International journal of choice theory and reality therapy

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 6

CHOICE THEORY AND REALITY THERAPY: AN OVERVIEW

Ezrina L. Bradley, Chicago State University

Abstract

An old cub scout saying states that “We need to keep things simple and make them fun,

and then before we know it, the job will be done.” Notably, William Glasser seemed to be

aware of this saying as he sought to create Choice Theory and Reality Therapy. Truly, he

consistently sought to help others to better relate to their experiences, and then guided

them regarding how they might more readily take efficient control of their lives. This brief

overview simply seeks to explain how all of this can be simply done.

INTRODUCTION

Often times, we blame other people or things for our own misery. “The kids are driving me

crazy.” “My husband makes me so mad.” “Being sick is making me depressed.” When

saying these things, many do not realize that they are actually choosing how they feel, and

that these people or things are not causing their emotions. According to choice theory

(formerly known as control theory), we choose all of our actions and thoughts, based on the

information we receive in our lives. Other people or things cannot actually make us feel or

act a certain way (Glasser, 1998)

Choice theory, developed by Dr. William Glasser, evolved out of control theory, and is the

basis for Reality Therapy (Howatt, 2001). Control theory,on the other hand, was developed

by William Powers and it helped explain many of Dr. Glasser's beliefs, but not all of them.

Dr. Glasser spent 10 years expanding and revising control theory into something that more

accurately reflected his beliefs, what we now know as choice theory (Corey, 2013).

Although reality therapy is based on choice theory, it was actually reality therapy that was

coined first in 1962. It wasn't until some 34 years later, in 1996, that Glasser announced

that the term “control theory” would be replaced with “choice theory”. The rationale for the

name change was that the guiding principle of the theory has always been that people have

choices in life and these choices guide said life (Howatt, 2001).

Glasser believed that people needed to take more responsibility for their behavior and that

reality therapy could help them do this. The essence of choice theory and reality therapy is

that we are all responsible for what we do and that we can control our present lives (Corey,

2013). Glasser also believed that the root problem of most unhappiness is unsatisfying or

non-existent relationships. Because of this void, an individual chooses their own

maladaptive behavior as a way to deal with the frustration of being unfulfilled. In reality

therapy, a person can be taught how to effectively make choices to better deal with these

situations. Reality therapy can help an individual regain control of their lives, instead of

letting their emotions run the show, which is the key to their own personal freedom

(Howatt, 2001). Although traditionally thought of simply as a therapy technique, reality

therapy is actually a philosophy of life that is applicable to more than just psychological

deficits. It can be used in all aspects of human relationships and in various settings,

including schools, hospitals, and correctional institutions (Corey, 2013).

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 7

ESSENTIAL CONCEPTS OF CHOICE THEORY AND REALITY THERAPY

Choice theory is an internal psychology that postulates that all behavior is a result of

choices, and our life choices are driven by our genetically encoded basic needs. Originally,

Dr. Glasser presented only two basic needs: love and acceptance (Howatt, 2001; Litwack,

2007). By 1981, the basic needs had increased to five and are: survival, love and belonging,

power, freedom, and fun (Litwack, 2007; Brown, 2005; Corey, 2013; Glasser, 1998).

Survival is the only physiological need that all creatures struggle with. Love and belonging is

a psychological need and is considered the primary need in humans. Power is also a

psychological need that includes feelings of accomplishment, success, recognition, and

respect. Freedom is a psychological need that involves expression of ideas, choices, and

creativity. Lastly, fun is also a psychological need that involves laughing and enjoying ones

life. These basic needs are not in a hierarchy as Abraham Maslow's needs are. Instead, our

basic needs as presented by Dr. Glasser vary in strength depending on the person, and can

also change within an individual over time and circumstance. If any of these needs are not

being met, which can be displayed in our feelings, we respond accordingly to achieve

satisfaction (Corey, 2013).

