Promoted reality therapy and contributed in the development of it
Theoretical Concepts
Goal: "Helping people make choices that increase their happiness and meet their needs without harming others is the essence of reality therapy" (Seligman & Reichenberg, 2014, p. 369).
More philosophical compared to other cognitive-behavioral approaches with emphasis on self-determination and process instead of results
Clients are encouraged to take responsibility for choices (Wubbolding, 2011)
Development of reality therapy
Three concepts of reality therapy
Reality
Responsibility
Right and wrong
Two basic human needs
Relatedness: To love and be loved
Respect: Feeling worthwhile to oneself and others
(Glasser, 1965)
Reality therapy has eight steps for clinicians
Build rapport
Ask "What are you doing?"
Collaborate with client in evaluating behaviors
Help client make a plan to do better
Help client commit to a plan
Do not accept excuses
Do not interfere with reasonable consequences
Never give up!
(Evans, 1982)
Control theory (Control system theory)
People are influenced by inner control systems like the brain, which impacts behaviors and emotions
People experience difficulties when they try to control others rather than controlling themselves
Awareness and assessment must be used to modify the systems that are in control
What are the pictures in our head and what are our needs and wants?
Is our behavior successful or do we need to change?
People have the choice of whether or not they want to control their long-term feelings
(Seligman & Reichenberg, 2014)
Choice theory
Control theory was later replaced by choice theory due to the idea that people have choices about their thoughts, feelings, actions
Human development
Problems stem from early childhood experiences and interactions with people who determine what is right for us
External controls from childhood are believed to be the cause of our feelings and actions (other people make us feel and act the way we do)
Children who receive love, support, freedom, power, and fun in a responsible way develop into emotionally healthy people
Past issues reoccur in present problems, therefore the focus of therapy is on present issues
Five basic needs
All people are born with five needs that determine differences in personality
Belonging: Loving and feeling loved; connecting and interaction with others
Power/achievement: Feeling accomplished and competent in life
Fun/enjoyment: Pleasures of life; ability to laugh and appreciate being a human
Freedom/independence: Making choices and living without excessive constraints
Survival: Good health, food, air, shelter, safety, security, and physical comfort; the essentials of life
(Wubbolding, 1991)
All behavior has a purpose and aims to meet our needs (Wubbolding, 2011)
Concept of mental illness
Glasser believed that people can have symptoms but there is nothing wrong with their brains that can't be changed through supportive relationships
Glasser considers choice theory to be a better option over medication
Mental illness occurs when people are not meeting their five needs
(Seligman & Reichenberg, 2014)
Concept of mental health
Emotionally healthy people meet their five needs and choose healthy thoughts, feelings, and behaviors
Setbacks are seen as warning signs to evaluate choices
People who are emotionally healthy also seek to improve the lives of others (Wubbolding, 1991)
Total behavior and motivation
People's overall function is total behavior; total behavior is made up of four components
Acting
Thinking
Feeling
Physiology
All four components must be active in order to facilitate change
Change can occur in overall direction, specific actions, or by changing wants (Wubbolding, 2011)
Actions must be changed before thoughts can be changed
Feelings and emotions are secondary
Quality worlds
People have images in their mind about what they would like their life to look like; those pictures help to guide efforts of satisfying needs
When people pick unattainable pictures, they will experience frustration and disappointment
When people are aware of their pictures they can adjust them to make it more realistic, resulting in better choices, more control, and fulfillment of needs
WDEP System
Made up of four elements
W-Wants: Wants are connected to the needs of the individual.
D-Direction and doing: Exploring total behavior (what people are doing vs. why they are doing it)
E-Evaluation: Nonjudgmental evaluation about realistic behaviors and perceptions that are present
P-Planning: Essential in development of long-term plans and goals and should reflect desired changes; there are eight qualities for planning
Simplistic
Attainable
Measurable (inventories and diaries)
Immediate implementation
Involving the clinician in an appropriate manner (feedback)
Controlled by the client
Commitment to change
Consistent behaviors are reflected upon
(Wubbolding, 2007b, p. 305) Importance of relationships
Key to development of achieving rewarding life and developmental difficulties
People can dislike a person's behaviors, but they should accept the person
Helping people learn from their mistakes turns disappointments into success
(Seligman & Reichenberg, 2014)
Treatment
Goals: "The fundamental goal of reality therapy is to enable people to have greater control over their lives by making better choices" (Seligman & Reichenberg, 2014, p. 336). Wise choices meet the following criteria:
Helps people meet innate needs
Choices are responsible and right to make choices is respected
Choices are realistic and planned
Additional goals
Form positive relationships
Develop success identity instead of failure identity
A repertoire of healthy actions
Therapeutic alliance
Collaborative relationship
Little attention paid to transference and countertransference
Clients are responsible for choices made
Clinicians are responsible for direction and success of treatment
Clinicians don't waste time with excuses and never give up
Language is important
Problems referred to in the past tense and solutions in the present tense
Use first-person pronouns like "I" and "we"
Ask "what" questions instead of "why" questions
Strategies
Metaphors: Clinicians' use metaphors to send messages and also are aware of clients' use of metaphors
Relationships: Essential to creating a rewarding life
Wubbolding (1991) outlined characteristics for strong relationships
Effortful
Valued by both parties
Enjoyable
Positive
Noncritical/nonargumentative
Promotes awareness
Questions: Questions are carefully structured so client can become aware of what needs to change vs. what does't need change
WDEP: Evaluating wants, direction, and creating a plan
SAMI2C3: Stands for, simple, attainable, measurable, immediate, involving, controlled, consistent, and committed (Seligman & Reichenberg, 2014, p. 378)
Positive addictions: Developing positive addictions can lead to a reduction of negative behaviors (exercise, journal writing, yoga/meditation, playing and listening to music) Glassar (1976) recommends that behaviors should be:
Behavior should be noncompetitive and can be done individually
Accomplished without inordinate mental or physical effort
Behavior should be of value to the client
Behavior should lead to improvement if client is persistent
Can be performed without self-criticizing
Using verbs and "ing" words: Emotions are not fixed and can be changed through actions
Reasonable consequences: People should be held accountable for their actions through consequences
No excuses or exceptions
Focus remains on what the client can do differently to avoid negative consequences
Renegotiation: Develop new or revised plans that has greater likelihood of success
Paradoxical interventions: Encourages people to take responsibility for themselves
Wubbolding (1988) outlined two forms of paradoxical interventions
Relabel/reframe: Offering alternative perspectives to promote choice and control
Paradoxical prescriptions: Clients' imagine the worst-case scenario to develop coping skills needed
Skills development: Clinicians teach assertiveness, rational thinking, development of positive addictions, and planning