1. William Glasser Control Theory (1970) Choice Theory (1998) Reality Therapy
William Glasser was born in 1925—earned a chemical engineering bachelor degree at 19 and completed medical school at 28 in Cleveland---did psychiatric residency in Los Angeles and became board certified by 36.
Glasser didn’t care much for the traditional psychoanalytic training he received which laid the foundation for the development of reality therapy (do you see a common theme…..later practitioners became more and more dissatisfied with psychoanalysis and the idea that folks are controlled by innate drives/ or that they should look to their past to blame people for their problems…they began to see that we are responsible for our choices and our own happiness). He also felt that the relationship with the client should be involved and friendly, with appropriate self-disclosure from the therapist, rather than distant, as he perceived the relationship in psychoanalysis. Reality therapy became attractive and appropriate to counselors, correction officers and others dealing with institutionalized populations---- difficult populations appeared to be responsive to this line of therapy.
Glasser became a consultant in the school system in California because of the success of the Ventura School for Girls which he founded (he was known for making inroads with difficult populations.) He wrote Schools Without Failure (1969) which had an impact on school administrators and teacher training in schools. Glasser was concerned that schools don’t do enough to prevent students from developing “failure identity”. He believed that schools could be changed to help students find a sense of control over their lives and have successful learning experiences by developing a success-oriented philosophy that would motivate students to perform well and be involved in their work --- this therapy was designed to remove failure from school to increase student performance and self-responsibility of behavior and to decrease the amount of discipline in the school (sounds like a school counselor!)

2. William Glasser
Glasser- choice theory
Glasser interview

3. 5 Basic Needs of Choice Theory
Survival:
Physiological needs (eating, drinking, etc.), stay alive and reproduce
Non-Survival:
To belong (to love, to share and to cooperate)
To gain power (uniquely human)
To be free
To have fun
Very early, Dr. Glasser came to the conclusion that genetically we are social creatures and need each other and that the cause of almost all psychological symptoms is our inability to get along with the important people in our lives.
Survival:
Physiological needs (eating, drinking, seeking shelter, etc.), stay alive (resisting illness) and reproduce
Non-Survival:
To belong (to love, to share and to cooperate). This need is met by family, friends, pets, plants or objects such as a baseball card collection or commemorative coins.
To gain power (uniquely human- often conflicts with our “belonging” need) Our need to be powerful in a marriage often conflicts with the need to be loved by one’s spouse.
To be free (how we wish to live our lives, express ourselves, whom we wish to associate with, what we wish to read or write, where we wish to worship and other areas of human experience. Total freedom of choice!
To have fun (not as significant as the other four- but still an important need---)
All five of these basic needs are met thru our perceptions, the pictures in our heads! According to Glasser, people do not become miserable or sad, they CHOOSE to be miserable or sad. For instance: saying “I am depressed” sounds like you have no control over this feeling, that you are a victim or that it is something that just happens to you. On the other hand, saying “I am choosing to depress” they are less likely to depress and therefore less likely to FEEL depressed. We have a choice!

4. Reality Therapy: Basic Process
Existence- here & now
Control/Choice theory
Rejection of medical model - no labeling
Success identity and positive addiction - successful picture album
Emphasis on responsibility/choice
de-emphasis on exploration of past or unconscious
de-emphasis on transference/working through with therapist

5. Reality Therapy – Basic Process
Friendly environment
Enhance relationship
Explore total behavior
Doing, thinking, feeling and physiology
Evaluate behavior
Clients make value judgments about their behavior; counselors ask value questions
Make plans to DO better
Specific plans to meet needs
Commitment to plans
Plans must be feasible; consider a contract
The Process of Reality Therapy
Friendly environment: begins with a counselor making a sincere effort to build a relationship with the client that will sustain over the length of the therapy---counselor must show that he cares (be warm, friendly, optimistic, honest) and that anything can be discussed between counselor and client that both feel is worth changing. When the client trusts and confides in the counselor the client is able to meet the basic need of “belonging” that helps sustain the therapeutic relationship. The counselor practices appropriate self-disclosure.
Explore total behavior: reality therapists believe that change in one’s life or control over one’s life occurs through DOING. Therapists want to know what the client is doing “now” and how it impacts their “wants”– do these behaviors help to realize these wants or hinder the process? May need to help change the clients perceptions or pictures of their “doing” behavior to actually achieve the “wants”.
Evaluate behavior: clients are asked to make value judgments of their behavior---counselors skillfully ask value questions to help clients self-evaluate. For example: “Does your behavior help you or hurt you?” “By doing what you are doing, are you getting what you want?” “Are your wants realistic and attainable?” These questions help the client determine if the effectiveness of the behavior and if it is helping the client meet needs and wants.
Making plans to do better: when behavior has been evaluated the next question is what to do about it. Plans are detailed in nature, should be attainable and realistic and fulfill a basic “need”. The responsibility of the plan should depend on the client not someone else (getting up early for school should not be the responsibility of mom to set the alarm clock, but rather the student). Work in positives: not that I won’t do something but rather I will do something.
Commitment to plans: feasible, doable plans are a must! A written or verbal contract may prove helpful in accountability and clarity of responsibilities. Discussion of consequences is plan is not met.

