What is Reality Therapy

Reality therapy is a specific type of cognitive-behavioral therapy which was first introduced in 1965 by psychiatrist Dr. William Glasser. The focus of reality therapy is choice and the patient’s ability to solve problems. Reality therapy focuses on the present moment in an effort to create a better future.

Dr. Glasser’s philosophy on what is reality therapy

Dr. Glasser developed reality therapy because he believed that society drastically needed a new choice in therapy. He did not believe that people should be diagnosed with any mental disorder other than for meeting the requirements of insurance companies unless the person suffered actual brain damage. Dr. Glasser did not believe that people suffer psychological disorders due to chemical brain imbalances. He believed that the brain will react to a person’s thinking process, not vice versa.

In 1965, Glasser published the book Reality Therapy where he outlined the core principles and approach to the approach. Several years later, Glasser furthered his ideas in the book Control Theory.

Core principles of what reality therapy is

The core idea of reality therapy is that people are in control of their own actions. Instead of focusing on complaints and symptoms, people should be focusing on the aspects of the problem which they can control.

Glasser’s reality therapy breaks down behavior into four separate groups: thinking, actions, feelings, and physiology. While feelings and physiology cannot be directly changed, actions and thought process can be changed. If they are changed, then the other behavioral groups will change too.  

Reality therapy in practice

Reality therapy works on the idea that human beings have basic needs which can be broken down into the following categories:

  • Power
  • Love and acceptance
  • Freedom
  • Pleasure
  • Survival

Even if a person does not realize it, all people are constantly acting so that one or more of these needs can be met. However, we are not always acting effectively on these needs. This can lead to feelings of dissatisfaction, depression, inadequacy, and other psychological problems.

With reality therapy, the first step is to acknowledge that something must change and that change is possible. In reality therapy counseling, patients may be challenged to explore their unmet needs and see how their behaviors/choices are stopping these needs from being met. The therapist will often act directive questions like: what do you want? What are you doing to get what you want? Is this approach working?

The patients are then expected to make a plan which incorporates the change into practice in the real world. The therapist will hold the patient accountable for following through on the changes. If the patient does not make the changes, then the therapist will challenge whether the patient really wants to change and, if not, why?

Reality therapy can be broken down into a step-by-step problem solving method which involves:

  • analyzing the situation and identifying the problem (unmet need)
  • identify aspects of the problem which can be changed
  • make a plan for change
  • follow through on change

Because of the systematic approach to reality therapy, it can also be used as a self-help method for dealing with problems. However, if a person is unable to see how his/her actions are causing the problem and that change is possible, then a therapist may be needed to assist. Further, if a person does not even realize that there is a problem present, then the therapist can help the person see the issues with more clarity.

What is Reality Therapy’s goal?

The core goal of reality therapy is to help the patient assess current behaviors and see if these behaviors are effective methods of obtaining needs. If the behaviors are not effective and the patient decides to change them, then the ultimate goal of reality therapy is to make a plan for changing behaviors and obtain needs. 

What is the the role of the therapist using reality therapy?

In reality therapy, the therapist frequently challenges the patient the address his or her behavior. The therapist will urge the patient to look at the impacts of these behaviors and whether they are working effectively in life for that person. It is up to the patient, not the therapist, to decide whether change to behavior should be made. If the patient does decide on change, then the therapist will challenge the patient to make concrete plans and commitments to change. The role of the therapist in reality therapy is to teach the patient through constant challenges.

It is very important that the therapist in reality therapy make a conducive, warm environment. Thus, the therapist does not need to take on a professional persona and can participate in the discussion.

When is reality therapy used?

Reality therapy could be applied to various psychological disorders. More commonly, the ideas of reality therapy are applied to problem solving or for helping people gain more control over their lives. The methods of reality therapy have shown effective in helping educators, parenting, leadership, and management. Reality therapy has not been widely tested in a clinical environment. However, reality therapy does have characteristics of other common therapeutic methods though, such as focusing on the present and decision making.


“Reality Therapy.” Choice Theory. www.choicetheory.com, n.d. Web. Sept 2011.

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