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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

16. WDEP system
Wants
Direction and Doing
Evaluation
Plan
SAMI2C3

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

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

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

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

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

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