Keywords: reality therapy interventions, reality remedy evaluation
Initially, control theory was foisted as the theoretical basis for reality remedy (Glasser, 1989). Overtime, however, it developed and was renamed choice theory to highlight the personal freedom people was required to choose their behaviours to lead healthy lives and keep maintaining loving human relationships (Nelson-Jones, 2001). The key ideas and assumptions that inform choice theory are basic needs, quality world, and total behaviour.
Basic needs. Choice theory assumes that individuals are determined by basic needs, that have a genetic source. The five basic needs include 1) survival needs of self-preservation and conference physical needs, 2) love and owed needs of sustaining healthy human relationships, 3) electricity needs of attaining a feeling of self-worth through position and reputation from others, 4) independence needs of freedom and autonomy, and 5) fun needs of excitement which motivates learning. These five needs are usually evenly important and could work in tandem or against one another (Austad, 2009). The duty of satisfying needs is never-ending, as another need arises after you have been fulfilled. Pleasure employs a fulfillment of these needs and pain results from failing to fulfill them. Consequently, people make an effort to optimize pleasure and minimize pain (Austad, 2009). So, the choices that people make are behaviours which signify how people try to gratify these basic needs (Nelson-Jones, 2001).
Quality world. The quality world is what Glasser (1998) refers to as the personal picture album. It contains mental snapshots of people, things, ideas, and systems of beliefs that a particular person perceives to be critical in gratifying his / her needs. Every person is supposed to truly have a different mental picture for every related need. So as the basic needs that drive behaviour are common (Wubbolding et al. , 2004), the images, which stand for the ways where the needs are satisfied, are unique to each individual. The product quality world pictures can be altered, though it is challenging and the pictures in the mental world of others can only be accomplished through "negotiation and bargain" (Nelson-Jones, 2001). Choice theory considers the desire to reduce dissonance between your ideal quality world picture and the real situation in reality as the drive which engenders behaviours (Austad, 2009).
Total behavior. Choice theory is aware of all behaviour as total behavior comprising of four interlocked components: operating, thinking, sense, and physiology. Folks are thought to be more aware of how they respond and think but have less control over their feelings and physiology (Austad, 2009). Choice theory, however, proposes that everyone has control over their emotions and physiological responses, albeit indirect. The notion of total behaviour underscores how behaviour is a decision and its other components are also within someone's control. Additionally, Glasser expresses the sensation part through verbs (rather than adjectives), such as depressing, anxietying, and phobicking, under the choice theory framework where active vocabulary further emphasizes the way the behaviour is made internally and it is within people's choice (Austad, 2001).
Ultimately, choice theory posits that the healthy person is one who selects appropriate behaviours to fulfill his/her five basic needs. Likewise, abnormal behavior, also by choice, implies failing in gratifying one's needs. Glasser (1998) disregards the psychiatric medical style of DSM prognosis and argues that, apart from genetically based ailments such as Alzheimer's, other unnatural behaviours stem from unhappiness, scheduled largely to dysfunctional connections. Choice theory shows that, so that they can fulfil their own needs, people should control someone else but this inevitably disrupts their relationship. As a result, the core assumptions of simple fact therapy and choice theory is that individuals can only just truly control themselves, and can thus make alternatives on their behaviours to meet their needs.
Therapist Techniques
Even although concepts may seem to be simple as presented, having the ability to convert them into genuine therapeutic practice calls for considerable skill, creative imagination and versatility on the therapist's part. The artwork of practicing actuality remedy differs for different therapists, depending on the personal characteristics and interpretation style. (Corey, 2009) Generally, the therapist should employ the client in thinking about him or herself regarding to a four-stage method - wishes, doing, assessing and planning - which can be typified in the form of four main questions (Wubbolding, 1991).