Choice theory also postulates that everyone has what they would consider their quality

world. This is the place in our minds where we store everything that makes, or that we

believe would make, us happy and satisfied. This is where all of our good memories and fun

times go. This is also where that dream vacation and dream home would go. It is like a

photo album or inspiration board of all our wants and needs (Corey, 2013). People are the

most important part of this quality world, remembering that a key point of choice theory is

that behavior is the result of unsatisfying relationships or the absence of relationships.

Without people in your quality world, there are no relationships. Without relationships, the

quality world cannot be satisfied. Part of the goal of the reality therapist would be to

become a part of their client's quality world, thereby facilitating the process of learning to

form satisfying relationships (Corey, 2013).

Choice theory explains that all behavior is made of four components: acting, thinking,

feeling, and physiology. These four components combine to make up our total behavior.

Our acting and thinking controls our feelings and physiology. Choice theory also explains

that all behavior is purposeful, and is an attempt to close the gaps between our needs,

wants and what we are actually getting out of life (Corey, 2013). Our behavior can help us

deal with our emotions, give us some control over our circumstances, help get us the help

we need from others, or become a substitute for behavior that should occur. Behavior is like

a language sending out coded messages to the world on our behalf expressing our wants

and needs (Wubbolding & Brickell, 2005). Again, usually these wants and needs stem from

unsatisfied relationships.

The focus of reality therapy is to address the issue of these unsatisfying relationships which

can result in unfavorable behavior. Emphasis is placed on the client focusing on their own

behavior rather than playing the blame game. We cannot blame others for our lives and, in

turn, cannot control the behavior of others. “The only person you can control is yourself.”

(Corey, 2013). Reality therapy also involves being in the present and not focusing on the

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 8

past. The past is just that, the past. We cannot allow the past to dictate our present and

future actions. Again, focus should be on current behavioral issues since that is what needs

to be “fixed” (Corey, 2013).

REALITY THERAPY'S THERAPEUTIC PROCESS

As stated, the primary focus of reality therapy is to address the issues associated with

unsatisfactory or non-existent relationships. The therapist is responsible for helping the

client learn better ways to satisfy their needs while establishing better relationships. They

will help the client establish attainable short and long-term goals as a focus for therapy.

Also as mentioned, the therapist must try to make a connection with the client in order for

the process of learning how to establish beneficial relationships to begin. It is not the

therapist's job to judge or evaluate the client. Rather, they strive to challenge the client to

look deeply at their behaviors and help to establish goals to make changes in their lives

(Corey, 2013).

In order to establish a good client-therapist relationship, the therapist needs certain

personal and professional qualities that support a therapeutic learning environment. Some

personal qualities that a reality therapist need are empathy (understanding), congruence

(genuineness), positive regard (acceptance), energy, and the ability to see everything as an

advantage or positive while not being naïve to the nature of humans. Some professional

qualities include having the ability to communicate hope, the ability to redefine the problem

in solvable, more attainable terms, the ability to use metaphors effectively, and cultural

sensitivity (Wubbolding & Brickell, 1998).

The therapeutic process is one of exploration of the client's wants, needs, and perceptions.

The client's responsibility in the therapeutic process is to stay on task, focusing on the

present behaviors and not past experiences. They should participate in the exercises as

presented by their therapist and answer questions as truthfully as possible, in an effort to

get a better understanding of their behavior in relation to their quality world and the

relationships they have established. These sessions are seen as a learning process so the

client should be able to take away lessons on how to deal with problems as they arise and

use the information learned in their daily lives. Again, choice theory and reality therapy can

be viewed as a way of life instead of just a form of therapy (Brown, 2005).

REALITY THERAPY'S TECHNIQUES AND PROCEDURES

Reality therapy uses action-oriented techniques that include teaching, positiveness, humor,

confrontation, questioning, role-playing, and feedback. It is a “cycle of counseling” which

consists of creating an effective counseling environment and implementing specific

procedures that lead to change (Corey, 2013). Creating the counseling environment

involves establishing a therapeutic relationship with the client that is supportive yet

challenging. Therapist should avoid non-productive behaviors such as demeaning and

criticizing, and focus more on mildly confronting the client while being caring and accepting.

