William Glasser wrote the book reality therapy in 1965. Since its publication, it has gained increasing prominence in the United States, as well as the world. Dr. Glasser developed his ideology to address the limitations he found in the Freudian model of psychology. The methods and practices intrinsic to reality therapy differ substantially from conventional therapy. Dr. Glasser challenges several widely accepted notions of psychiatry, such as mental illness and the role of therapists. Glasser founded the William Glasser Institute to encourage the spread of his ideas into psychiatric practice.
Over the last thirty-five years, Glasser's ideology has proven to be an effective form of therapy, with successes in both institutional settings and private practices.
Reality therapy concentrates on the client's needs and getting them to confront the reality of the world. In Reality Therapy, these needs are classified into power, love and belonging, freedom, fun, and survival. Survival includes the things that we need in order to stay alive, such as food, clothing and shelter. Power is our sense of achievement and feeling worthwhile, as well as the competitive desire to win. Love and belonging represent our social needs, to be accepted by groups, families and loved ones. Freedom is our need for our own space, a sense of independence and autonomy. Fun is our need to enjoy ourselves and seek pleasure. We seek to fulfill these needs at all times, whether we are conscious of it or not.
In our society, survival needs are generally met, but we use ineffective methods to satisfy the other four needs. These methods lead us into decisions that compromise our ability to get what we want. Socially unacceptable behaviors are motivated not by any mental illness, but by an individual's inability to adequately meet their needs. For instance, a teenager could try to fulfill his need for freedom by sneaking out to a concert without his parents' permission.
Upon arriving home, he finds his irate parents waiting up for him. Quite likely the parents will feel justified in confining the boy's activities further, say by grounding him. Instead of fulfilling his desire for freedom, the teenager's actions have actually worsened his problem, which is his lack of autonomy.
Reality Therapy is about choices. We choose our behaviors. If we get cut off on the highway, we sometimes respond with anger, blaming the other person for the anger we feel. However, reality therapy states we choose to be angry. We could just as easily wave a dismissive hand in response to the other person. If we don't, it is ultimately because we choose not to. Many of us feel we don't have a choice, and must react in a certain way. To build upon the previous example, the teenager didn't have to sneak out to see the concert, he could have chosen to pursue his desires in another fashion. Additionally, the parents may feel required to be angry about the incident. But the parents have a choice as well. Instead of responding with anger, they could choose another way to express their displeasure.
This focus on options and choices provides one of the fundamentals to reality therapy, that of choice theory. Formerly known as control theory, choice theory states that the only person an individual can control is himself or herself. Many problems originate in relationships where one person tries to control the actions or decisions of another. For example, the parents of the teenager may want to lock him in his room in an attempt to control him. This could lead to further incidences of sneaking out or possibly to running away to "escape the prison." In reality therapy, the parents would be encouraged to control their own choices, instead of their son's.
The role of the therapist in Reality Therapy also differs from conventional therapy. In conventional therapy, the therapist remains aloof and uninvolved, in order to preserve objectivity. By contrast, Reality therapy encourages the therapist to develop a relationship with the client based on trust and honesty. It is important for the client not to feel judged or condemned for their decisions. Instead, the therapist merely acknowledges those actions and points out alternatives. The therapist is to help the client create a workable plan to deal with his problems, and encourage the client to dissuade from negative or unproductive actions that have become habitual.
Once this personal relationship is established with a client, the therapist then proceeds to reject the socially unacceptable behaviors, without rejecting the person. In this way, the therapist reinforces the client's self-image as a person who is capable of controlling their actions. The therapist maintains the close personal relationship throughout the process and never rejects the client or makes him or her feel judged. Any unrealistic behaviors or attitudes are addressed directly and honestly, and the client is encouraged to pursue alternative action.
To further this aim, reality therapy utilizes three primary questions that are continually asked of the client. What is it that you want? What are you doing to get what you want? Is it working? This direct line of questioning forces the clients to examine not just their motivations but the actions they choose to pursue wants and needs.
To further build upon the previous example, let us imagine that the teenager has continued to deny his parent's wishes or authority and has continued on his escapades. At a loss, the parents seek professional help in the form of a reality therapist. When asked what it is he really wants, the boy responds with "freedom to go and hang out with my friends and do the things I want to do." This directly implies the teenager's desire for freedom, as well as his need for love and belonging (hanging out with friends). The therapist continues by asking the teenager what he is doing to meet his desires. The teenager tells him about sneaking out to concerts or parties and declares his intent to continue this practice. "My parents can lock me up for as long as they want, as soon as I can, I'm outta there," says the teenager. The therapist confirms that the boy sneaks out in order to establish his autonomy, and continues by asking if what the teenager is doing is working. By then pointing out that the real results of his actions are further confinement and restrictions on his activity, the therapist can begin to construct a plan for alternate actions. In this way, the client is being taught to confront his own responsibility in the situation.
Responsibility is a fundamental principle in Reality Therapy. Responsibility is defined as the ability to fulfill one's needs without interfering with other's ability to meet those needs as well. Reality Therapy advocates dispensing with common psychiatric labels, such as psychosis or neurosis, as these terms tend to stereotype and classify people. When labeled by one of these terms, such as agoraphobia, individuals tend to view themselves as different from other people, as being ill. This mentality prevents the person from accepting himself or herself as a real person, fit to be a member of society. In addition, the patient who believes they are "sick" tend to think they have no control over their condition or actions, and thereby disempowers them from making productive choices. Reality therapy pursues a different end; to help the person feel a sense of self-worth and to enable them to choose their actions instead of reacting in a pre-set, determined pattern. Instead of utilizing labels, Reality Therapy recognizes these people as incapable of meeting their needs, and terms them irresponsible. The goal of reality therapy is not to "heal" any "mental illness," but to teach the client responsibility.
Reality therapy has seen success in institutional settings. Many applications have been used to address problems in schools,…