About the Author
Dr. William Glasser is an internationally recognized psychiatrist who is best known as the author of Reality Therapy, a method of psychotherapy he created in 1965 and that is now taught all over the world.
Born in 1925 in Cleveland, Dr. Glasser 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.
Dr. Glasser’s path has been one of a continuing progression from private practice to lecturing and writing — ultimately culminating in publication of over twenty books. After writing The Mental Health or Mental Illness (Glasser, 1961), The Reality Therapy a New Approach to Psychiatry (Glasser, 1965), and Positive Addiction (Glasser, 1972) he started to develop a theory of the internal control of behavior and greatly expanded the understanding of motivation, behavior and therapy resulting in additional works: Stations of the Mind (Glasser, 1980), Taking Effective Control of Your Life (Glasser 1984) Choice Theory (Glasser, 1998), Reality Therapy in Action (Glasser, 2000).
Leading to his most recent works Warning: Psychiatry Can Be Hazardous to Your Mental Health
(Glasser, 2003), and a booklet Defining Mental Health as a Public Health Problem ( Glasser, 2005)
– primarily offering a new resource for mental health professionals focused on helping people improve their mental health and happiness.
Dr. Glasser’s approach is non-traditional. He suggests that a vast array of mental disorders and emotional distress (including many of the disorders described in the DSM V) are caused by our human needs being severely frustrated, threatened or violated in some way, and in particular the need for love and belonging. He contends that the distress of such perceived loneliness, emptiness and sense of powerlessness cannot be tolerated or suppressed indefinitely by human beings, and given time, may express itself as a mental, emotional and/or physical symptom or disorder. Many such symptoms or mental disorders are described in the DSM V.
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’ (the belief that we can control other people’s behaviour against their will) – literally trying to force people to do what we want them to do. This struggle has led to the symptoms described in the DSM-
IV. Dr. Glasser teaches that if we can’t figure out how to learn to satisfy our power need by respecting each other, our days on earth are numbered. He offers ‘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 then, thousands of people worldwide have taken intensive training to gain knowledge on how to apply his ideas in their professional life. They have discovered that by using choice theory, their personal relationships have improved as well.
Reality therapy has a fortunate theoretical ground in profound Choice Theory; it provides possibility to use some of its principles not only in psychotherapy and clinical counselling but also in many other supporting professions and everyday life situations. We believe that this feature of reality therapy and choice theory is rather an advantage than disadvantage.
Dr. Glasser maintains a very active schedule and is a much sought-after speaker nationally and internationally. Some of his many accomplishments are as follows: listed in Who’s Who in America
since the 1970s; in 1990 awarded an honorary degree of Doctor of Humane Letters, Honoris Causa from the University of San Francisco; in 2003 presented with the ACA Professional Development Award recognizing the significant contributions made to the field of counselling; in 2004, presented with the “A Legend in Counselling Award” by the ACA; in January, 2005, presented with the prestigious Master Therapist designation by the American Psychotherapy Association; and finally, in 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.
European RT national associations set up European Association for Reality Therapy (EART) on November 24th 1999. In 2011 EART recognized Institute for Reality Therapy as European Institute for Reality Therapy that provide RT psychotherapy training in Europe.
Reality Therapy has clearly defined areas of enquiry, application, research and practice
The basis of reality therapy is Choice theory. Choice theory is the understanding of human behaviour in the context of second-order cybernetics, which proves that living beings are self-directed systems that function purposefully. It defines a person as a free and responsible being who is intrinsically motivated and whose behaviour is always purposeful, very diverse and flexible. The purpose of behaviour is to follow internal motives and thus establish and maintain internal balance and balance with the environment. The idea of intrinsic motivation, integrity and the purposefulness of behaviour defines a person as a closed-loop system that functions according to the principle of intentional, circular causality.
The construct of total behaviour is undoubtedly Glasser’s greatest contribution to psychotherapy. When explaining behaviour, Glasser was not referring only to the acting we typically think of when we talk about behaviour, but to the indivisible whole of the internal processes of acting, thinking, feelings and physiological processes that are intertwined and indivisible, and characterised by creativity. Thus, the use of the name TOTAL BEHAVIOUR. That concept underscores the indivisibility of the mental and physical, meaning that the concepts of behaviour and the organism are equal (i.e. behaviour = the organism).
In contrast to theories that explain the individual as an operationally open system that is defined by the environment and as such functions according to the principle of linear causality, choice theory, as previously stated, explains the individual as a closed-loop system with a structure that allows them to function according to the principle of circular causality.
Organism as a closed-loop system has three innate characteristics that it continuously develops:
a) instructions, b) the ability to monitor information from the environment and compare it with its own instructions, and c) the ability to harmonise with itself and the environment.
Functioning as a closed-loop system, the human organism continuously attempts to follow its own instructions and achieve internal balance and balance with the environment. It has the ability to monitor information perceived in the environment, compare that information with internal instructions and register differences between them. Registered differences (frustrations) activate the ability to harmonise and achieve balance. In choice theory, the functioning of the organism, which pursues its own purpose in different ways, is explained using the final or circular causality of behaviour, where behaviour flows in a closed loop without a beginning or end. This means that all of the processes and the production of the organism as a system are purposeful. It is in this sense that choice theory differs from other theories that interpret the functioning of an organism applying linear causality, where
behaviour flows in one direction: cause (stimulus) – organism – response (behaviour). We believe that our behaviour is not a response to external or internal events, but rather an attempt to achieve balance by following our inner instructions and those we develop through a lifetime of experiences. We believe that the environment does not change an organism, but that an organism changes itself and the environment.
Instructions serve as guidance for the functioning of an organism as a system. Because it is a closed- loop system, instructions and not the environment are crucial for the survival of a living organism.
According to Glasser, we are born with BASIC NEEDS that he believed are written into our genetic structure. Needs are one of the core constructs of choice theory. Survival means much more to a person than breathing, and having a roof over their head, water and food. There are therefore other psychological needs important for survival besides the actual need for survival. They are: love, power, freedom and fun. Thus, when we are born into this world, we must love people (belong and cooperate with others), feel a sense of worth (be important and take initiative), be free (be independent and autonomous) and have fun (be creative and learn) in order to survive. Needs are that part of our instructions in which we are almost all similar. According to Glasser, there is no predefined hierarchy of needs (as Maslow believed), as that hierarchy constantly changes in line with an individual’s priorities. As closed-loop systems, people are already equipped with needs and function by pursuing and satisfying them. It is a process that can’t be halted. In this sense, we are not dependent on the environment, despite the fact that we live in it. This means that it is not the environment or others who decide whether we have satisfied our needs, but rather us because it is our task to continuously satisfy them. The subtitle of Glasser’s book Choice Theory is A New Psychology of Personal Freedom. As closed-loop systems that pursue their needs and produce behaviours to best satisfy those needs or achieve balance, we are already independent and autonomous, i.e. free. We love, cooperate with others, belong, establish a sense of worth, take initiative, create, learn and have fun freely. It should be emphasised that as beings with the intrinsic need for love, we largely satisfy our needs in the company of others. Everything that we do is, in fact, the satisfaction of needs, but this doesn’t necessarily mean that we are always satisfied. It is important to understand that the environment (including others in it) does not dictate our satisfaction.
In addition to needs, we also have specific instructions that we develop our entire life and that make us different from others as individuals. It is the second core construct of choice theory, which Glasser referred to as the QUALITY WORLD. While needs represent general instructions, the images that accumulate in the part of the memory we call the quality world are very specific instructions that tell us what love, power, freedom and fun are. The images that we are talking about are actually our past experiences of everything good, of everything that we’ve ever experienced in life, and we connect with our needs. It is important to understand that, although Glasser used the metaphor of a picture, the quality world is not a static category. It would be wrong to understand that we are talking about positive images frozen in time. Our positive experiences develop over time and are more like sequence from a movie than individual photos. Although we experienced something pleasant in the past, our view of that experience did not become stranded in the past; instead we give to it the meaning that it has for us in the present. We must therefore understand our quality world as a dynamic category.
As also Carl Rogers we believe that “Man’s behaviour is exquisitely rational, moving with subtle and ordered complexity toward the goals his organism is endeavouring to achieve” (On Becoming a Person; 1961) Reality Therapists are close to Rogers when he states in the same paragraph, of “the natural and internal balancing of one need against another, and the discoveries of behaviours which follow the vector most closely approximating the satisfaction of all needs.”
The structure of the closed-loop system includes the ability to monitor information from the environment and compare it with our own instructions. Like most of our behaviour, the process of monitoring information from the outside world and comparing it with internal instructions is automatic. That ability allows us to register the smallest of differences between external information and internal instructions, while activating our ability to reduce those differences and establish balance. In essence, we are talking about the desired perception and chosen perception of reality, and the
registered differences, i.e. the frustration that serves as the basis of development. Perception is a very complex boundary between an organism and the environment, i.e. the ability to process and transform information from the environment, which the organism uses to establish and maintain balance with the environment. According to Glasser, feelings, knowledge and values are important elements of perception. He described those elements as the filter of a camera through which we view the world. Although he did not specifically mention them, bad experiences are also a part of how we perceive reality, similar to the experiences in our quality world. Perception undoubtedly has numerous levels that we develop throughout our life and that represent all of our experiences in all aspects of behaviour.
What comes out first and most notably when meeting and talking with a client is their ability to monitor and compare information with references. This is seen as the client continuously describing their perception of reality or highlighting their frustration. The client’s perception of reality is entirely their own product (choice), i.e. their view, which rests on the client’s potentials all the way up to their needs. An important element of that perception are the client’s beliefs. These are primarily the beliefs on which the client’s understanding of their own behaviour is based, although they are entirely unaware of this. The client mostly sees themselves as the victim of their circumstances or others, which is entirely in the manner of linear causality, i.e. the understanding that people are part of the environment and thus our behaviours are a response to what is happening around us. Through this, although not explicitly, the client also shows their, more or less, formulated expectations from the environment (desired perception). The client’s expectations likewise rest on their potentials all the way to their needs, with an emphasis on good experiences (quality world). We could say that the client’s expectations or desired perception are, in fact, their quality world as addressed to the outside world. The client believes that it is the outside world and the people in it who are responsible for meeting those expectation, entirely in terms of their beliefs.
Expectations (desired perception) are specific instructions that an organism develops through indirect and direct experiences and that it addresses to the environment with the aim of establishing balance. We are in balance when our chosen perception is congruent with our expectations (desired perception). Thus, as long as we perceive circumstances as favourable, we are typically unaware of our expectations. The fact is that we formulate our expectations ourselves because we want the outside world to be exactly as our instructions tell us.
As previously mentioned, our quality world is a wonderful collection of all of the good experiences we have collected in our life. Although it seems that good in our life is harmless, that is not exactly the case. If, for example, we direct that good to others as an expectation, it is entirely possible that it will prove unfeasible. Not because good cannot be done, but because another person does not or is unwilling to do it. Thus, if we expect something from someone that they usually don’t do, our expectations are unrealistic, regardless of how simple it would be to meet them. Remember that our good experiences can be indirect or direct. When we address our experiences to the outside world, our indirect experiences, in the form of expectations, can be even more unrealistic.
We call the moment when we register a difference between expectations (desired perception) and experience (chosen perception) FRUSTRATION. Frustration is thus the difference between our desired and chosen perception.
Frustration activates our ability to harmonise and establish balance within ourselves and with the environment. We harmonise in two ways: through the conscious choice of behaviour and through creativity, without which we, as living beings, wouldn’t survive.
Acting, thinking, feelings and physiological processes are aspects of total behaviour that are intertwined and entirely indivisible. It is important to understand that acting and thinking are those components of total behaviour that are under an individual’s direct control. A change in the way we act and think includes a change in feelings and physiological processes because they are indivisible. We can thus say that we indirectly control our feelings and physiology, although they are not under our direct control. When an individual registers frustration, they mobilise all of their potentials to reduce it. The individual functions at the level of conscious choice (albeit automatically for the most part) and makes use of previously known methods from the range of behaviours that they have developed. When we talk about conscious choice, we mean ways of acting and thinking that are under the individual’s wilful control.
The human organism is constantly creating new behaviours that facilitate its survival. The creativity of an organism is best reflected when an individual fails to reduce their frustration and establish balance after sustained unsuccessful attempts from a set of previously learned ways. Creativity is that aspect of the ability to harmonise that in an attempt to establish balance allows an individual to develop new, different ways of behaviour, including various unusual behaviours (psychopathology), that further deepen their frustration although they are intended to lessen it.
