Module 15 Reality Therapy

Module 15 Reality Therapy Component 1A Role Name Affiliation Principal Investigator Dr. Geeta Balakrishnan College of Social Work, Nirmala Niketan, Mumbai Paper Coordinator Prof. Xavier Kanickairaj National Institute of Social Work and Social Sciences, Bhubaneswar Content Writer Prof. Kirubakaran Loyola College, Chennai Content Reviewer Dr. Yamini Suvarana College of Social Work, Nirmala Niketan, Mumbai Language Editor Ms. Marianne Claudia Rayer Research scholar, Pondicherry University, Pondicherry Component 1B, Subject Name Paper Name Module Name Description of Module Social Work Education WORKING WITH INDIVIDUALS AND FAMILIES Therapeutic Approaches in Social Case Work Interventions(contd.) - Reality Therapy - Module ID SW/SCW/15 Pre Requisites Not applicable Objectives To know the origin of Reality Therapy To grasp the basics of Choice Theory To understand the method of applying the Reality Therapy Key words Choice Theory, Seven Caring Habits, Seven Deadly Habits, Five Major Principals, Ten Axioms, WDEP System

Quadrant 1 INTRODUCTION Reality therapy, developed by Dr. William Glasser, is founded on the principles of Choice Theory and has developed into a widely popular and recognized therapy form. Professionals in education, mental health, social services, and even parents have embraced the fundamentals of this therapy. Reality Therapy suggests that all human issues derive from a lack of fulfilling relationships with others. The goal of this therapy is to provide a connection for people, beginning with the therapist-client connection. Objectives To learn about the origin of Reality Therapy and also about its founder To grasp the basics of Choice Theory To understand the method of applying the Reality therapy WILLIAM GLASSER (1925-2013): REALITY THERAPY Dr. Glasser is an internationally recognized psychiatrist who is best known as the developer of Reality Therapy, a method of psychotherapy he created in 1965 and that is now taught all over the world. Born in 1925 and raised in Cleveland, Ohio, Dr. Glasser was initially a Chemical Engineer but went into psychiatry when it became apparent to him that this was his real interest in life. He attended medical school at Case Western Reserve University in Cleveland, and took his psychiatric training at the Veterans Administration Hospital in West Los Angeles and UCLA (1954-57). He became Board Certified in 1961 and was in private practice from 1957 to 1986. Glasser's path has been one of a continuing progression from private practice to lecturing and writing and ultimately culminating in the publication of over twenty books. After writing the counseling book, Reality Therapy (1965), he published his first book on education, Schools without Failure (1969). In the late 70 s, Glasser was introduced to control theory systems through the writings of William T. Powers. In consultation with Powers, Dr. Glasser applied Powers knowledge of how systems work to

the field of human behavior. In his next key book, Choice Theory (1998), Glasser greatly expanded the understanding of motivation and behavior. He and then added, Warning: Psychiatry Can Be Hazardous to Your Mental Health (2003), to help people improve their mental health and happiness. In 2005 he produced a booklet, Defining Mental Health as a Public Health Issue to provide a new resource for mental health professionals. Finally, in 2007, Eight Lessons for a Happier Marriage, which he co-authored with his wife, Carleen, became his third book to help couples learn important tools for improving their relationship. Dr. Glasser s approach is a non-traditional one. He did not believe in the concept of mental illness unless there is something organically wrong with the brain that can be confirmed by a pathologist. Very early, he came to the conclusion that genetically we are social creatures and need each other and that the cause of almost all psychological symptoms is our inability to get along with the important people in our lives. By 1980, he had begun to form the idea that led to choice theory: why so many people are unhappy in their relationships. Unlike all other living creatures, only human beings are genetically driven by the need for power. We try to satisfy that need by using what he calls, external control psychology literally trying to force people to do what we want them to do. This struggle led to the symptoms described in the Diagnostic and Statistical Manual of Mental Disorders 4 th edition (DSM-IV), the official manual of approved diagnostic terms for psychiatric diagnosis, published by the American Psychiatric Association (APA) in the year 1994. Dr. Glasser had maintained that if we were unable to figure out how to satisfy our power need by respecting each other, our days on earth were numbered. He offered the choice theory to replace external control and has dedicated the remainder of his life to teaching and supporting this idea. In 1967, he founded The Institute for Reality Therapy. Since that time, over 75,000 people worldwide have undergone the Intensive Training program to learn how to apply his ideas in their professional life. They have discovered that by using choice theory, their personal relationships have improved as well. Some of his many accomplishments are as follows: listed in Who s Who in America since the 1970s; 1990 - awarded an honorary degree of Doctor of Humane Letters, Honoris Causa from the University of San Francisco;

