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Reality therapy is a client-centered form of cognitive-behavioral therapy that focuses on improving present relationships and circumstances, with less concern and discussion of past events. This approach is based on the idea that our most important need is to be loved, to feel that we belong and that all other basic needs can be satisfied only by building strong connections with others. Reality therapy sees behavior as choices, and it teaches us that while we cannot control how we feel, we can control how we think and behave. We choose to behave in certain ways and these choices can help or hamper the ability to satisfy essential needs and reach individual goals. This therapy also uses choice theory, the behaviors we choose are key to our accountability and who we are. This therapy is less concerned with actual mental health diagnoses; the goal of this type of therapy is to help people take control of improving their own lives by learning to make better choices.

When It's Used

The principles of reality therapy can be applied to individual, parent-child, and family counseling. Studies have proven the effectiveness of reality therapy in treating addiction and other behavioral problems. It is also an approach that works with people in leadership positions, from education to coaching and administration to management, where problem-solving, instilling motivation, and a focus on achievement play essential roles in their connection to others.

What types of problems is reality therapy used for?

Therapists use this approach for tough problems such as eating disorders, addiction, substance use, anxiety, phobias, and relationship difficulties.

There is significant overlap in the two approaches. They differ to the extent that CBT examines a person's thought process and emotions more closely, whereas reality therapy focuses on unmet needs and goals in a dispassionate manner. Both are present-day focused, reality therapy may be more so. 

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What to Expect

Reality therapy focuses on present issues and current behavior as they affect you now and will affect you later. Little or no time is spent delving into the past. Since reality therapy is solution-oriented, you will examine how your behavior is interfering with your ability to form stronger relationships and figure out what kind of changes you can make in your behavior to get what you want out of life. You can learn how to reconnect with people from whom you have become disconnected and how to make new connections. If you try to make excuses or blame others for your behavior, the therapist will show you how that kind of thinking results in behavior that prevents you from improving relationships and reaching your goals. You have the opportunity to learn and practice new ways to relate and techniques in the privacy of the therapist’s office before you employ them in your life outside of sessions.

What is WDEP in reality therapy?

• W wants: What the individual wants

• D doing: What the individual is doing to progress

• E evaluation: Assessing the effectiveness of the individual’s behavior

• P planning: Plan a course of action to change behavior

How It Works

Based on the work of psychiatrist William Glasser in the mid-1960s, reality therapy is founded on the idea that everyone is seeking to fulfill five basic needs, and mental health issues arise when any of these needs are not being met. The five basic needs are:

1. Power, or a sense of self-worth and achievement

2. Love and belonging, or being part of a family or community of loved ones

3. Freedom, or independence

4. Fun, which includes a sense of satisfaction or pleasure

5. Survival, or the comfort of knowing that one’s basic needs—food, shelter, and sex—are met.

When one or more of these needs go unfilled, the resulting problems occur in the present time and in current relationships; hence, it makes sense to act and think in the present time. Reality therapy is also based on choice theoryyou cannot change or control others, and the only sensible approach to solving problems is to control yourself and your own behavior. This will help you make choices that work toward your life goals.

And these seven habits will help you to connect in your relationships:

• Support

• Encouragement

• Listen

• Accept

• Trust

• Respect

• Negotiation

Conversely, these seven habits may lead to disconnection in your relationships:

• Criticism

• Blame

• Complaints

• Nagging

• Threats

Punishment

• Bribing

What is the quality world versus the perceived world in reality therapy?

The perceived world is what you think reality is, and the quality world is what you actually want. If there is a large gap between the perceived world and the quality world, life satisfaction will be rather low. The idea is to bring the two worlds closer together, either by bringing your reality closer to your quality world or by changing what you want in your quality world.

What to Look for in a Reality Therapist

It’s a good idea to screen your potential therapist either in person or over video or phone. During this initial introduction, ask the therapist:

• How they may help with your particular concerns
• Have they dealt with this type of problem before
• What is their process
• What is the treatment timeline

Look for a licensed mental health professional, a cognitive-behavioral therapist, or a counselor with training and experience in reality therapy and choice theory. Health providers can receive training and certification for this type of therapy. In addition to checking credentials, it is important to find a reality therapist with whom you feel comfortable working. Note that not all types of therapy are covered by insurance, so call your carrier for information.

References
Grant, Sheila K. Reality Therapy.(Powerpoint). California State University Northridge.  
Wubbolding RE, Brickell J, Imhof L, Kim RI, Lojk L, Al-Rashidi B. Reality therapy: A global perspective. September 2004;26(3):219-228 [Abstract]
Law FM, Guo GJ. Who is in charge of your recovery? The effectives of reality therapy for female drug offenders in Taiwan. International Journal of Offender Therapy and Comparative Criminology. 2014;58(6). First published online Feb 6, 2013.  
Reality Therapy with Robert Wubbolding; Washington, DC. American Psychological Association Psychotherapy Video Series 1, Item No. 4310784 
Last updated: 07/01/2022