The first is, "What do I'd like?" which denotes the desires stage. The idea of a quality world is powered by specific needs and needs, and therefore, to totally understand and have a tendency to the client's needs, the therapist should set up adequate engagement and an optimistic relationship with the client. Relating to Glasser and Zunin (1973), involvement sometimes appears as the "primary intrinsic push governing all behaviour". It really is associated with an authentic, caring and warm therapist-client connection (Turpin & Ososkie, 2004). An excellent relationship is essential; without which, succeeding steps and strategies in remedy would not succeed. After the establishment of any warm relationship, the therapist can get your client to share what the main issue accessible is, and what his goals of therapy are. Questions can dwelling address goals as short-term such as "What do you want to eliminate when you leave today's session?". They can also dwelling address particular needs such as "Who, in your life, is the main to you?" (belonging) and "What sorts of decisions are you reluctant to make?" (flexibility).
The second is, "What am I presently doing?" which denotes the doing level. A key concept in reality therapy is concentrate on the present, not on the past. Present perceptions affect a person's current behaviour. As such, the therapist should strive to work on the present rather than dwelling on previous events. Also, the therapist should get your client to give attention to what he or she can directly do or change (such as that they respond and think) rather than what can't be done as easily (such as thoughts and physiological reactions). The predominant subject of conversation is behaviour, as it's the area that can be most easily and effectively modified. When this element is successfully modified, thinking and feeling will follow suit because they are all interconnected (Wubbolding, 2000). Inadequate cognitions, such as "I have no choice there is no other way", are also discovered and worked on.
The third is, "Could it be working?" which denotes the analyzing stage. This is the core of remedy. Here, the client is prompted to self-evaluate his / her actions, encouraging her or him to evaluate if current behaviours (today, last night, or generally) are either facilitating or hindering the attainment of the previously mentioned goals. On top of that, the therapist should get the client to consider the suitability and rationality of the needs and goals help with, and consider how far he or she is willing to visit attain them. Self-evaluation thus includes assessing the degree of willingness to work to bring about a positive change. Since certainty therapy is essentially focused on social romantic relationships, the therapist also needs to get your client to consider the impact that his or her current activities have on individuals around. Relating to Wubbolding (2000), many people are "not capable of making judgments on the basis of internal norms or even of perceiving the impact of their behaviour on others". Thus, the client should be prompted to appraise whether current actions might oppose any guidelines or goals of the individuals around them.
When current behaviours are evaluated as inappropriate, the final question that may be raised is, "What else can I do?", which denotes the look stage. Plans should not have the motive of directly treating or resolving problems; alternatively, they should serve to enhance and improve conditions. The therapist may suggest a plan of action, but it is more useful and effective if your client himself has input into the subject. It really is highly crucial that strategies be specific and incredibly workable. The primary steps shouldn't be too ambitious; the therapist should ensure they are simple enough to ensure that your client will succeed and therefore continue with following stages of therapy confidently.
It should be known, however, that 4-stage style of remedy is more cyclical than it is linear. The cycle repeats many times over several therapy sessions until the goals of the client and therapist are achieved. As such, it is critical that the therapist constantly evaluates the progress of the client. Your client should be totally focused on the plans applied and to remedy in general. The therapist should be non-accepting of excuses not to adhere to strategies. Thus, a good therapist-client romance might easily ensure in a "working alliance" (Grencavage & Norcross, 1990) which would indefinitely assist in ensuring continuous determination and engagement throughout remedy.
Current Applications of Reality Therapy and their Effectiveness
Owing to the social nature of certainty therapy and the ubiquity of sociable situations, Glasser (1965) has layed out many uses of simple fact therapy in a variety of settings. In fact, the many William Glasser Institutes set up round the world teach actuality remedy and choice theory in these applications, and has an international following, including here in Singapore. However, many of these applications, as with the concept of reality therapy itself, has a dearth of aiding literature.