Given that we understand the organism as a closed-loop system, we talk in choice theory about its production as a choice, regardless of whether production is based on wilful control or not. The concept of CHOICE is thus a unique metaphor for creativity and for the fertile production of the human organism as a whole, through which the individual attempts to control the environment to their advantage. It is not merely a matter consciously choosing a certain action with the aim of satisfying needs or establishing balance. We thus understand that an individual’s unusual behaviours (psychosomatic, psychotic, etc.) are purposeful, although they may also be unsuitable over the long term. Notwithstanding the fact that the majority of our production is automatic and only a small portion relies on conscious choice and decisions, no one besides us can transmit our behaviour.
As most of the psychotherapeutic modalities (including very famous and established ones) regarding basic propositions of Choice Theory and Reality Therapy have not strong validating evidence in the frame of experimental methodology. The same is with the basic propositions of Choice Theory. However, Glasser has always believed and experienced that our behaviour is purposeful and our motivation intrinsic and his encounter with W. Powers’ Perceptual Control Theory (the model strongly supported by research and experiments) gave him the scientific explanation how the purposeful behaviour works.
Dr. Glasser first developed RT mainly on the basis of his clinical practice and not so much through a methodologically ‘pure’ scientific research; later he has construed the Choice theory. He has created a ‘Diagram of Brain as a Control System’ to transmit the ideas of the choice theory and reality therapy in the shape of the model the science prefer. However, as psychiatrist and psychologist he continues to develop the theory in the sense of hypothetic-deductive theory (Marx, 1963): Initial experiences > postulate formation > deduction from postulates > leads up to empiric facts > verification of correspondence among facts and postulates > correction of postulates, etc. Quality of the Choice theory and RT is thus subject to constant growth and verification.
The choice theory is not only internally consistent and open to constant growth. It is also a kind of a model of human behavior and man’s relationship with his environment and himself, which can be understood by anyone and verified by scientists. Observed behavior is not a deduction from past patterns of behavior but from the way of present co-operation between individual subsystems within a system and the outer world. Perhaps it does not suit all the requirements of the model in physical science but this has probably not been the Glasser’s intention in any case.
Besides, here is also ‘subject – object’ problem. “We can no longer look at a fact as something revealed by itself. We need to recognize it as something perceived, evaluated, observed, analysed and dependent on some system which is very similar to the observed system. In a research process, we can no longer avoid the psychological characteristics of the researchers themselves. We need to set at least a minimum requirement for a model if it is to be generally accepted as well as applied to his creator.” (Musek, 1982)
Most of Glasser’s assumptions in the field of human relationships and helping people are confirmed by different models of behaviour – especially the models pursuing the ideas of the cybernetics of the ‘second order’ and some discoveries of the neuroscience like those of ‘mirror cells’ (Bauer, 2005) responsible for compassion and empathy. This is a great commendation to the Choice Theory that represents a basis for the psychotherapeutic method of RT.
Contemporary RT is based on circular causality and belongs to the therapies based on systemic- evolutionary approach to human behaviour. The discoveries of cybernetic and systemic theories about
how living organisms control the environment have revealed to Glasser why reality therapy is so efficient. Since the invention of RT has derived from his psychiatric practice he has retained and developed some constructs that make Choice Theory understandable not only to therapists but to clients as well (basic needs, quality world, perceptual filters, comparing place, frustration and creativity, total behaviour, feedback loop). Glasser has never declared which specific theoretical approach the Choice Theory belongs to, retaining thus the possibility to change his postulates whenever empiric facts do not support them (according to hypothetically deductive kind of theory described earlier).
We can say that basic postulates of the Choice Theory are conceptually proved (conceptual method) and they have strong indirect evidence in the researches of systemic theories.
For the evidence of the efficacy of RT we use research procedures already developed, such as, pre and post test, control groups, meta-analysis reviewing etc.
Reality Therapy has been used in virtually every kind of setting from private practice to mental hospitals and prisons. In private practice it is usually used as a short term approach but in institutions it is used as long as clients are required to be in the program. The method is applied to individual, small groups and family therapy alike.
Reality Therapy is applicable to a wide range of problems, from suffering because of disturbed relations, psychosomatic difficulties to psychiatric disorders.
Reality Therapy has demonstrated its claim to knowledge and competence within its field tradition of diagnosis / assessment and of treatment / intervention
Our claim to knowledge in diagnosing and assessing presenting problems is evidenced by Dr Glasser’s writings as they have developed his theories over the past forty years, and the writings of those who have followed him, e.g. contributors to the International Journal of Reality Therapy. Beside many awards listed at the beginning of this paper (The Brief introduction to fifteen answers) Dr. Glasser has received – he is also the Board member of American Psychotherapy Association.
Central to that knowledge is Choice Theory, our understanding of human psychology, which is the model of human behaviour and personality that informs our assessments and our choice of therapeutic interventions. Reality Therapy/Choice Theory is taught in many universities and colleges around the world. Our claim of competence in our treatment is evidenced by our comprehensive training programmes, which, when Faculty Training and the Post Certification Programme are included, we believe matches the standards of the EAP for the award of the ECP. The model is most widely used in Addiction Treatment centres around the world. Competence is also evidenced in the research findings on the effectiveness of RT/CT
The training for the reality therapist matches the EAP quantitative, qualitative and ethical standards. Besides education prerequisites the training consists of theory, supervised practice, personal psychotherapeutic experience and experiences in a mental health settings or equivalent.
(See more on the page 23)
Reality Therapy has a clear and self-consistent theory of the human being, of the therapeutic relationship and of health
Personality in reality therapy
It can be understood from his book Choice Theory that Glasser defined personality as a dominant mode of behaviour used to establish relationships with others or as dominant behaviours that a person chooses in their relationships with others in order to bring the external (primarily social) world as perceived closer to the desired images of their own internal world.
According to Glasser, we can only satisfy basic needs in the company of others. He was not referring to Jung’s social self as a mask, which Musek talks about, but as a whole personality. To quote Trstenjak: “In contrast to the naked individuum, personality entails sociability”. The author of reality therapy and choice theory did not like to address constructs such as blind spots, self-intimacy, the unknown, conscious, subconscious, unconscious, etc., because he believed they were difficult to prove and very easily used by an individual as excuses, i.e. that problems befell them, and that they did not choose them indirectly through their own behaviour and can therefore abandon them. He also doubted that it is beneficial to explore a client’s past, which is increasingly unclear and unprovable the further removed it is in terms of time. Like the majority of non-analytical theories in psychotherapy and counselling, he believed that the client begins to perceive their past differently by resolving problems in the present and future.
To some extent, Glasser’s view of personality can be compared to cognitive theories (e.g. Albert Ellis and George Kelly), to humanistic views (e.g. Abraham Maslow and Carl Rogers), to existential and phenomenological views (Viktor Frankl), even to psychoanalysis (Alfred Adler), and above all to systemic-cybernetic theories (William T. Powers).
Similar to systemic-cybernetic and other theories of self-directed systems, Glasser did not believe that we can apply science to predict and control behaviour, and that understanding the personality traits of the individual does not help us a great deal in that respect. As someone once said, the only thing we can predict about behaviour is that an individual will demonstrate behaviours in a given moment that will bring them closer to some desire in a constantly changing environment. Even if we have general knowledge of that desire, we know nothing specific.
People developed the concept of personality because they wanted to know why people are different and why they behave differently in similar situations. The aim was to know what they could expect from others. They also asked what they could expect of themselves, who they are, what is their identity, etc. The purpose of identifying personality traits in psychology is most frequently predicting and controlling behaviour. Glasser did not believe that predicting (and even less so controlling) behaviour is even possible. Moreover, he believed that trying to control the behaviour of another person is one of the greatest and most damaging misconceptions, as it indicates that a person understands another as an object and not as a being that also wants to control their environment.
Perhaps bothersome in psychotherapy is the lack of personality traits, from which a psychotherapist could reliably predict and regulate a client’s behaviour. This finding also has a brighter side: if a client so decides, they can choose to make changes that will improve the quality of their life without taking into account their identified personality traits or personality which, in addition to everything, could be the reification of something that doesn’t even exist.
For example, how do we answer the question as to whether aggressive personality exists? There is no doubt that aggressive behaviour exists. Living beings, from single-cell organisms on up, initially control external variables that they perceive, i.e. they control their input. As long as they control variables in their environment, they survive; when they fail to do so, they perish. The same applies to a
person. Of course, single-cell organisms control their environment to a considerably lesser extent than people. Man, the crowning achievement of creation, also wants to control his fellow man, who is likewise a self-directed being that wants to control his own environment. Here, a surprise may be awaiting them both. A fellow human is not an object that can be shaped and moved at will, but a subject that also controls what happens to them. Both of them attempt to control and act as obstacles to one another in order to exercise control over the satisfaction of needs. This represents an interpersonal conflict. Because other innate psychological needs are frequently as important as the need for survival, every such conflict, if left unresolved, represents a potential threat, including for aggressive and violent behaviour. A person feels extremely threatened if they are unable to satisfy their psychological needs through normal behaviour for an extended period of time. They may demonstrate some creative, new behaviour in the form of mental issues, psychosomatic diseases, psychosocial problems, despair, etc., as well as aggressive behaviour through which they attempt to satisfy their basic needs in a way that is frequently painful for them and others, and inefficient for the observer.
We can quote the words of William T. Powers to answer the above question as to whether aggressive personality exists: “Aggression and violence could be the natural result of one organism treating another as a moveable obstacle and not as an independent, goal-oriented system. Whenever we observe aggression and violence as the learned process of control that is linked to ignorance, conflict seems more logical, without having to believe in innate acts of aggression or to cry over our fate if we give in to such acts.” Aggression is thus not some trait of the personality or genes of someone who behaves aggressively, but the product of the controlling person (organism) due to the frustration they experience when the environment resists. In reality therapy, we thus avoid the gloomy question of what kind of person am I that all of these things happen to me, and we lead the client to ask themselves how do they understand their own behaviour, what is out of reach of their control, what are their beliefs regarding behaviour and what can they do, and how can they control the satisfaction of their needs in another, more effective way.
So why do we then need the concept of personality? Probably so certain qualities (values) that are highly resistant to change remain unchanged for practically the entire life of an individual, so that they might perceive themselves as the same. We could give such characteristics the attribute of personality. We cannot, however, predict from these personality traits the behaviour that an individual will choose in an attempt to bring the outside world closer to their own values. Let’s take, for example, the value that all people are entitled to well-being. Someone might attempt to achieve this, like Mother Theresa or a supporter of communist totalitarianism, with the aim of achieving an ideal for every person according to their own needs. People whose most cherished value is to eliminate evil from this world might pray, organise humanitarian campaigns, burn evil witches, attack countries that represent an axis of evil, etc. We must remember that the majority of people in the past and present were killed in the name of the highest values taught by religion and ideology.
Even if Glasser didn’t believe that we can predict behaviour by identifying personality traits, let alone control another’s behaviour, he had to develop a model to explain how a person functions and how they control the world around them to their benefit through their behaviour, as a closed-loop, self- regulating system, from birth until death. His theory about personality does not fit with those that understand personality as a justified construct, a hypothetical entity that plays a role in the causation and explanation of behaviour (such as psychoanalysis, and personality type and personality trait theories). Glasser’s personality is secondary, and derives from consistent behaviour where the causes of behaviour lie elsewhere. For this reason, personality has no interpretive role (similar to humanistic, behavioural and certain other theories).
According to Rychlak, literature suggests that every personality theory is based on the following four questions:
- A basic personality structure exists, but what takes its place if it doesn’t exist?
- On what basis does that structure function or behave?
- Does that structure change over time and how?
- How do we explain different behaviours in different individuals?
- Personality structure
In order to understand a person, their personality, their problems and the resolution of those problems, we must be familiar with the following four theoretical concepts in reality therapy:
- Choice theory, which finds that living organisms control the environment and not the other way around. The real world, which is based solely on physical, efficient causality (the cause-and-effect chain), comprises living organisms that purposefully ensure the survival of themselves and their offspring. Choice theory emphasises that all of our behaviour is internally motivated and purposeful. It differs significantly from the most widely known behavioural theory, which we simplify to: stimuli cause responses or stimuli-response behaviourism. If we wish to understand behaviour from the point of view of choice theory, we must know which variables an organism attempts to control and not which variables control the organism’s behaviour. Glasser thus understood man as a free, responsible and internally motivated being, and human behaviour as purposeful, extraordinarily flexible and creative. Choice theory also differs from other theories that attribute the causes of current behaviour to past events; it believes that past events affect us, but do not dictate current behaviour.
