicates that "conventional psychiatry wastes too much arguing over how many diagnoses can

dance at the end of a case history".

Glasser's first book, Mental Health or Mental Illness? (1961), continued many of the ideas that were

later more formally expressed in Reality Therapy: A New Approach to Psychiatry (1965).

Shortly after the publication of Reality Therapy, Glasser founded the institute of Reality Therapy in

Canoga Park, California.

He applied reality therapy to various areas, as propagated many of his books given below:

Schools Without Failure (1969)

The Identity Society (1972)

Positive Addiction (1976): he asserted that individuals can become stronger instead of

weaker from so-called addictive habits. Two examples of habits that improve physical and

mental health are jogging and meditation.

Control Theory (1984) which argues that all behavior is generated from inside persons.

Two of Glasser's more recent books, Stations of the Mind (1981) and Control Theory: A New

Explanation of How We Control Our Lives (1984), reflect his theoretical stance and emphasizes

how the brain influences our perceptions.

View of Human Nature

A major tenet of reality therapy is its focus on consciousness: human beings operate on a conscious

level; they are not driven by unconscious forces or instincts.

A second belief about human nature is that there is a health/growth force within everyone which is

manifested on two levels:

Physical Orientation

There is need to obtain life-sustaining necessities such as food, water, and shelter and use

them. According to Glasser, human behavior was once controlled by physical needs for

survival, such as breathing, sweating, digesting, etc. Survival is associated with old brain,

because it is automatically controlled by body.

Psychological Orientation:

Belonging: the need for friends, family and love.

Power: the need for self-esteem, recognition, and competition.

Freedom: the need to make choices and decisions.

Fun: the need for play, laughter, learning, and recreation.

An Associated need is of Identity: i.e., the development of a healthy sense of self. Identity needs are

met by being accepted as a person by others. Especially important in this process is experiencing

love and worth. When this happens, people achieve a Success identity; those whose needs are not met

establish a failure identity, a maladjusted personality characterized by a lack of confidence and a

tendency to give up easily. Because "almost everyone is personally engaged in a search for

acceptance as a person rather than as a performer of a task," personal identity precedes

performance. Failure identity develops in a child if:

The child does not get love, support, and guidance during 2-5 years of age.

159

Theory and Practice of Counseling - PSY632

There are problems in learning and relating during 5-10 years of age.

It presents an optimistic view of human nature that learning is a life-long process.

Control theory: people have mental images of their needs and behave accordingly. Personal actions

are based on perceptions. Human beings create behaviors, including mentally disturbing ones like

hallucinations, to satisfy internal pictures (perceptions).

Role of the Counselor

The counselor primarily serves as a teacher and model, accepting the client in a warm involved way

while focusing him or her on the control of displayed thoughts and actions. The counselor

increases focus by using `ing' verbs like bullying, arguing, angering to describe thoughts and actions.

There is an emphasis on choice- on what the client chooses to do. It indicates that behavior is

linked with feeling and physiology that is why other positive changes also become possible at the

same time.

Counselor-client focus is on the areas of change and making desires a reality.

It emphasizes positive constructive actions in bringing change.

There is a little attempt in reality therapy to test, diagnose, interpret, or otherwise analyze client's

action except to ask questions, e.g., what are you doing now? Is it working?

Do not concentrate on early childhood experiences, clients insightful of them, unconscious, blame,

etc.

Goals

To help clients become psychologically healthy and rational. Become autonomous and responsible.

To help clients clarify what they want in life, and to be aware of life goals. Poor mental health is

sometime the outcome of not knowing how to achieve goals. The counselor thus helps the client

finding out alternatives.

Willingness of the counselor to express faith in the client's ability to change

Six criteria to judge a healthy behavior:

Behavior is competitive

Easily completed

Can be done by oneself

Has value for the person

Improvement in life-style by the practice of behavior

Person can practice the behavior without becoming self-critical

To help the client formulate a realistic plan to achieve personal needs.

To have the counselor become involved with the client in a meaningful relationship.

To focus on the behavior and present.

Aims to eliminate punishment and excuses from the client's life. The client should not be punished

for failure by either the counselor or other people.

Techniques

This approach uses Action oriented techniques as described below:

160

Theory and Practice of Counseling - PSY632

Teaching

"The specialized learning situation ....is made up of 3 separate but interwoven situations:

Involvement between client and counselor.

Counselor rejects the unrealistic behavior without rejecting the person.

The counselor teaches the client better ways to fulfill needs within the confines of reality.

Posititiveness: the counselor talks about, focuses on, and reinforces positive and constructive

planning and behavior.

Employing humor

Confrontation: Asking or confronting about a behavior as a way of helping the client accept

responsibility.

Role playing: role-playing past or future behavior.

Feedback: The counselor provides feedback on client's behavior.

Application of Reality Therapy

The WDEP System

The focus of the therapy is on what do the clients want, what they have been doing, evaluation of the

helplessness of their behavior, and then planning their future behavior.

W: What do you want

D: Will this choice get you in the right direction? What you have been doing?

E: Self-Evaluation

P: Planning

Steps Incorporating Goals & Techniques

Establishing a relationship

Focusing on present behavior

Client evaluation of his/her behavior

Developing a contract or plan of action

Getting a commitment from the client

Not accepting excuses

Allowing reasonable consequences without punish

Refusing to give up on the client

Strengths

A real working model for different problems, populations, and settings, e.g., for troubled

adolescents, victims of abuse, drug addicts, etc. It has been pointed out that "it is crucial for group

counselors who work in school settings to create a trusting climate within their groups (Corey,

2004)."

Accountability and concrete outcomes.

Emphasizes short-term treatment.

161

Theory and Practice of Counseling - PSY632

Promotes responsibility and freedom within individuals without blame or an attempt to restructure

the entire personality.

The approach addresses the resolution of conflict:

Conflict occurs on 2 levels: on true level it develops over interpersonal disagreements (no

single solution); on false level it can be changed, like weight loss.

Limitations

Too much emphasis on here and now

Simplistic and Superficial

Ignores biology as a factor in mental illness

Does not deal with the full complexity of human life

Depends on two-way communication or establishment of a good client-counselor relationship

Approach keeps changing its focus

Skill Enhancement Activity

Decide on specific changes you want in your life.

You are held responsible for implementing these changes -Take ownership!

162

Table of Contents: