Counselling Psychology- Chapter 11: Reality Therapy – Flashcards

- William Glasser - Chemical Engineer, Psychologist, Psychiatrist • Rejected Freudian model early - The notion of transference, the unconscious, & dwelling on one's past • Best to talk to the sane part of clients, not the disturbed side • Reality Therapy influenced by Control Theory (William Power) • Glasser expanded, revised, ; clarified - Choice Theory, the theoretical basis of Reality Therapy • Essence of Reality Therapy - People are responsible for what they choose to do • Symptoms are result of choices we've made - We can choose to think, feel, & behave differently • Emphasise active language-depressing rather than being depressed - mental illness is a result of an individual's unsatisfying present relationship or general unhappiness - a choice

• Basic focus is on what clients are doing ; how to get them to evaluate whether their present actions are working for them • Inborn needs for survival, love and belonging, power, freedom, and fun • People are mainly motivated to satisfy their needs, especially the need for significant relationships - love ; belonging • Driven to meet these unmet needs - May not be well aware of what needs are unmet - Ways chosen to satisfy need may not be optimal • Since we are responsible for what we choose to do, we can choose differently • Most clients underlying problem - Either involved in present unsatisfying relationship or lack relationship - Inability to connect, get close to others, have satisfying or successful relationships • Therapist recognises clients choose their behaviour as way to deal with frustrations caused by unsatisfying relationships • Therapist's role to establish therapeutic relationship as prerequisite for effective therapy • Therapy consists of helping & teaching clients to make better choices around relationships

• Choice Theory is theoretical basis for Reality Therapy - Explanation of why & how we function • Reality Therapy provides the delivery system • Choice Theory is the highway • Reality Therapy is the vehicle delivering the product • Choice Theory - Not born as blank slates waiting to be externally motivated by forces in the world around us • Born with five genetically encoded needs that drive us all our lives: - Survival or self-preservation - Love & belonging - primary need - Power or inner control - Freedom or independence - Fun or enjoyment • Whenever we feel bad, one or more of these need is unsatisfied • Every total behaviour is best attempt to get what we want to satisfy our needs • Total behaviour made up of four inseparable but distinct components - Acting, thinking, feeling, physiology • Choice Theory emphasises thinking & acting • Primary emphasis is on what the client is doing & how this doing component influences other aspects of total behaviour • Focus on what client can control in relationships - their own behaviour

• Therapy is about - Helping clients realise these unmet needs and learning ways to meet them in a better way - Teaching clients to take more effective control of their lives • Focusonaction,what the client can do - When behaviours change, often feeling/thinking change • Focusonthepresent • Rapport essential to helping client courageously examine & evaluate their behaviour & make changes

• Choice & responsibility - Clients choose what they do & must be responsible for these choices • Reject transference - Therapists strive to be themselves - Transference - way of avoiding being who they are & owning what they do • Keep therapy in the present - Past mistakes not relevant now - Past does not determine future • Avoid focusing on symptoms - Symptoms warn chosen behaviour unsatisfying • Challenging traditional view of mental illness - People should not be labelled with diagnosis - Mental illnesses associated with brain abnormality

• RT - active, directive, & didactic therapy • Skilful questioning - central technique used throughout the therapy process • Various techniques may be used to get clients to evaluate what they are presently doing to see if they are willing to change • If clients decide that their present behaviour is not effective - They develop a specific plan for change - Make a commitment to follow through • Reality therapists help clients to - Identify basic needs - Discover clients' quality world • The world we would like to live in if we could - Help clients understand that they are choosing their total behaviours • Clients learn to make better choices

• Therapeutic alliance foundation for effective practice - Understanding ; supporting relationship - Firm, friendly, ; trusting environment • Mentoring process - therapist as teacher, client as student • Personal qualities of counsellor - Warmth, sincerity, congruence, understanding, acceptance, concern, respect for the client, openness ; willingness to be challenged • When relationship established, therapist challenges clients, gently but firmly, to examine what they are doing - Self-evaluation process

• Robert Wubbolding • describes key procedures in the practice of Reality Therapy • Used to help clients explore their wants, possible things they can do, opportunities for self-evaluation, ; design plans for improvement 4 factors: W - wants D - Doing and direction E - Evaluation P - Planning

W - Wants - Therapists help clients discover their wants ; hopes through skillful questioning eg. What do you want to be ; do? What does your quality world look like? - Helps clients move from sense of external control to sense of internal control - Relevant questions help clients gain insights ; arrive at plans ; solutions D - Direction ; Doing - Questioning around what the client is currently doing to meet their needs, and how well those behaviours are working for them - What are you doing now? Where do you want to go? What would you do differently? - This facilitates a focus on the present (vs. past), focus on action, and sets the stage for self-evaluation E - Evaluation (self) - Self-evaluation is the cornerstone of Reality Therapy procedures - Does your present behaviour have a reasonable chance of getting you what you want? Is it helping? It is working for you? - Needs to be an honest self-evaluation to facilitate change P - Planning (and action) - The culmination of cycle of counselling - Helping clients identify specific ways to fulfil their wants ; needs - Translating insight and evaluation into action • Effective only if client has made a self-evaluation ; determined that they want to change a behaviour - Throughout process, therapist continually urges the client to be willing to accept the consequences of their choices ; actions good plans are SAMIC: Simple, Attainable, Measurable, Immediate, Controlled by the planner, Continuously done (daily), Committed to

• Group counselling - well suited because of emphasis on connection ; interpersonal relationships • Brief Therapy - focus on current behaviours ; making changes in the present vs. delving into unconscious dynamics ; intensive exploration of the past

• Counselling, social work, education, crisis intervention, corrections ; rehabilitation, institutional management, ; community development • Schools, general hospitals, state mental hospitals, halfway houses, alcohol ; drug abuse centre

- Gives only limited attention to helping people address environmental ; social problems, eg. discrimination ; oppression - what is the power of the individual in this situation? - Therapist needs to appreciate the role of discrimination ; racism ; help clients deal with social ; political realities - Some clients very reluctant to directly verbally express what they need - socialised to think more of what is good for the social group than individual wants/ needs

- Application in various countries ; with many different cultures... with some adaptation - Proponents stress the similarity of all people - universal needs for survival, love ; belonging, power, freedom, fun - Clients decide what is problematic ; what/how to change - therapist is not imposing their own background/culture - Respectful of clients' cultural values by helping them explore how satisfying their current behaviour is both to themselves & to others

• Positive view of human nature & possibility of ch • Action approach that relies on simple & clear concepts • Brief approach - by focusing on present behaviours & conscious elements • Imparts skills in self-examination & change - client acquires sense of self-direction & empowerment • Works well with reluctant/ resistant clients, eg. addiction treatment & recovery programs • Can be applied to a diverse population • Wide applicability - can be used by educators, nurses, ministers, social workers & counsellors

• Problem-solving therapy that tends to discourage exploration of deeper emotional issues • Discounts the therapeutic value of exploration of the client's past, dreams, the unconscious, early childhood experiences, ; transference • Glasser's view on psychopathology-all psychological disorders as behavioural choices - Struggle to cope with real illness + additional guilt • Vulnerable to 'expert' practitioner - Danger of fixing problems & imposing values