- The concept of total, flexible and creative behaviour represents the belief that the mind and body are indivisible. Man’s physical actions, thinking, feelings and physiological phenomena are understood as the four components of behaviour. Mind-body dualism is thus transcended. Each of the four components is accompanied by the other three. A person is primarily aware of the emotional and physiological components that are not under their direct wilful control and that they complain about. They are considerably less aware of the components of acting and thinking, which are under their direct wilful control. They thus fail to exploit these components sufficiently in attempts to improve their life. Instead of focusing on the emotional and physical components of behaviour, which the client typically presents as problematic and in need of fixing, the reality therapist focuses on the components of thinking and acting, which the client can control themselves.
Given the opportunity to manage the components of acting and thinking, the client is also able to influence feelings and physiological process, and thus their physical, mental and social health. In this way, we achieve optimal effectiveness in reality therapy. Behaviour is also extremely creative. When a person is in severe distress due to the protracted failure to satisfy their needs, they may create (reorganise) behaviour (autoimmune diseases, psychosis and suicide, as well as works of art, scientific and technological discoveries, etc.).
- Construct of basic needs: in addition to the physical needs required for the survival of the individual and species, this construct also includes psychological needs that are likewise written in our genes (basic instructions for the functioning of the system). From the cradle to the grave, man discovers and chooses behaviour that ensures the survival of the species and individual, as well as behaviour that ensures the satisfaction of the hereditary needs for love (cooperation and belonging), power (feeling of worth and self-respect), freedom (independence) and fun (in the discovery of something new). It seems that variations in our descendants and their selection in various evolutionary periods resulted in not only strong species of humans, but also in species that worked together, freely explored and playfully learned new things. Although we developed these four psychological needs to increase our chances of survival, they are so strong that man sometimes neglects survival itself. We thus explain to ourselves that people die due to honour, freedom, love and even fun. The diagnosis in reality therapy is thus relatively simple: people who seek psychotherapy are not connected with others or their important relationships are deteriorating because they attempt to satisfy their basic needs based on external control beliefs that do not offer them the balanced satisfaction of their needs over the long term.
- Construct of the quality world: specific instructions that we follow and that a person develops based on the experiences of everything that is for them pleasant and positive, but not necessarily socially acceptable. We constantly compare this simulated world with the real external world. A person functions in the real world by choosing those behaviours that change their perception of the real world and bring them closest to the images in their quality world. The quality world is the core of human life. Everything that satisfies or seems to satisfy (e.g. drugs) the basic human needs written in our
genes is positive and pleasant for us.
- Motivational construct Through total behaviour, i.e. using all four components, we attempt to act on the real world, as we perceive it, to satisfy our basic innate needs. The difference between the real world as we perceive it and the specific, individual images in our quality world (reminders of what pleased us in the past) of how the world should be represents the frustration that a person addresses through their behaviour. Our simulated quality world is constantly changing and thus represents what we specifically want in the present. Throughout their entire life, a person demonstrates behaviour that is aimed at satisfying basic needs. For this reason, that behaviour is always rational to them, although it may seem neither rational nor effective to the outside observer, maybe even painful (for example in the case of depression). Of course, we cannot cast off our basic needs. We have learned the behaviours through which we satisfy those needs through experiences and can therefore change our behaviour (sometimes with the help of psychotherapy).
A living being requires three things in order to control the environment for themselves: a) internal instructions regarding what is good for the survival of the organism; b) the ability to monitor and compare the perceived world and internal instructions; and c) the ability to achieve balance between the environment and oneself. The difference between internal instructions and the perceived situation always triggers a signal to act on the external world and thus the input a being receives through the senses (the way a thermostat informs a furnace that the temperature has fallen below the set level, signalling the furnace to begin heating a house to the desired temperature). The difference between the thermostat and a person’s control over their environment lies in the fact that we set the desired temperature in the thermostat from the outside (first-order cybernetics), while we set the desired temperature in the thermostat in our head internally (second-order cybernetics). (More details can be found in the explanation of the organism as a closed-loop system; author’s note.)
- Development dimension: Through biological development, experiences and creativity, a human being develops their own specific instructions (quality world); by constantly choosing behaviours, they discover how effective a specific behaviour is for harmonising the chosen perception of the outside world with the desired perception. A new-born baby chooses the only behaviour it knows – crying – and thus satisfies its needs for survival, primarily for food and warmth. As it grows, it discovers new behaviours and develops new ways to satisfy its needs: smiling, walking, talking, etc. The wide variety of behaviours (instructions and abilities) constantly expands with new experiences, and with it the scope of our control. We can presume that the evolutionary development of species was also dependent on the expanding ability to control.
- Construct of individual differences: In addition to biological differences and the different environments in which individuals live, the specific behaviours chosen by individuals with different biological characteristics and in different circumstances in order to control external variables also lead to significant differences in the development of personality. Individuals also develop specific quality worlds, which again result in differences in individuals. Here, choice theory is in line with the thinking of Alfred Adler (I’m recalling from memory), who said that the question of how heredity and the environment impact what a person will become should be reversed to ask how a person has exploited his heredity and environment to become what they are.
Meta-theoretical: From the four types of causality (material, efficient, formal and final) stated by Aristotle to explain phenomena and thus behaviour, choice theory sees human behaviour and thus personality primarily in terms of purposeful (final) causality, i.e. teleological. This is rare, as academic psychology primarily leans on efficient causality, while medicine leans mainly on material causality. The viewpoint of final causality is seen primarily in certain psychotherapeutic approaches, most radically, perhaps, in reality therapy.
Epistemological: If we take Locke’s approach to empiricism and Kant’s critical realism as two points on which various schools of psychology and thus psychotherapy are based, we must search for the parallel of choice theory (on which reality therapy is based) in Kantian critical realism and Kant’s belief that things as they are cannot be recognised. We can only recognise them as they are for us.
Glasser’s parallel for Kantian phenomenology lies in the perceived world, which is not identical to the real world (noumenon), which otherwise exists and affects a person, but does not dictate their behaviour. We can thus conclude that choice theory takes into account the influences of the real world (i.e. bottom-up explanations of behaviour or Locke’s constitutive model). Behaviour, however, is demonstrated according to the perceived world that a person constructs according to their needs (i.e. taking into account top-down explanations of behaviour or Kant’s conceptual, constructive model). It thus seems to me that reality therapy takes into account the concepts of the behavioural and cognitive approaches, and in the combination of the two, offers something new, such as Powers’ perceptual control theory.
On account of choice theory, reality therapy can be classified as a constructive therapy, where mental issues are not viewed as elements of specific diagnoses, nor are they attributed to personality traits or the development of personality. They are instead understood as different and, according to reality therapists, very creative, sometimes very odd ways to control the environment whenever the latter is perceived as extremely unfavourable.
Interesting from a scientific perspective is William T. Powers, the author of Perceptual Control Theory (based on Powers’ theory, Glasser claimed that he discovered why reality therapy works. He later developed choice theory, which he adapted for psychotherapeutic purposes). While talk in the Middle Ages centred around deistic teleology, and around humanistic teleology with the emergence of phenomenologist and existentialists, the emergence of (primarily second-order) cybernetics led to the understanding of natural teleology. Through scientific consistency, Powers constructed a second-order cybernetic model, and captured with it, according to Musek, “… not only internal and subjective views of acting, but also objective views of acting”. To date, this has emerged less frequently in academic psychology.
Powers’ definition of control is as follows: a system controls a variable if it acts on that variable in such a way that it preserves it in the desired state chosen by the system, despite the presence of unpredictable and strong influences on the variable. Most important in this regard is that external influences that otherwise acted entirely normally on a variable according to physical laws no longer have an effect, and it seems that the variable changes or is dormant, independent of physical influences. (Wind at sea that changes direction acts as force on a sailboat and thus on the sailor, but the sailor is steering the boat in a direction they chose independent of the wind.) Here we see the link between the names of the two theories: choice theory and perceptual control theory.
Natural teleology argues against one-way causality: stimulus – organism – response. An organism is not a black box that prevents us from precisely predicting a response, as behaviourists say; a black box is the environment in which an organism must find what it needs to survive. We are actually talking about circular causality, where an action has no beginning or end. Similarly, we cannot explain behaviour as the functions of independent variables in the environment, where the purpose of changing behaviour is to control those variables. Thus, the environment does not form an organism; according to Powers, it is the organism that forms itself and the environment.
The old assumption for organisms that act on the environment was that the process of feeling is more primal than the process of acting. But we could also say the opposite, i.e. that in certain cases, feeling is dependent on the action demonstrated by an organism. It is more likely that this is an inseparable, simultaneous and continuous process.
Powers found that physical laws dictate the behaviour of an organism, as a real system that lives in the real world. The same laws, however, cannot explain how that organism acts on the environment. Organisms impose on the environment incredible shapes and movements, and act in a way that prevents physical forces from expressing their normal effect. According to Powers, none of this can be explained by physical laws, but instead through the specific ordering of energy and matter.
From an anthropological and ethical point of view, choice theory is reminiscent of Sartre’s concept
that human existence precedes essence. A person is thus responsible for what they make of themselves. In the book Being and Nothingness, he wrote, “… we have no excuses behind us, no justification before us. We are alone with no excuses.” A well-known metaphor involves playing cards: just as players are dealt different hands, we too are dealt different conditions at birth, from material, genetic and social conditions to personal, if you will. Because complaining about bad cards doesn’t help, we teach people in reality therapy to play the cards they were dealt with as little complaining as possible, as this dulls the realisation that we weave our own future. For this reason, it might seem to someone that this therapy is less delicate. Here it should be emphasised that in reality therapy, the relationship with the client is the main therapeutic instrument and goal of therapy. The therapist must therefore assess when the time is right and how to communicate to the client the belief that their choice of behaviour contributes to their problems, and that they can transform themselves from the victim of fate to the makers of their own happiness. (In this respect, Glasser emphasised on numerous occasions that thoughts about contributing to one’s own unhappiness must never be misused when people who live in dreadful social, economic and political conditions are involved.)
Of course, we address the problem of human non-juridical responsibility using circular (purposeful) causality interpretation. If we choose behaviour and specific expectations (images in our quality world) of how to satisfy basic needs, every behaviour bears responsibility for the associated consequences. The French psychiatrist Philippe Pinel removed the chains from patients and, by declaring them mentally ill, set them free. This was a giant step forward in the humanisation of work with people suffering from unusual behaviour. Developed on this basis, however, were various treatment methods, psychoanalysis and an entire range of psychotherapies that, except for a few, all maintained the view of mental issues and disturbances as mental illnesses for which the individual was not responsible. (Even today we avoid admitting that a person is a responsible being. Caution is justified, as people and the law take an entirely different approach to an irresponsible, mentally incompetent person or personality than they do to a responsible person or personality.)
We almost always link responsibility to punishment. According to Glasser, however, punishment is a man-made invention that derives from the erroneous belief about a person’s responsive behaviour to external stimuli: if the person who perpetrates an act suffers enough, they will respond by not repeating that act. The fallacy of this belief is confirmed by choice theory and by repeat offenders in prisons. Glasser did not talk about responsibility for past behaviour because that behaviour can no longer be changed; he spoke of responsibility for behaviour in the present and future.
Understanding mental health in reality therapy
We understand mental health in reality therapy as continuously improving balance and satisfaction in all areas that an individual develops in close connection with other important people and in the belief that they control their own life.
In his book Warning: Psychiatry Can Be Hazardous to Your Mental Health (2003), Glasser warns, “You are mentally healthy if you enjoy being with most of the people you know, especially with the important people in your life such as family and friends. Generally, you like people and are more than willing to help an unhappy family member, friend, or colleague feel better. You lead a mostly tension- free life, laugh a lot, and rarely suffer from the aches and pains that so many people accept as an unavoidable part of living. You enjoy life and have no trouble accepting that other people are different from you. The last thing that comes to your mind is to criticise or try to change anyone. You are creative in what you attempt and may enjoy more of your potential than you ever thought was possible. Finally, even in difficult situations when you are unhappy – no one can be happy all the time – you’ll know why you are unhappy and you’ll attempt to do something about it. You may even be physically handicapped, as is actor Christopher Reeve (a quadriplegic following a severe accident; author’s note), and still fit the criteria above.”
The evolutionary-systemic approach developed with the emergence of cybernetics, and understands the behaviour of every living organism as the balancing of external variables, which the organism attempts to reshape to its advantage based on the criteria of prior knowledge of what is and what isn’t
good for its survival. This prior knowledge is obtained both individually and through evolution. Unusual behaviour in a person is thus their creative attempt to control external variables in a way that suits them, taking into account prior knowledge obtained through both personal development and through the development of the human race, and is therefore pre-empirical in relation to the individual. No present behaviour is a consequence of external forces in the environment, but is rather an intentional effort to adapt these forces to internal criteria. Concepts of ‘prior knowledge’ in Western philosophy date back to Plato, to Kant’s a priori knowledge, and later to psychology with Konrad Lorenz and his study of animal behaviour, to cybernetics with W. T. Powers and his perceptual control theory, and to psychotherapy with W. Glasser, his choice theory and the practice of reality therapy.