6. Glasser’s concept of Total Behavior
According to Glasser behavior is “all we know how to do, think and feel”.
The behavioral system has two parts:
1. organized behaviors that are familiar to us
2. reorganized behaviors that keep changing based on our new “pictures and perceptions”; the creative component of behavior
Driven by our ever-present needs, we require a large supply of behaviors to deal with ourselves and the world around us.
4 components make up “total behavior”
1. Doing: involuntary or voluntary active behavior such as walking, talking or moving in some way.
2. Thinking: includes both voluntary or involuntary thoughts, including daydreams and night dreams
3. Feelings: include happiness, satisfaction, dismay and many others that may be pleasurable or painful
4. Physiology: voluntary and involuntary bodily mechanisms, such as sweating and urinating.
If we choose our behavior and how to act, then why do some folks choose behavior that makes them miserable?
(how many of you know someone that is in this place??!!)
1. By choosing to depress individuals can keep their anger under control. More control and power over others is gained by depressing than angering behaviors. Depression is more socially accepted than anger because it may lead to violence, hostility, prison, etc.
2. People may choose to depress to get others to help them, this helps meet their “belonging” need. By claiming depression it is an outcry for help—school age kids use this technique often.
3. People may choose their pain and misery to excuse their unwillingness to do something more effective. It is often difficult to choose “pictures” that will lead to effective behavior.
4. Choosing to depress can help individuals gain powerful control over others. Others wind up doing things for that person because of their state---offer comfort/encouragement, look after the person, provide food/housing, etc.

7. Assessment in Reality Therapy
Ask client what they want, to determine
Doing
Thinking
Feeling
Physiology
Listen for choices that client makes
Assess how client needs are being met
More than many other theories, reality therapy is specific in its goals and procedures.
Goals of reality therapy emphasize fulfilling needs by taking control over choices in life.
Assessment is integrated into reality therapy and is based on principles of choice theory.
The relationship between client and therapist and the specific procedures to bring about behavioral change are very important constructs in reality therapy
In bringing about change, therapists use strategies such as questioning, being positive, humor, confrontation and paradoxical techniques.
The general goal of reality therapy is to help clients meet their basic 5 needs in responsible and satisfying ways. The counselor assesses how the client is currently meeting these needs and what changes should take place to meet those that are not being met.
The counselor ascertains (assesses) how realistic the wants of clients are and whether their behavior (doing, thinking, feeling and physiology) is helping them realize their wants. Ultimately clients determine what they want not therapists although therapists help clients assess their “total behaviors” and “needs” and develop ways to meet them. Collaboration seems fitting!
The questioning the therapist does is important to the assessment of the client. By asking clients what they want, counselors begin to establish goals of therapy and understand the motivation for therapy--- key to being successful!

8. Therapist Role Develop a relationship with client
Warm
Genuine
nonjudgmental
Function as a teacher by being active, co - relationship
Helping clients develop plan, directive
Offering behavioral choices and guidance
Confronting and demanding

9. Eight Steps to Reality Therapy- Glasser (1965)
1. Create a relationship
2. Focus on current behavior
3. Invite client to evaluate behavior
4. Help clients develop an action plan
5. Get commitment of plan
6. Refuse to accept excuses
7. Refuse to use punishment
8. Refuse to give up on client
Eight steps to reality therapy by Glasser:
1-5 are the basic process described on slide 24
6-8 are therapists attitudes necessary for client success

10. Common Reality Therapy Strategies
description
Questioning
Explore “total behavior”, evaluating what client is “doing” and making specific “plans”
Being positive
Focus on what the client CAN do!
Metaphors
Using the clients language
Humor
Fits nicely with friendly environment
Confrontation
Do not give up on client or criticize the client and do not accept excuses from client
Paradoxical techniques
Reframing (seeing a behavior that was previously undesirable as desirable) and prescription (instructing client to choose a symptom ) Ex: a client who is afraid of making mistakes at work may be encouraged to make a mistake. If the client tries to make a mistake, then the client shows control over the problem.
Strategies used in reality therapy:
1. Questioning: exploring total behavior of clients, assessing what the client is currently “doing” and creating the action plan.
Questions serve to:
enter the client’s world
gather information
give information
help clients take control over their lives
Being positive: therapist focuses on what the client CAN do! Therapist reinforces positive actions and constructive planning.
Metaphors: using the client’s language can be helpful in communicating understanding…. The therapist is talking in ways that are congruent with the client’s perceptions. Ex: I was over the moon when he asked me to marry him. Therapist: “what does it feel like to you when you are over the moon?”
Humor: sometimes therapists have an opportunity to laugh at themselves, which encourages clients to do the same. (students/children seem receptive to this technique especially). This also meets the basic need of fun!
Confrontation: because therapists do not accept excuses from clients or give up on them, they must confront the client at times.
Paradoxical techniques: these techniques are those that give contrary instructions to clients. Ex: a client who is afraid of making mistakes at work may be encouraged to make a mistake. If the client tries to make a mistake, then the client shows control over the problem. Voluntarily doing something is having control! If the client refuses to do what the counselor suggested then the behavior is controlled and eliminated. Either way, the client wins!
Reframing: helps individuals change how they think about a topic. Ex: a man asks a woman out to dinner and she declines the offer. This can be reframed by commenting on the man’s strength in asking the woman out and for weathering the rejection.
Paradoxical prescriptions: instructing a client to choose a symptom. Ex: if a person is choosing to depress, she can be told to schedule to depress---to depress at certain times. Ex: “There’s no crying in baseball!” Demonstrates control.

11. Applications Individual counseling Marriage counseling
Family counseling
Group counseling
Social work
Education and teaching
Crisis intervention
Corrections and rehabilitation

12. Reality Therapy One final note on therapy……
Two and a Half Men- Charlie in therapy

13. Class Exercise Good Will Hunting Failed Therapists SuperPhilosophy
Park Scene
What Do You Want To Do?
When Did You Know?
It's Not Your Fault
Stimulus Questions for class discussion