2003 - presented with the ACA Professional Development Award recognizing the significant contributions made to the field of counseling; 2004 - presented with the "A Legend in Counseling Award" by the ACA; January - 2005 presented with the prestigious Master Therapist designation by the American Psychotherapy Association; and finally, 2005 - presented with the Life Achievement Award by the International Center for the Study of Psychiatry and Psychology for his enormous influence as a psychotherapist and author. Dr. William Glasser devoted himself to teaching the world Choice Theory, a new psychology that explained human behaviour. This new psychology was diametrically opposed to the psychology he believed most people in the world adhered to, which he termed External Control Psychology. Dr. Glasser believed External Control Psychology, with its postulate that our behaviour is caused by people, situations and things outside of us, promoted adversarial human relationships. On a daily basis, people living by the tenets of External Control Psychology lose effective control of their lives while attempting to control other people. Dr. Glasser believed that when External Control Psychology was replaced by Choice Theory in the minds of people, individuals everywhere would lead more productive lives and failure and misery would be eliminated from human endeavours that rely on functional relationships (i.e., marriages, families, communities, schools, businesses, agencies, organizations, and government). CHOICE THEORY Reality therapy is based on Choice Theory developed by Dr.William Glasser. The Choice theory states that: 1. All we do is behave, 2. That almost all behavior is chosen, and 3. That we are driven by our genes to satisfy five basic needs: survival, love and belonging, power, freedom and fun. Regardless of what had happened in the past, one can re-evaluate one s current reality and choose behaviours that will help us to satisfy our needs more effectively now and in the future. When one learns to meet his/her needs effectively in the present, the influence of the past disappears. What underlies reality therapy is choice theory which was based on control theory. Control theory focused on external

control whereas Glasser felt that inner control was important and most, if not all, of our behaviour is internally motivated and chosen. He opined that the most important need is for love and belonging, as being close and connected to the people we care about is a pre-requisite to ensure the satisfaction all of needs. Choice theory, with the Seven Caring Habits, replaces external control psychology and the Seven Deadly Habits. External control is destructive to relationships and can destroy the ability people to find satisfaction in relationships leading to disconnect. Dr. Glasser believed that being disconnected was the source of almost all human problems such as mental illness, drug addiction, violence, crime, school failure, spousal abuse, to mention a few. Relationships and our Habits Glasser created a list of seven caring habits we should cultivate and seven deadly habits that we should avoid. These are given in tabular form below. Seven Caring Habits Seven Deadly Habits 1. Supporting 1. Criticizing 3. Listening 3. Complaining 4. Accepting 4. Nagging 5. Trusting 5. Threatening 6. Respecting 6. Punishing 7. Negotiating differences 7. Bribing, rewarding to control Glasser was of the opinion that our behaviour is generated or chosen not because of external stimuli however influential such stimuli might be, nor because of the past unresolved conflicts but to fulfill one or more of the five basic needs that are universal and genetic. He suggested that teachers should cultivate the Seven Caring Habits and avoid the Seven Deadly Habits so that they create an environment conducive to students needs. THE FIVE MAJOR PRINCIPLES OF CHOICE THEORY 1) Our basic needs:

(1) Survival, health and reproduction: These include the sexual drive and the physiological functions performed by the body in an attempt to establish and maintain our health and homeostasis. (2) Love and belonging: These refer to the need to love and to be loved and to belong to a group. (3) Self-worth/power: These are competence, self-esteem, and empowerment. (4) Freedom: It is the ability to make choice and feel unrestrained and unconfined and having enough physical space. (5) Fun and enjoyment: It also includes interest and play, which are essential for learning. 2) Our quality world : Each one of us tries to fulfill the needs in very specific ways. We have an inner picture album otherwise called quality world of specific and unique wants or desires of how we would best like to fulfill our needs. 3) Frustration: The difference between what one wants and what one perceives he/she is getting from the environment causes one to generate specific behaviour. Behaviour is purposeful and it is intended to close the gap between what the person wants and what one perceives he is getting. Whether behaviour is successful or unsuccessful, in either case it is the best attempt by the person to fulfill his needs. 4) Total behaviour: Actions, thinking, feelings and physiology are inseparable components of total behaviour and they are generated or chosen from within. Thus most of them are choices. It is extremely difficult if not impossible to change directly our feelings and physiology, purely by will alone, but we have an almost complete ability to change our actions and some ability to change what we think. When we change our actions and thinking, our feelings and physiology also change. Therefore the reality therapist instead of encouraging the client to talk too much on their upset feelings on which they have no control, focuses on their actions and thinking over which they have control. 5) Perceptions and current reality : How one perceives the world around him and how he/she perceives himself/herself constitute the current reality. In therapy the therapist makes the client evaluate and reevaluate such perception of the current reality. Thus the source of all behaviour is in the here and now (current reality). The Ten Axioms of Choice Theory 1. The only person whose behavior we can control is our own. 2. All we can give another person is information.

3. All long-lasting psychological problems are relationship problems. 4. The problem relationship is always part of our present life. 5. What happened in the past has everything to do with what we are today, but we can only satisfy our basic needs right now and plan to continue satisfying them in the future. 6. We can only satisfy our needs by satisfying the pictures in our Quality World. 7. All we do is to behave. 8. All behavior is Total Behavior and is made up of four components: acting, thinking, feeling and physiology. 9. All Total Behavior is chosen, but we only have direct control over the acting and thinking components. We can only control our feeling and physiology indirectly through how we choose to act and think. 10. All Total Behavior is designated by verbs and named by the part that is the most recognizable. METHOD OF REALITY THERAPY: WDEP SYSTEM Practice or method of reality therapy: The procedures are summarized as the WDEP System. In reality therapy questioning is used much more extensively than in any other type of therapies. The WDEP System provides a questioning framework and each letter stands for a cluster of ideas. W = Want: W stands for asking clients about their wants, needs, perceptions and the level of commitment. What one wants from others and from oneself is thoroughly analyzed. D = Doing and Direction: What are you doing? and In which direction is your behaviour taking you? The doing here extends to exploring all the four components of total behaviour proper, which are actions, thinking, feelings and physiology. By doing this the therapist leads the client from the generalities to the specifics. The client will be asked to describe exactly what happened in terms of specific behaviours and the events of the specific day. E = Evaluation: It is to help the client to self-evaluate: The process of evaluation seems to be the heart of the reality therapy. Clients are asked to make self-evaluation of their specific behaviour. This includes an extensive area of one s action like the type of behaviour, the appropriateness of a specific behaviour, the attainability of the behaviour desired, their thinking or self-talk and the perceived level of control they exercise and the efficacy of their plans. P = Planning: Helping the client to make a plan of action: The ultimate goal of reality therapy is to make

a plan of action. Since clients can have control over their action, reality therapy focuses its attention on action. Since the four components of the total behaviour are inseparable, by changing the action the clients can change their thinking, feeling and physiology. Sometimes we keep waiting to feel better in order to act in which case we may have to wait forever. The characteristics of an effective plan are: 1) It is formulated by the client, 2) It is attainable or realistic, 3) It is put into action as soon as possible, and 4) It is within the complete control of the client. In his book Control theory (1986), Glasser expressed his view on current classroom management: We are far too concerned with discipline, with how to make students follow rules, and not enough concerned with providing the satisfying education that would make our over-concern with discipline unnecessary. Due to this, his Control theory attempted to explain why students perform poorly in school and suggested changes to the classroom structure in order to improve their academic performance. Glasser felt that all student choices were based on five basic and universal needs. These needs include survival, love/belonging, freedom, fun, and power (William Glasser Institute, 2005). In his Choice Theory (1998), he reasons that 95 percent of all behavior problems in the classroom result from students attempting to fulfill their need for power. Glasser suggested that teachers employ the methods of Reality Therapy when dealing with student misbehaviour. This involved avoiding past actions and forcing the student to respond to the following what questions: What the student was doing? What need was s/he fulfilling by doing this? What s/he was going to do to correct this behavior? Thus, the teachers avoid the negative reactions as detailed in the Seven Deadly Habits and transfer responsibility to the students. Glasser recommended that the teachers should enter into a contract with the student created by the student focusing on what the student will do to correct the problem. Glasser added this was necessary because it forced the student, who was lost in the symptom causing the behavior, to reconnect with his real needs.