In some sense, Powers applied the meta-theories of both Locke and Kant. Consistent with his own model of human behaviour (i.e. man’s relationship with his environment), he began with Kant’s viewpoint because he was aware that he, too, was searching for answers that suit his purpose, and that the model he developed depended primarily on his view (albeit as a scientist and researcher) of a person. If he says that the external world is a ‘black box’ to a living being, and if he doesn’t attribute any supernatural abilities to himself, he is then aware that he cannot see the world outside himself objectively, but only subjectively, and that the model of man’s relationship with his environment must also apply to him, the constructor of this very model.
We know about the world what it represents to us, i.e. we see it subjectively. We thus have no other choice but to believe that the world is the way we see it, with some reservation (i.e. that others may not see it the same way as we do). A precisely agreed definition of terms and mathematical principals provides a greater degree of intersubjective objectivity discussed by the philosopher E. Husserl. From here on, Powers was a reductionist. He researched, experimented and quantified the boundaries of experimenting with and researching a living, sensitive organism with the most elementary nervous system in a way that would please every empiricist and follower of Lockean meta-theory. When he had completed all of his research and calculations, he discovered that a person’s relationship with the environment is most similar to a cybernetic model of a closed-loop system (which differs from the concepts of the majority of other cybernetics) and is thus closer again to the understanding of a person according to Kant. He discovered and explained human free will, consciousness, spirituality and self as completely natural components of the whole that we refer to as a ‘human being’.
Glasser was interested by the precise observations and distinctions offered by diagnoses and standard nosology. He used these concepts in his writings. We cannot, however, let this misguide us. He believed that nearly all diagnoses are descriptions, while the observed individual chooses their behaviour (choice represents the entire production of an organism; author’s note) with the aim of establishing balance and satisfying their needs. He only considered as mental illnesses those behaviours that are linked to pathological changes or brain injuries, as seen, for example in Alzheimer’s and Parkinson’s disease, epilepsy and multiple sclerosis. He also rejected the explanation that chemical imbalance in the brain is evidence of mental illness because this approach does not view the individual as a whole. Brain chemistry, as a physiological aspect of total behaviour, changes in the individual and is co-dependent on other aspects of behaviour (thinking, acting and feeling). Moreover, we cannot view a person isolated from the life context (chosen roles) in which they attempt to satisfy their needs.
According to Glasser, all mental distress arises from protracted, unsuccessful attempts to resolve unhappiness, which is turn derives from alienation or unsatisfactory relationships with others, or loneliness. Alienation is based on the belief that we are victims of our circumstances and the behaviour of others. In such circumstances, a person consciously or unconsciously attempts to establish balance in their life through sometimes unusual (psychopathological) behaviour. Psychopathological phenomena are thus not some states, but rather purposeful behaviours. Glasser therefore suggested that we use words such as ‘depressing’ and ‘psychotising’ to refer to such
behaviours. He wanted to emphasise that these are behaviours that can be controlled by the person who demonstrates them, and that a person is capable of finding more appropriate ways to satisfy their needs.
Reality Therapy has methods specific to the approach which generate developments in the theory of psychotherapy demonstrate new aspects in the understanding of human nature and lead to ways of treatment / intervention
Beliefs about human behaviour are our specific instructions and are thus an important element of our perception. Understanding human behaviour in the manner of cause and effect, or external control psychology as Glasser called it, is very broad. People developed the belief that what is happening around them or what others do drives their behaviour. According to the same logic, they believe that they also control the behaviour of others. Without being aware of it, people strengthen that belief, reinforce and follow it. As previously stated, beliefs about the functioning of human behaviour are the most important element of our relationships with others. According to Glasser, the goal of reality therapy is to create conditions for the client to replace external control psychology beliefs (which we refer to as traditional beliefs because they are widespread) with choice theory beliefs. Choice Theory explain that behaviour is one’s choice in certain circumstances no matter if it’s in one’s willing control or not since the choice is the metaphor for all production of the organism as a closed loop system. The purpose of each behaviour is one’s best attempt to achieve the balance in their life.
The new view of themselves that the client develops in the therapeutic process allows them to better harmonise and connect with others and establish internal balance in all areas of their life. The therapist’s task is to offer the client a different understanding of human behaviour and thus the opportunity to evaluate their current behaviour and establish themselves in realistic frameworks. We will try to explain what the reality therapist has in mind below.
In their work with client reality therapist uses formulation which begins the moment a client begins to tell their story and continues until the end of therapy. Formulation is the mutual process of exchange, reflection and self-evaluation that is part of the continuously developing therapeutic process. After identifying the difference between the client’s and their own interpretation of the problem, the therapist continuously coordinates with them and verifies how they and the client understand one another in order to avoid misunderstandings. Trust and respect are crucial for developing a relationship with the client. The relationship between the therapist and client is based on two entirely different beliefs: external control psychology beliefs and choice theory beliefs. As a result, the client may sometimes perceive the therapist’s intervention as an attack on their personal values rather than a new perspective on the problem in question. For this reason, the therapist’s continuous sensitivity, patience and acceptance of the client are crucial for a successful therapeutic process. The client’s personal involvement and cooperation are likewise crucial for improving the quality of their life. The timeframe of the formulation process depends on and differs with regard to how a client enters therapy, i.e. whether they opt for inclusion voluntarily or are referred to a therapist by others. In the first case, clients tend to begin telling their story right away, which allows the therapist to begin formulation immediately. In the second case, the therapist often needs more time to establish a working relationship with the client and to reach a mutual agreement on how to proceed in order to continue the formulation process.
Reality therapy is the process of applying choice theory beliefs in psychotherapy/counselling. The most important aspect of establishing and forming a relationship with the client is the therapist’s sharing and exchanging of choice theory beliefs with the client, and the self-evaluation of their relationship vis-à-vis the client in the therapeutic process.
The new beliefs enable client to improve their relationship with significant others and rise the quality of their life and by that improve their mental health.
As Peter R. Breggin, M.D., Director of the International Center for the Study of Psychiatry and Psychology writes: ”Dr. Glasser’s therapy is based on inescapable truths: meaningful relationships are central to the good life, the choices we make will determine their quality, and we can create them only if we take responsibility for ourselves not controlling other people.” (Glasser, 2000)
Reality Therapy includes processes of verbal exchanges, alongside an awareness of non-verbal sources of information and communication.
Reality therapy has no sound structure that would be recognisable in the same way in every conversation. We can see in every conversation, however, a very authentic structure that is based on an authentic therapist-client relationship. The therapist leads a conversation based on the beliefs that they have developed in their private life according to choice theory. Through that lens, they listen to and challenge the client.
On this basis, the therapist leads the conversation with the client and redirects them from the past to the present because the client cannot change their past, but can do a great deal for themselves in the present. The therapist redirects the client’s focus from others back to themselves because the behaviour of others cannot be controlled; the client can only control their own behaviour. The therapist redirects attention from circumstances to the client’s behaviour because circumstances represent facts that must be taken into account before the client decides on their behaviour. The therapist redirects the client from feelings and physiology to acting and thinking because only these two components of behaviour are under our direct control.
In reality therapy, a genuine relationship with the therapist makes it possible for the client to gain new experiences that enrich their life and give them the feeling that they control their own life, which is actually the essence of therapy. A relationship is thus the goal of therapy because the client develops a new view of themselves (beliefs), through which they learn to successfully satisfy their needs over the long term, as well as a means because the therapeutic relationship facilitates such an important experience during therapy itself.
A therapist who views the client’s problems in terms of choice theory thinks it is the beliefs that the client cultivates that prevent them from helping themselves and living a higher-quality life. The therapist therefore sees their role as facilitating a change in the client’s behaviour through a change in their point of view, which in turn allows the client to contribute to the quality of their own life. For this reason, the therapist continuously challenges the client from the perspective of choice theory, and thus offers the client an opportunity to begin developing a different belief through experience.
Language is very important in reality therapy because it reflects our beliefs. The therapist is very mindful of the language that the client uses. Attentive listening helps the therapist identify the client’s beliefs and offer an alternative view. Characteristic of the client’s language, which derives from external control psychology beliefs, are passive forms that the client frequently uses to express their expectations (to be loved, respected, accepted, etc.) or their perception of themselves (forgotten,
trapped, abandoned, etc.), which clearly shows that the client does not take the initiative and leaves their satisfaction to others or their circumstances.
Changing a traditional belief that is just the opposite is not so simple. Because the therapist understands that the client cannot suddenly reject their own belief because that belief is part of the values that the client has reinforced through experiences, the therapist does not force the client to change, but instead perseveres in their belief and unobtrusively offers another view for the client to test. In this way, the client feels safe in their relationship with the therapist and continuously self- evaluates their own behaviours, and thus moves closer to a new understanding and choices. Only if through their relationship with the therapist the client learns that the therapist practices what they advocate, will the client find the courage to change their behaviour and thus likewise change their belief.
Metaphors, stories, anecdotes and humour are some of the indirect approaches used with the client to facilitate insight into their problems and speed up the process of self-evaluation, without which progress is not possible. We don’t view these approaches in reality therapy as therapeutic techniques, but as part of the therapeutic relationship. In this case, they are seen as the creations of the therapist that arise during conversations with the client. The therapist is thus unique in their approach, which in turn makes their relationship with the client unique. In addition to the effect achieved in the resolution of a problem, we also achieve a better connection with the client. The majority of the therapist’s approaches are unique, while some can be generalised and used with several clients at the right moment as the therapist deems fit. It is equally difficult to apply the approaches of other therapists because it’s impossible to maintain authenticity, which is so important in reality therapy.
Paradoxes, reframing and similar approaches are also not deemed techniques, despite the fact that they are also recognised in reality therapy, primarily because we don’t understand the client as the object of treatment and because it is impossible to plan such approaches in advance.
All of this is in the context of a helping relationship, which draws on the therapist’s skills and expertise in using and responding to verbal and non-verbal communication skills in a subtle, sensitive and complex manner.
Evidence that the modality includes processes of verbal and non-verbal sources of information might include the following: Dr. Glasser’s demonstration videos; the three case study books (“What are you doing?”, “Control Theory in the Practice of Reality Therapy”, and “Counselling with Choice Theory”) which demonstrate Reality Therapy in practice as well as “ Reality Therapy: Theory and Practice” by L.&B. Lojk, and the therapeutic skills development modules of our training programme, where the key training methodology is participant role-play, focussing on verbal and non-verbal communication skills in the therapeutic relationship.
Reality Therapy offers a clear rationale for treatment / intervention facilitating constructive change of the factors provoking or maintaining illness or suffering.
As previously stated, the goal of reality therapy is to replace external control psychology beliefs with choice theory beliefs. This means that, as therapists, our work does not focus on the client’s manifested, symptomatic behaviours for which they have sought help, but on the life context (relationships with others). Although the client is most interested in a change in their actions that will lead to their improved mood, the therapist’s focus is on the theory of change that the client perceives in their life and for which they sought therapy. The client conceptualises the changes they perceive in their life based on external control psychology beliefs and, from that understanding, blames their problems on their circumstances and the behaviour of others, which in turn serves as the basis for everything they do in this regard.
We cannot, however, view a change in the client’s behaviour independent of the therapist’s behaviour. In terms of second-order cybernetics, on which reality therapy is based, we view the therapist and client the same in a creative attempt to change behaviour, despite the fact that they are positioned differently in their roles.
Although work in reality therapy requires a change in the therapist’s behaviour (beliefs), which is a precondition for performing their role in their work with the client, we will first explain the process of change through the client’s behaviour.
The overall process of changing behaviour entails three mutually related processes that are conditional on each other: 1. The self-evaluation process; 2. The experiential verification process; and 3. The integration or reprogramming process.
- Self-evaluation is the process of continuous reflexive thinking and self-verification. As long as everything is going according to plan, self-evaluation is almost unconscious. It is conscious and intense when faced with some frustration. Similar to all aspects of our behaviour, self- evaluation is also linked to beliefs, i.e. our understanding of human behaviour. It matters whether it is based on external control psychology beliefs or choice theory beliefs. Before they enter therapy, the client has reached a point through self-evaluation where ‘things cannot continue the same way’ and has made a decision to change their behaviour in anticipation of something new, something different from what they already know. At the start of therapy, they tell their story and explain the theory of change that they are currently experiencing. Their self-evaluation is based on external control psychology beliefs, which they don’t even know exist. They are even less aware that they have developed and practice those beliefs. The therapist develops their own theory of the changes occurring in the client’s life, and thus offers them the opportunity to recognise and address their understanding and on that basis define the beliefs on which they act. At the same time, reflecting on their story based on choice theory beliefs allows the client to identify an alternative understanding of their problems. Through the trust they have developed in their relationship with the therapist, the client makes a new decision, this time to replace their external control psychology beliefs with choice theory beliefs. This does not mean that they have committed themselves to something, but that they have decided to continue with therapy after recognising the therapist’s approach. Thus, begins the process of the experiential verification of new beliefs.
