Mario De La Garza, M.Ed. University of North Texas Theoretical Models of Counseling and Psychotherapy, 2nd Edition Chapter 11: Reality Therapy and Choice Theory Mario De La Garza, M.Ed. University of North Texas

Historical Context 1950s: mental health professionals began honoring people’s ability to choose and control thoughts, feelings, and behavior Free will accepted more than determinism Mental health professionals began being more active in the therapeutic relationship

William Glasser Mother was extremely controlling; father epitomized choice theory Studied engineering and psychology Eventually entered medical school at Case Western Reserve Trained in psychoanalysis, but disagreed with Freud’s theory

William Glasser Had no interest in clients’ past Worked at a residential facility for delinquent girls; began treating them with kindness and respect and emphasized personal responsibility for behavior. Reality Therapy → Control Theory → Choice Theory

Philosophical Underpinnings Glasser has not identified underlying ideas that may have contributed to his viewpoint, notwithstanding Powers (1973) . He developed his theory based upon his work with clients. Shares philosophy with Adler, Existential and Person-Centered approaches

Function of the Psyche Five basic needs: Survival Love and belonging Power Fun Freedom All individuals seek to fulfill needs to avoid pain of not having them met. Strength of needs varies among people

Function of the Psyche People translate needs into specific wants. Total behavior: thinking, doing, feeling, and physiology Responsible or irresponsible Effective or ineffective A person’s behavior represents one’s best effort to get a need met.

Structure of the Psyche Brain is the controlling system for the organism Automobile metaphor: Engine – basic needs Steering – unique wants Front wheels – thinking and doing Back wheels – feeling and physiology

Structure of the Psyche Quality world (inner picture album) – what a person perceives will fulfill and continue to fulfill the basic needs People Things Ideas/beliefs

Role of the Environment Family factors supply initial need fulfilling opportunities for a growing child Family has a significant impact on individual’s quality world Church, school, neighborhood, culture, and geographic location also influence need satisfaction

Healthy Functioning Behaving responsibly – meeting one’s own needs without preventing others from meeting theirs Form and maintain connections with others There is a balance of need fulfillment Effective life direction “I Want to Change and I Want to Grow” “Effective Behaviors” “Positive Addictions”

Unhealthy Functioning The lack of satisfying present relationships Disconnection between individuals and others NOT mental illness People choose behaviors to deal with their loneliness and isolation

Personality Change Take responsibility for choices Choose to change Realize myriad of options Choose new total behavior Assess efficacy of new total behavior

Client’s Role Be willing to focus on and change behavior Be willing to accept here-and-now focus Be willing to learn choice theory Be willing to build a relationship with therapist Be willing to persist in the relationship when challenged

Counselor’s Role Continuously practicing the AB’s Focusing on the present Using humor Using empathic confrontation Don’t accept excuses Don’t argue or criticize Don’t give up quickly

WDEP system Wants Direction and Doing Evaluation Plan SAMI2C3

Interface with Recent Developments in Mental Health Nature/Nurture Genes and environment impact but DO NOT dictate behavior; choice dictates behavior DSM 5Diagnosis Diagnostic labeling is inappropriate or unnecessary Can be used for insurance purposes (practicality) Pharmacotherapy Glasser has consistently and adamantly opposed the use of medication for mental problems

Interface with Recent Developments in Mental Health Managed Care and Brief Therapy Diagnosing and medication are antithetical to the pure version of reality therapy Therapy seems well suited for brief work Technical Eclecticism By design, a flexible system Draws heavily from the philosophy of other theories so can use other techniques and remain congruent

Interface with Recent Developments in Mental Health Diversity Issues A significant effort has been made to adapt reality therapy to a wide range of cultures. Choice theory is flexible and should be modified to incorporate the client’s cultural worldview. Spirituality Spirituality can help a person meet his/her needs as defined by his/her quality world Effectiveness of Psychotherapy Research has shown a medium effect

Contributions Significant contributions to education Formulation of basic genetic needs and quality world as well as WDEP system

Limitations Lacks comprehensive evidence based research support on effectiveness Glasser’s hard line stance that mental illness does not exist is difficult to conceptualize in today’s society

References Fall, K. A., Holden, J. M., & Marquis, A. (2016). Theoretical models of counseling and psychotherapy (3rd ed.). New York, NY: Routledge.