There are, however, a few studies which quantitatively examine the effectiveness of reality remedy in clinical, institution, correctional and counseling options. Sheryl (2006) examines a customer with Post-Traumatic Stress Disorder (PTSD) and the effectiveness of reality remedy in symptom reduction. It was discovered that reality therapy treatment resulted in a 50% reduction in PTSD-linked somatization and rumination conducts. It really is notable that this research study approach is without conditions of control topics, and so requires additional research. Additionally it is acknowledged that in a clinical environment, one of the requirements for successful request of reality remedy is that the patient must have the ability to adequately perceive and behave regularly according to actuality. McMordie (1981) suggests that a psychotic patient, being "not in contact with actuality" (p. 140), requires behavioral intervention first to bring the improper behavior into reliability before a cognitive involvement of any dynamics. Thus we can deduce that the truth therapy is effective in clinical configurations insofar as there is no significant cognitive impairment. Additionally it is significant that Glasser (1965) himself acknowledges the restrictions of reality remedy when coping with organic and natural disorders.
The most researched use of fact therapy at this point appears to be in school settings. A report by Peterson, Chang and Collins (1998) confirmed that Taiwanese school students studying either choice theory or undergoing truth therapy were a lot more alert to control over their own behaviors, and actually employed the approaches for changing than the control group. Loyd (2005) evaluated the identified satisfaction of high school students on measurements of mental needs such as belonging, power, freedom and fun and its effect on behavior. It was discovered that students exposed to choice theory and actuality therapy have scored significantly higher on these internal needs in comparison to control groups. Passaro, Moon, Wiest and Wong (2004) conducted truth therapy in an in-school support room, and found that students undergoing treatment could actually make smarter decisions, and in a position to self-initiate cognitive and behavioral change. These students were less likely to receive disciplinary actions as compared to students who didn't undergo the procedure. Additional studies conducted on primary school students in Korea (Kim, 2002) reinforce the efficacy and the universality of simple fact therapy and its own applications in cross-cultural institution adjustments, as well as across schooling age groups.
Another application of reality therapy would be in group counseling settings. Group counseling predicated on reality remedy has been considered to aid in shifting clients from an external to an interior locus of control, as well as increase achievement motivation (Rose-Inza and Mi Gu, 2001). The group setting up has been recommended by reality therapy proponents due to safe haven provided where inter-personal relationships can be developed (Glasser, 1965), which is important to note that interpersonal relationships are fundamentally linked to the basic human problems as reported by reality remedy and choice theory.
Although not thoroughly studied, reality remedy can even be applied in correctional configurations. Rachin (1974) experienced advised that clients in correctional institutes responded well to simple fact remedy, despite numerous failed endeavors to reform using standard treatment options such as behavioral or medical approaches. Reeder (1997) discovered that the utilization of any therapy which possessed a prosocial action element (including other treatments such as Friendship Therapy) resulted in more prosocial action in jail immates. However, it was also suggested that because the prison setting up itself will not promote the development and sustainment of such action, and could thus counteract any enduring positive effects of the treatment.
There are a lot more settings where proponents suggest simple fact therapy may be employed, such as athletics where goal-setting and achievements motivation is required for success (Edens, 1997). However, there is still much research required in this aspect of reality remedy, and many of these applications have yet to be rigorously researched and evaluated in order to complete the current dearth of data and books.
Application of Actuality Therapy's Principles and Techniques in Future Settings
Since reality therapists believe that the underlying problem of most clients is due to a present unsatisfying romance or lack of a marriage, we claim that reality therapy principles and therapist techniques can be lengthened to other possible adjustments.
The practice of simple fact therapy assumes that a supportive and challenging environment allows clients to start making life changes. (Corey, 2009) While building a safe and sound atmosphere for clients the truth is therapy is comparable to the concept of rapport building in typical therapies but the techniques that reality therapists use are unique.