- The experiential verification process begins with the client’s acceptance of the fact that there are two explanations for the problems that motivated them to seek therapy. The first important experience through which the client verifies their new beliefs is the relationship with the therapist, through which the client recognises that the therapist also practices choice theory beliefs in that relationship, has confidence in the client’s potentials and gives them the courage to take the initiative. The therapist encourages the client to verify new beliefs through existing experiences in order to confirm those beliefs. Until the client finds the courage to verify their beliefs through a change in how they act in real circumstances, existing experiences, which motivate the client to persevere, are very important. In this phase, the client understands and verbalises their new beliefs, which means they have already mastered them on a cognitive level. However, without experiences in the current circumstances, which they would perceive as a contribution to an improved feeling of control, no significant changes will occur. It is the decision to change their actions, based on new beliefs and the self-evaluation of new experiences, that leads them to the process of integrating choice theory beliefs.
- The integration-reprogramming process entails the recognition of traditional beliefs in situations in which the client is frustrated, and the redirection of the client to choice theory beliefs and a change in behaviour on that basis. Although the client already has many direct positive experiences that confirm their new beliefs, they still function at the beginning of the integration process as if they were beginning to learn how to drive a car. Their new view only now becomes part of their potential, but has yet to become a programme according to which they would function automatically. The change in behaviour does not end here. The integration process continues to be reflected in the processes of self-evaluation and experiential verification, and flows onward and speeds up the client’s further development.
The therapist’s understanding of behaviour and their conceptualisation of the client’s problems are based on choice theory beliefs. The therapist thus combines the client’s theory of change with their own understanding and knowledge, and redirects the therapeutic process by offering the client the opportunity to verify their own understanding. In this way, the therapist and client offer each other the possibility of changing their behaviour: the therapist by offering the client new beliefs, and the client by explaining to the therapist their understanding of the changes occurring in their life.
For the therapist, the process of changing behaviour (beliefs) began long before they met the client, when they enrolled in training. With that decision, the student (future reality therapist) begins the process of changing behaviour. That decision is based on self-evaluation, with the aim of achieving greater satisfaction in and improved control over their professional life. Similar to the client in the therapeutic process, the student’s education also begins with understanding human behaviour, which is not fully harmonised with their previous understanding. The goal of education is to make it possible for the student to replace external control psychology beliefs with choice theory beliefs that can be later used in the therapeutic process in accordance with the goal of therapy. As previously emphasised, the reality therapist is unique in terms of their choice theory beliefs, the only tool in reality therapy.
At the beginning of the self-evaluation process, the student, like the client, addresses their understanding of behaviour or traditional beliefs. They recognise the alternative understanding offered by choice theory and begin the process of replacing their beliefs. What distinguishes the student from the client in this phase is the intensity of the frustration that motivates them to seek change. The student’s motives for change are career-based and differ from the personal motives that drive the client to take action as soon as possible. As we have emphasised several times, beliefs also represent purposeful behaviour in the function of improved control over the world. For this reason, a change in beliefs does not occur quickly or smoothly. Why should we change something that we don’t perceive
as a problem? The client will recognise harmful traditional beliefs faster than the student and will allow change to occur with greater enthusiasm.
The interpretation of the connectivity of all aspects of total behaviour, i.e. understanding the organism as a closed-loop, self-regulating system that is motivated internally through general and specific instructions (basic needs and the quality world), is very logical and understandable. Because students don’t typically have the need for radical changes in their lives, their understanding of the belief that we are free beings who control our own behaviour remains solely at the cognitive level for quite some time. On the other hand, training is conceptualised as the process of changing behaviour, and is thus based on personal experience from start to finish. Students are in the process of experientially verifying choice theory beliefs at almost all times. Teachers (trainers) offer students the possibility of verification through the relationships they develop with them in the training process, the experience of connecting in the here and now in study groups and peer groups, the development of the quality of relationships through chosen roles in selected areas of their personal life, work in clinical practice, etc.
The integration process – the reprogramming of beliefs – in the training process, in the context of differentiating between traditional beliefs and choice theory beliefs, also entails a choice to change one’s actions, with awareness of the freedom to choose, independent of the circumstances. The integration process does not end with the completion of training. The integration of new beliefs represents a structural change to the organism as a system, is constant and is reflected in all other processes of changes, which later continuously contributes to the development of the reality therapist’s potentials.
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Reality Therapy has clearly defined strategies enabling the clients to develop a new organization of experience and behaviour.
Strategies enabling the clients to develop a new organization of experience and behaviour in RT :
Reality therapist get client’s focus on present
Reality Therapists work from the simple logic that since all of us live in the present we can only control our present behaviour. Therefore, all psychotherapy takes place in the present. No one can control anything that happened in the past and we can only conjecture about the future. The past, no matter how good or bad, is over unless we talk about it right now in which case the past becomes a present but ineffective focus. Helping clients to see how ineffective it is will move the therapy on to a more productive present. While the reality therapist will listen empathically to the client’s story of their past miseries, they will work to move in a proper moment to the present. This is a strategy that demands a high level of skill to deal with client resistance while maintaining the deep, genuine relationship required for successful therapy. At the same time we do not deny that our past experience is also the source of our knowledge and understanding.
Past and present experiences do not limit us; only the importance we give them can limit us. During therapy, clients frequently resurrect painful experiences from the past that cannot be changed, unaware that the past does not control them; instead they give importance to the past that occupies their present. Glasser says : “ What happened in the past has everything to do what we are today, but we can only satisfy our basic needs right now and plan how to continue satisfying in the future”. Understanding the past and accept the present moment as relevant is important strategy in reality therapy.
Exploring client’s life context
Other people represent the most important information in the environment for an individual. What we do with information is also our choice, but it’s good to understand its meaning. These others allow us to satisfy our needs through various roles that we develop during the course of our life. This would be hard to do if they didn’t exist. According to Glasser, we can also be satisfied without other people, but we cannot be happy. We are only happy when we are well-connected with others.
The life context of an individual comprises family life, career and personal life, where we share the majority of our time with others in various roles. Thus, relationships with others are an appropriate way to satisfy needs during that time. In other words, we spend the most time with others. Our satisfaction is proportionate to the time and commitment that we invest in the realisation of our roles. A larger number of roles means a larger social network and the increased likelihood that we will achieve balance in the context of our own commitment and the even distribution of time. Lack of satisfying relationship and social network. Glasser says: “ All long- lasting psychological problems are relationship problems.”. Exploring life context, facing the deficit and understanding importance of being connected help client’s to change perspective.
Understanding the difference between external control beliefs and choice theory beliefs
Beliefs about human behaviour are our specific instructions and are thus an important element of our perception. Understanding human behaviour in the manner of cause and effect, or external control psychology as Glasser called it, is very broad. People developed the belief that what is happening around them or what others do drives their behaviour. According to the same logic, they believe that they also control the behaviour of others. Without being aware of it, people strengthen that belief, reinforce and follow it. Beliefs about the functioning of human behaviour are the most important element of our relationships with others.
If we cultivate traditional beliefs and believe that we are thus part of the environment, we attempt to change that which bothers us. For this reason, our actions are in line with our points of view: we criticise, blame, complain, insult, threaten, punish, bribe, etc. We thus develop an entire range of behaviours, including excuses for our behaviours, which Glasser referred to as ‘deadly habits’, as they usually distance us from those who are important to us. In the context of choice theory, all of these actions are purposeful, but focus on something that cannot be achieved, i.e. a change in something that cannot be changed (e.g. the past, circumstances or the behaviour of others). Because we understand behaviour as total, feelings of helplessness, anger, sadness, etc., are part of these attempts. Our physiology is also continuously engaged. All is for naught. If you imagine someone who has been repeating the same thing for years and feels increasingly worse, it is not difficult to understand the development of new behaviours in that individual, such as the abuse of alcohol, drugs or food, and the same unusual behaviours, supported by creativity, that are seen as psychosomatic or psychotic behaviours. If you’re asking yourself how you can recognise traditional beliefs in yourself if you’re unaware of them, the answer is quite simple: whenever you deem your emotions unpleasant, ask yourself what you want and you will discover that you would probably like to achieve something that can’t be achieved because it doesn’t depend on you.
If our beliefs are based on choice theory, our actions, feelings and physiology are in harmony. There is no reason that you shouldn’t, according to Glasser, behave connected, i.e. accept, encourage, listen, cooperate, respect, harmonise, take initiative. This, of course, does not mean that we prevent frustration in this way. The world revolves independently of us and we will always register differences between our desired and chosen perception of reality. We will not, however, make these differences worse and persevere in something that can’t be done. After all, we believe that we alone control our life. Understanding the difference enable client to change their behaviour.
Understanding the meaning of relationship
The dictionary defines a relationship as an interaction between two or more people. Moreover, the clients with whom we meet speak of their relationships as if they are some external location, i.e. in a marriage, parenthood, at work, in a friendship, etc. Such understanding is based on the belief that we are part of the environment in such a way that it is the environment that defines our behaviour and not us. Glasser called this understanding external control psychology and said that it is seen through four forms of interpersonal behaviour: 1. I expect from someone something that they are not prepared to do; 2. Someone expects from me something that I’m not prepared to do; 3. Two of us expect from one another something that neither of us is prepared to do; and 4. I demand from myself something that I’m not prepared to do. People frequently believe that others are responsible for satisfying their needs, and expect and demand this from them. Because they believe that they can control the behaviour of others, they focus on others and not themselves.
When we talk about relationships in the context of choice theory, they are neither interactions nor locations, but the behaviour through which we satisfy our needs in a certain role in relation to another. When we talk about relationships, we are in essence taking about ourselves: our needs, expectations, perception and actions. Relationships thus represent my behaviour. From that understanding term relationship and the role is the same. Moving focus from relationship as an interaction to personal role enable client to take responsibility over his behaviour.
That way client start to replace external control theory beliefs (being victim of circumstances) to choice theory beliefs (being in charge in any circumstances).
Understanding of frustration
Like most of our behaviour, the process of monitoring information from the outside world and comparing it with internal instructions is automatic. That ability allows us to register the smallest of differences between external information and internal instructions, while activating our ability to reduce those differences and establish balance. In essence, we are talking about the desired perception and chosen perception of reality, and the registered differences, i.e. the frustration that serves as the basis of development. Perception is a very complex boundary between an organism and the environment, i.e. the ability to process and transform information from the environment, which the organism uses to establish and maintain balance with the environment. According to Glasser, feelings, knowledge and values are important elements of perception. He described those elements as the filter of a camera through which we view the world. Although he did not specifically mention them, bad experiences are also a part of how we perceive reality, similar to the experiences in our quality world. Perception undoubtedly has numerous levels that we develop throughout our life and that represent all of our experiences in all aspects of behaviour.
What comes out first and most notably when meeting and talking with a client is their ability to monitor and compare information with references. This is seen as the client continuously describing their perception of reality or highlighting their frustration. The client’s perception of reality is entirely their own product (choice), i.e. their view, which rests on the client’s potentials all the way up to their needs. An important element of that perception are the client’s beliefs. These are primarily the beliefs on which the client’s understanding of their own behaviour is based, although they are entirely unaware of this. The client mostly sees themselves as the victim of their circumstances or others, which is entirely in the manner of linear causality, i.e. the understanding that people are part of the environment and thus our behaviours are a response to what is happening around us. Through this, although not explicitly, the client also shows their, more or less, formulated expectations from the environment (desired perception). The client’s expectations likewise rest on their potentials all the way to their needs, with an emphasis on good experiences (quality world). We could say that the client’s expectations or desired perception are, in fact, their quality world as addressed to the outside world.
The client believes that it is the outside world and the people in it who are responsible for meeting those expectation, entirely in terms of their beliefs.
Expectations (desired perception) are specific instructions that an organism develops through indirect and direct experiences and that it addresses to the environment with the aim of establishing balance. We are in balance when our chosen perception is congruent with our expectations (desired perception). Thus, as long as we perceive circumstances as favourable, we are typically unaware of our expectations. The fact is that we formulate our expectations ourselves because we want the outside world to be exactly as our instructions tell us.
