Threatment Approach
Reality Base & Choice Therapy
Reality Therapy
The founders of Reality Therapy (RT) and Choice Theory is William Glasser and his mentor and teacher, psychiatrist G. L. Harrington. It was developed at the Veterans Administration hospital in Los Angeles in the early 1960s. RT is an approach to psychotherapy and counseling. The term refers to a process that is people-friendly, 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. RT 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 symptoms of mental disorders. Reality therapy maintains the individual is suffering from a socially universal human condition rather than a mental illness. When the individual is not able to achieve their basic needs, one’s behavior moves away from the norm. Since fulfilling basic needs is part of a person's present life, reality therapy does not concern itself with the individual’s past. Neither does this type of therapy deal with unconscious mental processes. In these ways reality therapy is very different from other forms of psychotherapy. During counseling sessions, the therapist will discuss how the past is not something to dwelled upon, but rather to be resolved and moved past in order to live a more fulfilling and rewarding life. When applying reality therapy and choice therapy the goal is for the therapist to help the client (individual) find better ways to fulfill their needs by taking control of their lives. One could think of reality therapy as a mentoring process where the counselor is the teacher and the individual is the student. It assists people in identifying what they want, what they need, and then in evaluating whether they can realistically attain what they want. It helps them examine their own behaviors and evaluate them with clear criteria. The counselor would teach the individual how to evaluate their behavior, make plans for change, and set goals. This type of therapy encourages problem solving, and it is based on the idea that people experience mental distress when their basic psychological needs have not been met. These needs are:
• Power: A sense of winning, achieving, or a sense of self-worth.
• Love and Belonging: To a family, to a community, or to other loved ones.
• Freedom: To be independent, maintain your own personal space, autonomy.
• Fun: To achieve satisfaction, enjoyment and a sense of pleasure.
• Survival: Basic needs of shelter, survival, food, sexual fulfillment.
It is important for the counselor to help the individual explore their basic needs when faced with difficulty. People participating in reality therapy might learn ways to be more aware of any negative thoughts and actions that may prevent them from meeting their needs: as according to the tenets of reality therapy. However, changing one's actions may have a positive effect on the way that individual feels and on his or her ability to attain desires. These changes ideally take place through the use of Glasser's choice theory, which uses questions such as "What are you doing/What can you do to achieve your goals?" The counselor is to make a personal ethical connection with the individual. If this connection is not made, there is no possibility for the counselor to provide help. Reality therapy's focus on personal responsibility dictates that the counselor must sometimes confront the individual in a firm manner. However, they must also be accepting, sincere, and the therapist being the individuals biggest advocate.
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Choice Therapy
By the 1970s, the concepts from Reality Therapy were extended into what Glasser then called "Choice 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. Choice Theory asserts 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 Glasser’s choice theory it is a systematic explanation of how the human mind works. The therapist focuses on human beings choosing many of their behaviors in order to satisfy innate human needs:
1.self-preservation or survival,
2. Belonging and love,
3. Achievement or power or inner-control,
4. Freedom or independence, and
5. Fun or enjoyment.
It is important in sessions for the therapist to guide the individual in understanding the only person behavior we can change is our own which is the core belief when implementing Choice therapy. Our behavior is our best attempt to control our world to meet our needs and wants. This will allow one to aim to focus on the preference of the individual. Choice Theory implements axiom which ask:
• Is what I am doing getting me closer to the people I need? If the choice of behaviors is not getting people closer, then the therapist works to help the client find new behaviors that lead to a better connection.
The therapist is patient and supportive; however, keeping focus on the source of the problem. There are four aspects of choice theory utilized in sessions:
1. thinking, (We can directly choose our THOUGHTS)
2. acting, (We can directly choose our ACTIONS)
3. feeling (We have great difficulty in directly choosing our FEELINGS)
4. physiology. (We have great difficulty in directly choosing our physiology (sweaty palms,
headaches, nervous tics, racing pulse, etc.).
The therapist is aware of its critical and crucial first step in one understanding their behavior and mental processing by the emotions (feelings) that is displayed. The individual is prompt to conduct self-evaluation. Utilizing empathy in the sessions allows the individual to focus on making better choices. The process is as followed:
• self-realization that something must change
• realization and acceptance that change is, in fact, possible, leads to a—plans that are at the heart of successful reality therapy/choice therapy
• therapist helps the client create a workable plan to reach a goal