Reinforcement is not a part of Glasser s overall approach, as he felt any consequence of an action, whether positive or negative, should be a natural one instead of a teacher-given one. If a teacher were to interfere, this would let the student off the hook and not teach him to take responsibility for his/her action. The use of punishment was also dismissed because of its inabilities to provide the student with responsibility and because Glasser felt that it had been proven ineffective by the American judicial system. Glasser s method of confronting students about their behaviors led into what he felt was extremely important in the classroom: the Class Meeting. During these meetings, students and teacher sit in a circle facing each other to talk through problems. The teacher leads the class through three possible types of meetings. There is the open ended, educational, diagnostic, and problem solving, all of which allow the students to confront others about problems they see in a mature and clam manner. At the end of the meeting, the teacher and students should have a plan that is agreed upon by all just like the contract created in the teacher-student situation. Twenty schools across the US have adopted Glasser's philosophy and created what he termed Quality Schools. The criteria for Quality Schools are as follows: 1. Relationships are based upon trust and respect, and all discipline problems, not incidents, have been eliminated. 2. Total Learning Competency is stressed and an evaluation that is below competence or what is now a "B" has been eliminated. All schooling as defined by Dr. William Glasser have been replaced by useful education. 3. All students do some Quality Work each year that is significantly beyond competence. All such work receives an "A" grade or higher, such as an "A+". 4. Students and staff are taught to use Choice Theory in their lives and in their work in school. Parents are encouraged to participate in study groups to become familiar with the ideas of Dr. William Glasser. 5. Students do better on state proficiency tests and college entrance examinations. The importance of these tests is emphasized in the school. 6. Staff, students, parents and administrators perceive the school as a joyful place. Glassers s Reality therapy is a process that is people-friendly and people-centered and has nothing to do

with giving people a dose of reality (as a threat or punishment).. An understanding of the reality therapy and choice theory can help us make our clients in case work treatment to make better choices in life and help them to recognize how fantasy can distract them from their choices they control in life. Choice Theory asserts that each of us is a self-determining being who can choose future behaviors and hold ourselves consciously responsible for how we are acting, thinking, feeling, and also for our physiological states. It will enable us better to explain how each of us attempts to control our world and those within that world. The information in this module has been taken from Glasser s works listed below: Glasser, W. (1980). What Are You Doing? How People Are Helped by Reality Therapy. Glasser, W. (1981). Stations of the mind: new directions for reality therapy. New York: Harper & Row. Glasser, W. (1985). Take effective control of your life. New York: Harper & Row. Glasser, W. (1998). Choice theory: a new psychology of personal freedom. New York: Harper Collins. Summary Glasser, the Father of Choice Theory believed that people choose destructive behavior to reduce the pain of unsatisfying relationships. Reality therapy aims to bring about awareness that behavior, or "external control psychology," is a personal choice and not a biochemical impulse or mental illness beyond a person's control. Reality therapy is based on Choice Theory, which offers an explanation for healthy as well as unhealthy behaviour. All are motivated to satisfy the innate needs of survival or self-preservation, love and sense of belonging, self-worth/ power, freedom or independence, and fun or enjoyment. While some make healthy choices others make unhealthy and destructive choices. Glasser's theory can be used to help people make better choices. Glasser, created a case studies manual to accompany Choice Theory: A New Psychology of Personal Freedom and The Language of Choice Theory. Composites of clients and segments of Glasser's individual sessions are the basis of each chapter. Highlighted in his work are the critical interactions between therapist and client and the application of useful techniques in reality therapy. In this age of managed care, where restrictions on the number of visits limit the use of psychotherapy, reality therapy might be a better alternative to expensive psychiatric drugs.