As previously mentioned, our quality world is a wonderful collection of all of the good experiences we have collected in our life. Although it seems that good in our life is harmless, that is not exactly the case. If, for example, we direct that good to others as an expectation, it is entirely possible that it will prove unfeasible. Not because good cannot be done, but because another person does not or is unwilling to do it. Thus, if we expect something from someone that they usually don’t do, our expectations are unrealistic, regardless of how simple it would be to meet them. Remember that our good experiences can be indirect or direct. When we address our experiences to the outside world, our indirect experiences, in the form of expectations, can be even more unrealistic.
We call the moment when we register a difference between expectations (desired perception) and experience (chosen perception) frustration. Frustration is thus the difference between our desired and chosen perception. Understanding of frustration and self-evaluating its elements (expectations and experience) help client to change perspective and to get the balance in their life.
Understanding of total behaviour
Acting, thinking, feelings and physiological processes are aspects of total behaviour that are intertwined and entirely indivisible. It is important to understand that acting and thinking are those components of total behaviour that are under an individual’s direct control. A change in the way we act and think includes a change in feelings and physiological processes because they are indivisible. We can thus say that we indirectly control our feelings and physiology, although they are not under our direct control. When an individual registers frustration, they mobilise all of their potentials to reduce it. The individual functions at the level of conscious choice (albeit automatically for the most part) and makes use of previously known methods from the range of behaviours that they have developed. When we talk about conscious choice, we mean ways of acting and thinking that are under the individual’s wilful control.
The human organism is constantly creating new behaviours that facilitate its survival. The creativity of an organism is best reflected when an individual fails to reduce their frustration and establish balance after sustained unsuccessful attempts from a set of previously learned ways. Creativity is that aspect of the ability to harmonise that in an attempt to establish balance allows an individual to develop new, different ways of behaviour, including various unusual behaviours (psychopathology), that further deepen their frustration although they are intended to lessen it.
By changing understanding of their own behaviour and by consciously choosing certain action client can manage their life in desired direction. Therefore understanding concept of total behaviour has big impact in client development. The same effect has understanding of creativity when client comes with some unusual symptomatic behaviour (psychopathology ).
Self-evaluation
A key moment in any Reality Therapy session is when the client makes a self-evaluation of their present behaviours. Unless the client self-evaluates that their current choices are not helpful to them, then they have no reason to engage with the difficult process of change. It is only when the client decides that what they are doing is not helping them get what they want that they will be ready to
move to try other behavioural choices. In particular, the therapist will ask clients to evaluate if what they are choosing to do is helping their relationships. Even if the client’s evaluation is that what they are choosing is not effective, the therapist will still be very careful not to put any pressure on clients to commit to or act on their evaluation. To do that would be external control. But to talk about the evaluation, offer suggestions, be supportive or to show appreciation for the potential success of the evaluation leading to their choice to change are all integral to effective therapy. Helping the client to reach a moment of significant self-evaluation is a key strategy in Reality Therapy. Sometimes, it happens very quickly, and the client is ready to move on quite speedily. At other times it is a long and painful process that need therapist’s support and understanding.
In the move towards long-term change and personal growth, the reality therapist will encourage the client to understand the concepts of Choice Theory; and, not just to understand them, but to make them part of their chooses to live their life into the future, long after the need for therapy is over. This is a transformative process, through which the clients fundamentally reframe the way they understand themselves and others, and their way of being in the world. In reality therapy the client chooses the transformation of ‘natural’ deeply rooted subject-object understanding of relationship into the subject- subject connectedness. The awareness of possibility to choose makes client free and responsible toward self and because of the need to belonging also toward others.
The therapist has undertaken this transformative journey themselves in their training in Reality Therapy. The reality therapist does not just “use” Choice Theory to help clients but lives fully a life infused with the understanding that it brings, and this is what he or she wishes to share with the client. How well or how quickly reality therapist can share their understanding with the client and offer them opportunity to implement Choice Theory in their lives depends on their skill and their experience.
Reality Therapyis open to dialogue with other psychotherapy modalities about its field of theory and practise.
The author of RT, Dr W. Glasser, was extraordinarily active performing all over the world. He as well as other RT psychotherapists regularly attends different meetings and conferences, where they exchange their views on psychotherapy and their experience with it.
“The Evolution of Psychotherapy” organized by prestigious Milton Erickson Foundation (in December 2005, 8500 people from around the world attended.)
Dr. Glasser was invited and actively participated at such conferences in Hamburg, 1994 and Anaheim, California, May 2005
In 1996, at the Leight University Bethlehem, Pennsylvania, he was invited to the meeting of five different schools of psychotherapy: W. Glasser – Reality Therapy; Arnold A. Lazarus – Behaviour Modification; Frank M. Dattilio – Cognitive Behaviour Therapy; Marvin R. Goldfried – Integrative Psychotherapy; James D. Masterson – Object Relations Therapy. Five professionals performed role play with the same client – Linda. On that occasion, videotapes of all five approaches to the same client were made.
In May 1999 on Larry Litvack’s initiative (the editor of the International Journal of Reality therapy), a unique conference was held at Northeastern University, Massachusetts, USA. It was the National Conference on Internal Control Psychology that brought together four individuals each of whom had established a national and international reputation as writers, speakers, conceptual thinkers, and/or theorists: William Glasser, Albert Ellis, William Powers and Alfie Kohn. The Conference provided a
rare opportunity for those attending to hear presentations from each speaker, as well as the speakers interacting with each other and the audience.
In Chicago Conference (2004) organized by W. Glasser Institute John Carlson, Psy.D.Ed.D, Adlerian therapist and Glasser, M.D. showed the similarities and differences between the two approaches playing the role play counselling the same client alternatively.
Glasser had the keynote address Every Student Can Succeed at the 3rd Oxford Symposium (2005) held at Brasenose College, together with Carleen Glasser presentation of Defining Mental Health as a Public Health Problem.
The author of reality therapy was also the keynote speaker at the Slovenian NUO Conference (2006) The Transition of Psychotherapy: From Medical to Autonomous Activity. The audience consisted of the members of 7 psychotherapeutic modalities joined in NUO Slovenia and some other modalities not yet the members of NUO,
Robert E. Wubbolding, Ed.D., psychologist and senior instructor of reality therapy, previously a lecturer on counselling and psychotherapy at Xavier University in Ohio makes regularly presentations at different conferences including American Counselling Association, Association for Counsellor Education and Supervision, Ohio Psychological Association, Ohio Counselling Association, West Virginia Psychological Association, the Milton Erickson Brief Therapy Conference.
Like Glasser himself Wubbolding has also made videotapes and DVDs, for instance:
- Reality Therapy Psychotherapy Session, to be published by American Psychological Association, 2007.
- Dealing with Blaming, Resisting, Whining, Avoiding and Excuse-Making: A Group Reality Therapy Approach. This DVD (82 minutes in length) is published by Center for Reality Therapy.
- Reality therapy with an AIDS patient. Video tape published by Microtraining
- Reality Therapy and Drug Addiction video tape published by Allyn & Bacon
- Reality Therapy and Group Counselling published by American Counselling Association.
- Reality Therapy in Family Counselling, published by the William Glasser Institute
In Europe Reality Therapy was introduced through the lecture and workshop to other modalities by Lothar Imhof, M.D. and Leon Lojk, at the 2nd World Congress for Psychotherapy in Vienna, (1999), Reality Therapy: reality, responsibility and personal freedom
RT was also introduced to the audience by Boba and Leon Lojk at the Congress of the EAP in Belgrade (2004): workshop, Reality Therapy in Action.
RT was introduced by Dubravka Stijacic & Boba Lojk at EAP Congress “ Sense and Sensibility in Psychotherapy “ (2018): workshop, Sense and Sensibility in Reality Therapy
There are also many other RT conferences open to the adherents to different psychotherapeutic modalities, apart from the USA, in Croatia, Ireland, Slovenia, the UK and some other countries.
International Journal of Reality Therapy, 25-year lasting publication often compared and contrasted reality therapy / choice theory (RT/CT) to other theoretical approaches:
A Comparing and Contrasting RT to Rational-Emotive Therapy, Vol. 1 (2) Adlerian Antecedents to RT and CT Vol 3 (2)
RT and Brief Strategic Interactional Therapy, Vol 9 (2)
Control Theory and Paradigmatic Perspective of Thomas Kuhn, Vol 9 (1) Neuro-Linguistic Programming Compared to RT, Vol 9 (1)
The Early Years of CT: Forerunners Marcus Aurelius & Norbert Weiner, Vol 13 (2) A Comparative Analysis of RT and Solution-Focused Therapy, Vol 15 (2)
Glasser Quality Schoolwork and Dewey’s Qualitative Thought, Vol 15 (2) Choice Theory and Ta’I Chi Chuan: Are there any similarities? Vol 18 (1) Rational Emotive Therapy as an Internal Control Psychology, Vol 19 (1) PCT, HPCT and Internal Control Psychology Vol 19 (1)
Choice Theory and PCT: What are the differences and do they matter? Vol 21 (2) Social Cognitive Theory and Choice Theory: A Compatibility Analysis, Vol 22 (1)
The Relationship Between Glasser’s Quality School Concept and Brain-Based Theory, Vol 22 Mindfulness Based Reality Therapy, Vol 23, (1)
Integrating the Karpman Drama Triangle with CT and RT, Vol 23 (2) RT and Individual or Adlerian Psychology – A Comparison Vol 24 (2) A Comparison of Wellness Coaching and RT Vol 24 (2)
RT and Human Energy Field: Working with Needs that Influence Mind and Body, Vol 24 (2) Morita Therapy and Constructive Living: CT and RT’s Eastern Family, Vol 25, (1)
The effects of RT / CT Principles on High School Students’ Perception of Need Satisfaction and Behavioral Change, Vol 25, (1)
There are several text books that offer reviews of different psychotherapy modalities and among them also Reality Therapy:
- Case Approach to Counselling and Psychotherapy (Gerald Correy, 2009)
- Theory and Practice of Counselling and Therapy (Richard Nelson-Jones, 2006)
- Theory and Practice of Counselling and Psychotherapy (Gerald Corey, 2001)
- Current Psychotherapies (Raymond J. Corsini and Contributors, 1984)
- The Psychotherapy Handbook (Richie Herink, 1980)
Reality Therapy has a way of methodically describing the chosen fields of study, and the methods of treatment / intervention which can be used by other colleagues.
The fields of studies are methodically described in the books, video and audio tapes, etc.:
Reality Therapy A New Approach to Psychiatry (1965) was Dr. Glasser’s second book and best-seller in the field. Today, when train psychotherapists we use his newer books, especially:
- Stations of the Mind, New Directions for Reality Therapy(Glasser, 1981)
- Taking Effective Control of Your Life, (Glasser, 1984)
- Choice Theory, a New Psychology of Personal Freedom, New York, HarperCollins Publisher, (Glasser,1998)
- Reality Therapy in Action, New York, HarperCollins, (Glasser, 2000)
- Warning: Psychiatry Can Be Hazardous To Your Mental Health, NY, HarperCollins, (Glasser, 2003)
For the psychotherapy we also use many books written by other reality therapists. Some of them are purposely written as a handbook for trainings, others as a theoretical reflection:
- Reality Therapy : Theory and Practice (L.&B. Lojk, 2020),
- The Practice of Choice Theory Psychology (Brian Lennon, 2019),
- The Practice of Reality Therapy (Brian Lennon, 2019),
- Scientific Arguments for Reality Therapy (Lojk, 2001)
- Reality Therapy for the 21st Century (2000) by Robert E. Wubbolding
- Counseling with Reality Therapy (Wubbolding and Brickell 1999),
- The Language of Choice Theory (Glasser and Carleen Glasser 1998),
- Using Reality Therapy, (Wubbolding 1988),
- Two books of case studies, (Naomi Glasser, Ed. 1980 and 1989)
There is also a very rich collection of tapes and DVDs where the author himself or other RT teachers present role-plays.
Reality Therapy is associated with information, which is result of conscious self reflection, and critical reflections of other professionals within the approach.
As long as the discussion runs within the frame of the choice theory and not ‘external control of behaviour’ we affront the diversity of opinions from within our own ranks. Especially when we apply choice theory, as reality therapy there is always no-man’s-land. There are, frequent discussions like: is a specific method or technique based more on choice theory than ‘external control’ beliefs? Is the purposefulness of behaviour sufficiently explained to people in the helping professions with the choice theory? Is it more efficient to give the priority to client – psychotherapist relationship or to the dialectical (Socratic) procedure during the therapy? Etc.