Research on simple fact therapy has been conducted in adjustments such as academic institutions and correctional institutions; and with particular populations such as despondent clients, sexually abused clients and professors. However, limited research is available on reality remedy applied to marriage and family counselling. We claim that therapists can follow the 'Wants, Direction, Analysis and Strategies' (WDEP) system whenever using couples and people. Therapists can help lovers and families identify their common wants, behaviours, and perceptions as well as negotiate how to simply accept and live with the distinctions. For example, if the family has made a decision to stay intact and connected, therapists can help the family define what they want from one another and then check out make specific ideas to attain the goals. The WDEP system can be used with flexibility, depending on the client's circumstances. By aiding the client to explore the specifics of his/her behavior, they are really in tune with the truth, today's world around them and observe how their thoughts, thoughts and activities are impacting their lives. Therefore, all therapists may use the WDEP solution to work with all sorts of clients with enough cognitive level and insight to understand their behaviours and if they are going towards the entire direction that they really want in their life.
Secondly, self-evaluation is at the center of reality remedy. The explicit inquiry about the effectiveness of their specific activities and their life path helps them to pause, take stock of their lives, and analyze steps to make changes. Individuals will not change until they start to see the dependence on change. We suggest that asking clients who have dependency problems questions such as "Is what you are doing helping or hurting you?", will allow the clients to see the incongruence between their behavior and the greater goals in life. Also, when the reality therapist asks an addict if the unnecessary behaviour these are engaging in presently helps them in the long run, the thought of choice is being presented. Clients with alcohol problems will realize they can not control others around them from not having, they cannot stop the media companies from demonstrating advertisements on tv set, thus they can only control their own behavior and they are not subjects to the globe around them.
Personal responsibility, a concept basic to truth therapy, is thought as the capability to fulfil one's needs, and also to do so in a manner that will not deprive others of the capability to fulfil their needs. Therapists can task their clients after building a safe and sound environment because all clients, in their unsuccessful initiatives to fulfil their needs, talk about a common feature: Each of them deny the reality of the world around them. For instance, clients who have attempted suicide did it to avoid facing their problems with a more responsible frame of mind and clients who point out phobias of congested places freely admit their irrational concerns and are in incomplete denial about actuality. (Glasser, 1965) In correctional adjustments, there could be offenders who do not take responsibility for his or her actions. They could have felt they are being oppressed by the culture and they are not given chances to be always a meaningful person, thus they commit the unlawful action. Such clients usually come to therapy to talk about what infavourable things others are doing to him/her. These topics are easy as they excused one's failures and disregard one's personal responsibility towards the results. It is very important for the therapist to invest adequate time hearing their past behaviours to mention the concept of approval and more importantly, to focus on what the client does and pondering now. By empathetically guiding offenders to use responsibility for his or her own activities, these offenders will stop perceiving things through a poor worldview and begin afresh by learning how to hook up to others and living a far more satisfying life.
Reality Remedy in Multi-Cultural Settings
According to William Glasser, truth therapy can be applied both singularly and in groups to anyone with psychological problem in any cultural framework. Although reality remedy assumes all humans have the same basic needs, the therapist must modify the design of delivering the therapy when working with culturally diverse clients. However, a shortcoming of this approach arises when working with clients who are discriminated based on ethnicity and love-making. Discrimination, racism and sexism are societal forces that operate against these clients in everyday activities and may limit the choices that they have. Reality therapists who expose the concept of choice firmly in the first stages of remedy may make your client feel misunderstood and lead to them shedding out from treatment. Therefore, therapists should focus on the choices these clients have and also to address the problem of limited choice scheduled to environmental constraints.
Additionally, successful fact therapy requires active input from the customers. When working with clients from civilizations where clients may become more reluctant or shy to verbally share their needs or collectivistic ethnicities where clients are expected to place group needs above individual needs, the therapist may need to "soften" reality therapy and be more sensitive to the ethnical norms.
In conclusion, the truth therapist seeks to be involved with the client and aid him/her to handle reality together. While using power from the therapist, the client is challenged to decide if he/she would like to use responsibility for an improved future. By educating individuals who they have a choice in concerns help to ease the helplessness and hopelessness they face.