Outside this frame there are discussions among different meta-theories and psychotherapeutic modalities. Even in these cases the choice theory suggests moderateness in persuading. The author of the Reality Therapy and Choice Theory, is in the land of living and he respects and understands that everybody can construct the theory of the human being in his own way (consistently to choice theory, everybody can choose the theory). However, he is firmly convinced that understanding human behaviour as externally controlled phenomenon and denying its purposefulness is a big mistake.
As it mentioned before the contemporary RT is based on circular causality and therefore belongs to the therapies based on systemic-evolutionary approach to human behaviour. The construction of a theory depends on its author as well. That is why it is perhaps easier for those who are familiar with Kant’s viewpoint (dialectical, oppositional, dual, contradictory) to allow other authors to construct and to believe in the possible accuracy of their theories.
Perhaps it is more difficult for researchers in the case of Locke’s viewpoint (demonstrative, non- oppositional) to permit the possibility of the accuracy of other theories because they believe in unipolarity of any given.
Ernst Mach exposed Kant’s cause as early as the end of the 19th century in the case of two theories of light:
»So long as both theories have been framed objectively and proven empirically they both are true. The only reason you are bothered by this result is because you assume that reality has only one possible theoretical rendering. But since we know that what we learn depends on assumptions made in the testing of our knowledge, we now accept as routine that it is possible to hold to and prove more than one set of theoretical assumptions about the same world of experience. (Rychlak, 1981).
More recent Albert Einstein said: “Everything conceptualisable is constructive and not derivable in a logic manner from immediate experience. Therefore, we are in principle completely free in the choice of those fundamental conceptions upon which we base our picture of the world. Everything depends on this alone: to what extend our construction is suitable for bringing order into the apparent chaos of the world of experience«.
Conscious self reflection, and critical reflections of other professionals within and outside the approach is easier if we understand that the outer world is a ‘black box’ to a living being, and if the professional or scientist doesn’t attribute any supernatural abilities to himself, he is aware that he cannot see the world outside himself objectively, but only subjectively and that the model or theory of a man’s relationship to the environment must also be valid for him, the constructor of this very model or theory he chose!
Reality Therapy offers new knowledge which is differentiated and distinctive in the domain of psychotherapy.
Something fresh and new was brought forth in the field of working with people when more than a decade before the appearance of modern evolutionary-systemic-cybernetic theories in psychology Dr
W. Glasser, with his intuition of a practitioner and his sophisticated perception of human life, published his first two books, Mental Health or Mental Illness (Glasser 1960) Reality Therapy – New approach to Psychiatry (Glasser 1965).
Since then (at least eighteen more have later been written by dr. Glasser), various connoisseurs of literature in the field have classified RT as different and sometimes confronting psychotherapies (therapies, counseling): Behavior Therapy, Persuasion Therapy, Cognitive Therapy, Cognitive- Behavioral Therapy, Adlerian Psychotherapy, etc. It seems that RT is not too easy to classify. It is most frequently classified as cognitive therapy, which is the nearest hit, however, not precise enough.
Epistemology
Reality therapy (RT) based on telic choice theory presumes that a person is a free, responsible being, intrinsically motivated whose behavior is always purposeful, creative and flexible. Since the teleology has long been out of favor as far as human science and because of apparent simplicity of the RT this psychotherapeutic modality maybe needs some additional theoretical elucidation to understand its specific and original approach.
Final causality represents the greatest problem to scientists (also psychologists). Psychologists and psychiatrists engaged in psychotherapy are the ones that use behavior explanations based on final causality more often than others. This however means a risk that their approach will not be accepted as scientifically supported by arguments (Lojk, 2001)
Three branches of teleology (understanding human behavior as intentional) have developed out of the construct of final causality: deity teleology, human teleology and natural teleology. All three have constantly been refused by scientists as something unscientific throughout the last three centuries of scientific drive before the 20th century. This attitude of refusal is to a certain extend still present today. The philosophy of Empiricism was very influential of restricting the Aristotelian causes to two (material and efficient causation, skipping formal and final causation). Psychology has been following this lead and explaining the behavior predominantly with the efficient causation while psychiatry (especially bio- psychiatry) following medical model explaining behavior mostly with material causation.
In 17th century, science was mostly influenced by philosophers of empiricism and physicists. We can understand their refusal of deity teleology (final causality explained with God’s plan from the creation to the doomsday) as something leading towards mysticism, away from science. From scientific point of view we could also understand refusal of the humanistic teleology started by the philosophical branch of phenomenology and existentialism (‘A human being is a product of his own self’) influenced by Kant through his ideas of indirect experience of the world. They still consider humanistic teleology as something referring mostly to philosophy, something that might apply to psychotherapy, but certainly not to science.
After the cybernetic revolution in psychology in the second half of the 20th century and provable natural teleology and the purposefulness of behavior that has been proved by K. Lorenz in his ethology, by Noam
Chomsky in his psycholinguistic research, by Humberto Maturana and his autopoietic system, by W.T. Powers in his perceptual control theory, as well as by W. Glasser in his choice theory aimed to psychotherapeutic and counseling method of reality therapy, only to name the few – the refusal of the telic understanding of human behavior appears as anachronism; especially if one has in mind that scientists like Ernst Mach, Albert Einstein, Niels Bohr, Werner C. Heisenberg have doubted the empirical reality.
A brief look into the history of human cognition shows that two meta-theories have always interwound and taken turns: Lockean (constitutive) and Kantian (conceptual, constructive) meta-theory. Between Lockean meta-theoretical viewpoint, which means constitutive, one-way, demonstrative approach to explaining the world and Kantian meta-theoretical conceptual approach with its active, formative process that ‘doesn’t permit’ a ‘pure input’ of the noumenal world, just phenomenal, there are basis of the different approaches to the unusual, psychopathological behavior.
The scientists that follow Locke’s beliefs will approach reality ‘from outside’, create theories and be sure of their objectivity, while the scientists of Kant’s beliefs will constantly ask themselves in what way have their ‘inner’ intentions and assumptions influenced the research of reality. Medical and behaviorist approaches to unusual behavior have their origin in Lockean meta-theory. Humanistic, phenomenological and cognitive approaches have their origin in Kantian meta-theory. Theories of psychoanalytic and psychodynamic doctrines often have their origin in both; however, less consistent and rather vague. (Rychlak, 1981).
We can call modern theories of a human being and behavior which take both viewpoints (Lockean and Kantian) into consideration as an ‘evolutionary-systemic’ approach; ‘evolutionary’, because they take into consideration phylogenetic random surviving of living creatures through variation of off-springs and selection due to the changing environment (Cziko, 1995); ‘systemic’, because they explain ontogenetic behavior of an individual as purposeful using cybernetic discoveries from N. Wiener onwards. These theories surpass Plato’s doctrine of recollection (pre-knowledge) – pure providential epistemology, Locke’s ‘tabula rasa’ emphasizing sensory based knowledge received from the environment to the individual – pure instructional epistemology and Kant’s mixture of both with his ‘critical realist’ attitude.
Evolutionary / systemic approach has developed along with cybernetics. It understands the behavior of every living organism as balancing external variables, which on the basis of criteria of prior knowledge (innate needs, reference signal) of what is and what isn’t good for the survival of it try to reshape external world and profit from it.
W. Powers “The science of life started this century with the firmly incorrect picture of how behavior works, centered on the concept of behaviorism, and took a long detour starting in mid-century through the digital metaphor and cognitive psychology. Only now are scientists starting to realize what a horrific mistake was made when science rejected the idea that behavior is purposive, and only now are they beginning to ask how purpose, which is internal control, works.” (W.T. Powers, 1999).
Janek Musek writes about Power’s and similar theories: “There are numerous theories about the ‘ego’ or ‘self’ as an empirically collected ‘package of perceptions’ or only as a phenomenally experiential aspect or as the ‘ego’ or ‘self’ reduced to the objective dimension of the reactive system. There are rare system models of the ‘ego’ or ‘self’ that take into consideration inner, subjective as well as objective aspects of functioning of the ‘self’. “ (Musek, 1982).
The author of Choice Theory and Reality Therapy, W. Glasser as most psychotherapeutic practitioners, rarely explicitly addresses the meta-theoretical origins of his theory. However, the basic genetic needs we may understand as the result of the evolution and the total behavior to satisfy specific pictures in the real world as a system that enables purposefulness through the negative feedback.
From the choice theory we can also infer that Glasser does not believe in any ‘right epistemology’. Everything is chosen by human being, epistemology cannot be an exempt! From the choice theory point of view: the construction or choice of a meta-theory depends on its author as well.
Procedure of the reality therapy differs from other known counseling-psychotherapeutic procedures and is very transmissible. A counselor and his client find themselves rather optimistic. Their optimism is waked by the notion of unfulfilled basic needs, by specific pictures of satisfying these needs, intentional behavior the possibility of choosing the certain behavior and by the notion of the stress put on solving problems in the present as well as of total behavior (rejection of psychophysical dualism). All this along with the true role of the counselor and psychotherapists who is able to offer the client not only professional help but also the experience of a quality relationship achieved by sincere psychotherapy, make RT such an efficient helping procedure.
According to reality therapy people have diverse quality worlds, and a human being is a subject whose behavior can be understood from his intentions and not from external forces affecting him. Therefore, he is choosing his own behavior. That is why we ask what is it that he wants in his life, what his goals are and what kind of relationships he wants to maintain with people he needs. We know from the theory that a person, whenever his needs are not satisfied, uses all components of total behavior, but the way he uses his active and thinking components is, however, his own choice. The psychotherapeutic procedure is partially active as a conversation focusing on the client’s wishes, actions and comparison between actions and wishes; but it is also teaching the way choice theory understands human problems. If the client discovers that the present behavior is ineffective, a new and more effective one is found and a plan of its development is made as well.
Reality Therapy is capable of being integrated with other approaches considered to be part of scientific psychotherapy so that it can be seen to share with them areas of common ground.
The area of common ground with almost all modalities is at the pinnacle of importance of the relationship between client and psychotherapist yet, with a different accentuation. In RT, the connectedness is stressed as the means that enable successful treatment as well as the primary target of the psychotherapy — considering the connectedness is the main condition for mental health. Some discoveries of neuro-science support the main idea of the importance of the human closeness. The cybernetic models of closed controlling systems support the choice theory claim that it is difficult to abandon traditional view of other person as an object, but not impossible.
There is common area with Rational Emotive Behavioural Therapy. Albert Ellis cites stoic Epictetus: ‘Men are disturbed not by things, but by the views they take of them’; in REBT current life of the client is paramount, etc.
Notions of thinking and action are important components of change in the cognitive behaviourism (D. Meichenbaum and others) and represent common area with RT. Yet change in any component of the behavioural system – from the perspective of the reality therapy – requires self-inventory and self- evaluation of a client that one’s current way of living is not helping.
Adlerian therapy also has common area with RT. Considering Adler’s change of the question ‘How heredity and environment shape the client’ into the question ‘How the client does use heredity and environment?’ Reality therapy just adds the question: ‘How can the client make better choices to fulfil his basic needs?’ and does not give so much importance to the past family constellation. RT stresses the present relationship, where insight in RT is not the insight of the underlying dynamic but rather a profound discernment that everybody chooses his behaviour, that nobody can change other people but oneself that actual behaviour is not effective enough to satisfy the needs, etc.
There are common area between RT and Person Centred Therapy: optimistic view of the human nature, purposeful behaviour, responsibility, the therapist must be authentic, human relations are at the heart of both theories.
Moreover, we can find common areas with existential psychotherapies in the ideas of freedom and responsibility of the client with less philosophy at the RT side; with gestalt therapies RT share the idea that relationship between psychotherapist and client is more important than techniques; there are many resemblances to family system therapy, etc.
Reality Therapy describes and displays a coherent strategy to understanding the human problems, and an explicit relation between methods of treatment / intervention and results.
Choice Theory is the coherent psychology that informs our understanding of human problems. Using Choice Theory in our therapeutic work with clients is a central strategy in the Reality Therapy model. Glasser (Glasser, 2000) outlines some of the basic postulates, or basic principles or assumptions of Reality Therapy. These underpin our understanding of human problems, and offer guidance for effective therapeutic interventions. Interventions are solidly based on our understanding of the client’s psychological system, and how that interacts with his or her perceived world.
Thus, for example, our understanding of Choice Theory leads us to work with the client so that he or she will more clearly understand the frustrations that are driving the ineffective behaviours that are causing so much trouble. It is only by clarifying what he or she wants, at the deepest level that the client can begin to evaluate what he or she is doing to achieve what he or she wants. Such an intervention is intended to result in the enabling of the client to gain more conscious control of his or her life, and to move the therapeutic process into a more pro-active mode, where the client takes responsibility for his or her own happiness by choosing behaviours which will lead to change towards a more need-satisfied life.
Similarly, the other interventions explained on the page 19 and on have clearly intended results based on the therapist’s understanding of Choice Theory. Obviously, the model is a flexible one, and the therapist will engage in a continuous process of evaluation in the therapeutic moment, to choose the most effective intervention for the stage of the therapeutic process at that moment.
Dr. Glasser’s exposition of some of the basic principles of the Reality Therapy process may be helpful in understanding our answer to this question:
- Choice Theory explains why is it a valid and useful assumption that people choose the behaviour that lead them into therapy because it is always their best effort to deal with a
present, unsatisfying relationship – or, worse, no relationship at all.
- The task of the therapist is to help clients choose new relationship-improving behaviours and their ability to find more love and belongings, power, freedom, and fun by replacing external control psychology beliefs with choice theory beliefs.
- To satisfy every need, we must have effective relationships with other people. Satisfying the need for love and belonging is the key to satisfying the other four needs. As explained above, Choice Theory sees that most serious long-term psychological problems are caused
by chronic difficulties in significant relationships.
- As love and belonging, like all the needs, can be satisfied only in the present, Reality Therapy focuses almost exclusively on the here and now.
- Choice Theory explains how our inner motivations drive our behaviour to meet our needs in the present. The solution to our problem is rarely found in explorations of the past unless the focus is on past successes on which we can build to make more effective choices today. Although many of us have been traumatized in the past, we are not the victims of our past. Reality Therapy does not accept that we are prisoners of our past. We can chose to stay locked up in our unhappy history, or we can chose to find our way to a more meaningful, need-satisfied present life. This is the goal of therapy in the Reality Therapy model.
Reality Therapy in theoretical terms as an evolutionary-systemic approach to people with psychosocial problems and mental health issues, and in practical terms as the application of choice theory in psychotherapy with the aim of improving mental health.
Reality therapy is an approach through which the therapist helps the client recognise, understand and change their own behaviour based on the idea that they control their own life. The therapist’s approach is based on understanding that a person is a free and responsible being who is internally motivated and whose behaviour is always purposeful. The author of reality therapy called this approach choice theory.
The therapist shares their understanding of human behaviour with the client, which allows the latter to change their view of themselves as a victim of unfavourable circumstances into that of a free being who makes decisions about themselves, regardless of the circumstances. A client’s understanding of their own behaviour as a response to what happened in the past or what is currently happening around them prevents them from developing affiliation with people who are important to them. Their relationships are therefore deficient or they are lonely. They thus suffer and develop various symptomatic behaviours that cause then further harm.
The new view of themselves that the client develops in the therapeutic process allows them to better harmonise and connect with others and establish internal balance in all areas of their life. The therapist’s task is to offer the client a different understanding of human behaviour and thus the opportunity to evaluate their current behaviour and establish themselves in realistic frameworks. We will try to explain what the reality therapist has in mind below.
Reality Therapy has theories of normal and problematic human behaviour which are explicitly related to effective methods of diagnosis / assessment and treatment / intervention
As explained erlier, Choice Theory psychology provides the theoretical underpinning of the Reality Therapy model. It explains the motivation, perceptions and behaviours of normal human beings, and offers new and therapeutically promising ways of understanding problematic human behaviour, such as those categorized in the DSMIV.
Dr. Glasser stands within the tradition of those who question the current assumptions of modern psychiatry. He does accept that there is such a thing as mental illness, but he clearly defines mental illness in a very limited way, as brain dysfunction of some demonstrable kind, where there is a clear pathology evident, as in the case of damage caused by trauma, for example, or by a disease such as
Alzheimer’s. Other symptomatic behaviours, mild or extreme, he sees as resulting from the person’s creative efforts to deal with intolerable frustrations in their lives. When normal behaviours prove unable to meet the individual’s needs, the individual’s creative system generates new possibilities for dealing with extraordinary frustrations, and these possibilities are sometimes acted on. These behaviours, which Choice Theory sees as creative behaviours, are diagnosed as psychopathological in many other, more traditional theories.
So then, Glasser suggests that mental disorders and emotional distress have a cause (i.e. severely unmet needs) and disagrees that such disorders or distress (many of which may, indeed, be labelled as “mental illnesses”) emanate from a solely organic brain dysfunction. Indeed, Glasser would prefer that only those mental disorders/conditions that have a proven pathology should be classified as “mental illnesses”.
This is the basis of Dr. Glasser’s problem with much current psychiatric practice, based on ‘medical model’ of understanding the abnormal behaviour, which seeks to suggest that there is a chemical imbalance at work that explains the client’s difficult behaviour, which, if treated with drugs, will restore normal functioning. Dr. Glasser’s position is that there is no definitive evidence that much abnormal behaviour is the result of brain pathology. He sees changes in brain chemistry as a natural rebalancing of the behavioural system under serious stress because of the chronic frustrations of a life out of control. Therefore, the Reality therapist will rarely focus on the abnormal behaviours themselves (e.g. hearing voices), but will use the Reality Therapy process to help the client regain control of his or her life by finding need-satisfying choices, which reduce the frustrations that drive the extreme behaviours. When a person finds other, healthy ways of meeting his or her needs, the symptoms recede.
This perspective has profound implications for the progress of therapy. It places the client at the pro- active centre of the therapeutic change process, rather than the “expert” in psychopharmacology who will diagnose the client’s “condition” and prescribe medication to redress a presumed, scientifically unverified, “chemical imbalance” in the client’s brain, usually blamed on a genetic aberration that has not yet been pinpointed, yet is assumed to be there. Dr. Glasser suggests that current psychiatric approaches have a reductionist approach to the understanding of human problems, seeing them as caused by chemical disorders in the brain. In contrast, Reality Therapy sees those human problems as the consequence of lonely people engaged in a wide variety of unsuccessful attempts to get connected to other human beings, and in desperate need of compassionate, expert help to find better ways to relate so that they can meet their human needs more effectively. This does not mean that drug treatment is never indicated in therapy. It can reduce symptoms, and help clients to be more amenable to help, or to help themselves. However, as quickly as possible, the client is empowered to take control of their own total behaviour, which will include changes in their own physiology.
The Reality Therapy approach to the treatment of abnormal behaviour also trusts the client with the responsibility of recovery, creating with the client a safe place within the therapeutic relationship within which the client can initiate and complete the work of creating a new, need-satisfying life. Seen from this perspective, depression, for example, is a choice in the sense that a person can, drawing on the strength gained in the therapeutic relationship, chose new and more effective actions to meet his or her needs, or can chose new thought patterns (including the applied understanding of Choice Theory) which will impact positively on the depressed emotional state. In this sense, maintaining the depression is as much a choice (unconscious until brought into awareness through the therapeutic process) as is deciding to change doing or thinking component in a way which will shift the depressed mood in a positive direction.
Given the Choice Theory understanding of the cause of much emotional distress or mental disorder (be it labelled as “mental illness” or not), the Reality Therapy psychotherapeutic approach would involve, but not be limited to, helping the person to connect or reconnect with other people (i.e. the need for love and belonging) and find ways to adequately fulfil their other basic human needs (of empowerment, freedom, fun & enjoyment and survival & health).
It is worth mentioning in conclusion that Dr Glasser offers Choice Theory as more than a way of helping those who come for therapeutic help with serious problems in their lives. He believes that an understanding of Choice Theory (or indeed of any other similar psychology) can significantly improve the mental wellness of all people. Just as physical health is not just freedom from disease or pain, but has attributes such as vigour, strength, fitness and endurance, mental health has attributes beyond being free of mental illness, attributes described thus by Dr. Glasser: “you enjoy being with most of the people you know… you are more than willing to help an unhappy person to feel better…you have no trouble accepting other people who think and act differently from you… you will try to work out the problem; if you can’t you will walk away…even when you are unhappy, you will know why you are unhappy and attempt to do something about it. You may be physically handicapped as was Christopher Reeve (quadriplegia), and still fit the criteria above.” (Glasser, 2005) We could say that Glasser is as much interested in salutogenesis as in pathogenesis.
While clients in therapy are invited to transform their lives with Choice Theory as a permanent outcome of their therapy, leading to continuing mental well being, so too are all others who never find their way to the door of a therapist.
e) Characteristics of the reality therapist The atmosphere of counseling should enable the client to trust his psychotherapist. It should encourage him to learn new, more effective forms of behavior. Such atmosphere can be created only by a psychotherapist who is involved in quality relationships himself and is aware of the fact that he is constantly learning to behave more effectively in a never- ending process. W. Glasser says, »A good therapist is always becoming, he or she is never there«. The therapist’s experience with a new kind of relationship with people in everyday life she or he develops after becoming familiar with choice theory is crucial.
Reality Therapy has investigative procedures, which are defined well enough to indicates the possibilities of research.
The International Journal of Reality Therapy (in existence for 25 years) has published many research studies showing the efficiency of Reality Therapy in different fields of psychotherapy and counselling. Only few titles of the researches:
- Choice Theory and College Students With Learning Disabilities: Can RT Facilitate Self- Determination? Vol.17 No1
- The Effects of an RT Program Applied to Mental Health Clients, Vol.20 No2
- A Study on Counselling Program for Decrease of Aggression through RT, Vol.20 No2
- The Effect of Group RT on Internal Control and Self-Esteem, Vol.20 No2
- The Development and Effects of RT Parent Group Counselling Program, Vol. 20 No 2
- A Study of Effect of RT upon ego concept of unemployed youth who do not enter a higher school, Vol.20 No2
- Multiple Sclerosis and Choice Theory, Vol. 22 No1
- Using RT and Choice Theory in the Field of Physical Therapy, Vol. 22 No2
- Autism Spectrum Disorders/Learning To Listen As We Shape Behaviours: Blending Choice theory with Applied Behavioural Analysis, Vol. 23 No2
- The Effects of RT Group counselling on the Self-Determination of Persons with Developmental Disabilities, Vol. 23 No2
- Identifying Basic Needs: The Contextual Needs Assessment; Vol.24 No2
- The Effects of RT / Choice Theory Principles on High School Students’ Perception of Needs Satisfaction and Behavioural Change; Vol.25 No 1
The International Journal of Reality Therapy, Vol.17 No1, has published Reality Therapy: A Meta-
Analysis”. This study examined quantitatively the effectiveness of RT across 21 empirical studies. The authors, Lisa Radke, Marty Sapp, Walter C. Farrell concluded that although the study used also inexperienced therapists and some brief treatments RT has an average effect size within the medium range.
In the new journal The International Journal of Choice Theory (Vol.1 2006) is published article “A Meta-Analysis of Reality Therapy and Choice Theory Group Programs for Self-Esteem and Locus of Control in Korea” by Rose Inza Kim and MiGu Hwang. This study comprises 43 studies conducted in Korea between 1986 and 2006 on Reality Therapy and Choice Theory group programs in terms of their effects on participants’ self-esteem and locus of control. Comparing the counterpart control group with the groups under study the latter scored 23% higher of ‘self-esteem’ and 28% higher on ‘locus of control’.
In the book ‘Reality Therapy for the 21st Century’ author Robert E. Wubbolding (2000) claims that principles of Choice Theory and RT are multicultural and applicable in many areas. He presents research studies in relation to health, human needs, addiction, drug abuse in prison, juvenile offenders recidivism, domestic violence, corrections, humour, depression, arthritis, self concept, self-esteem, locus of control, minority groups, deaf population, management, organizational behaviour, quality education, self-concept, at-risk students, etc.
There are 82 doctoral dissertations written on reality therapy identified between 1970 and 1990 (Franklin, 1993). Of course, this number has eventually been redoubled.
Because Reality Therapy (RT) and Choice Theory (CT) are taught at universities and colleges around the world it is a high probability that there will be more researches with stricter methodology in the future. At some of these academic institutions RT is taught as a self standing course, at others it is included in course-work as one of psychotherapeutic theories and practices. The countries where RT and CT are taught as far as I know are: Australia, Bosnia and Herzegovina, Croatia, Japan, New Zealand, Slovenia, South Korea, USA.
It should be noted, that in addition to the above countries, I met many academics from North America and other countries that include Reality Therapy in their psychotherapy courses.
Reality Therapy has started to be taught in the year 2006/2007 at the University of Nova Gorica, Faculty of Applied Social Studies, Slovenia in collaboration with Vienna’s Sigmund Freud University.
To better understand principles of self-organization and complex dynamics of psychotherapy, counselling and management we also joined the training in synergetic last year in Ljubljana, Slovenia. Computer-based diagnostic of therapeutic process can improve the quality of psychotherapeutic practice and research of the therapy process and outcome. (Schipek, 2005)
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