After the counseling environment is created, reality therapist can use the WDEP (Wants,

Direction and Doing, Evaluation, and Planning and Action) system to individualize the

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 9

process of exploring wants, needs and perceptions, determining possible actions they can

do to elicit change, self-evaluating their progress, and helping in designing an actual plan of

action for change (Corey, 2013; Radtke, Sapp, Farrell, 1997). When exploring their wants,

needs, and perceptions, a therapist will ask probing questions to help the client realize what

they truly want and need. A question as simplistic as “What do you want?” can be used but

often does not elicit a fully accurate response. Other questions that could be used are “What

would you be doing if you lived as you want to?” and “If you were the person that you wish

you were, what kind of person would you be?” It's important to know what type of questions

to ask, and when and how to ask them. When exploring the possibilities of actions for

change, the therapist starts by asking the client what they are currently doing to make

change in their lives. Questions such as “What are you doing to get what you want?” and

“When you act that way, what are you thinking or feeling?” can be used. The next phase

would be a self-evaluating phase for the client. During this phase, the therapist will inquire

as to the effectiveness of current problem behaviors. “Is what you are doing working for

you?” or “Is what you are doing getting you what you want?” are just two of the questions a

therapist might use to elicit such information. The last phase would be to assist with putting

a plan of action into place to address the needs explored and confirming commitment to

enact the plan. The therapist can ask “What are you prepared to do?” or “What is your

plan?” These techniques can be used one-to-one and in a group setting.

VALIDITY OF REALITY THERAPY AND IMPLICATIONS FOR FUTURE STUDY

Reality therapy has been around for decades and for some has been very useful in

addressing problem behaviors and unsatisfactory relationships. But many are asking, does

research support the use of reality therapy? This subject has actually been one of the major

criticisms of reality therapy. There seems to be a lack of in-depth research about the

effectiveness of the therapy. There have been studies conducted and dissertations written

on various topics relating to choice theory and reality therapy, but not much beyond

“anecdotal reports” (Litack, Fall 2007). In 1997, Radtke, Sapp, and Farrell conducted a

meta-analysis of the effectiveness of reality therapy and found that reality therapy has

many applications and it has a medium effect on behavior in relation to the 21 quantitative

studies that were examined. But the meta-analysis was limited due to the limited number of

quantitative studies addressing the theory. Radtke, Sapp, and Farrell also noted that reality

therapy can be categorized as a cognitive-behavior therapy whose concept is easy for

clients to understand, but that more research is needed to truly determine reality therapy's

efficacy.

According to David Sansone in “Research, Internal Control and Choice Theory: Where's the

Beef?” (1998), there are standards for evaluating theories and therapies for effectiveness.

He points out that a theory and therapy should be scientific in nature, they should relate

well, they should be flexible to possible growth, the theory should provide a sound basis for

understanding the therapy, and both the theory and therapy should be based on verified

evidence. Although it would seem that choice theory and reality therapy mostly fill these

requirements, it would also seem the main area of discontent is with verified evidence or a

scientific basis. Many challenge that choice theory is not a scientific psychology at all but

actually more of a self-help coaching method (Sansone, 1998). In addition to these general

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 10

standards, there are very specific ethical considerations that should be considered while

evaluating rather or not reality therapy is a valid scientific, psychological therapy.

Standards for counselors and therapists all address the issue that psychologists, therapists,

or counselors should work with valid and reliable methods that are based on scientific

research.

When Sansone looked at the various articles in the Journal of Reality Therapy, the primary

publication for all things choice theory and reality therapy, he noted that only 9% of the

articles were of a research nature; far less were reported in other journals and databases.

In essence, it seems that there is not a lot of scientific research on which to base this theory

and therapy. In 2000, Wubbolding & Brickell noted that this is actually a misconception.

They believe that there is research which provides credibility for the practice of reality

therapy. Wubbolding agrees that more research is needed which is better controlled and

more visible in the professional world. Wubbolding noted that the 21st century would mark a

period in which the reality therapy community would be held more accountable for research

and validity of the method. Future generations will have to continue the momentum that

has been established (Burdenski, 2010). Dr. Glasser himself responded with his own call to

action. He requested that his work be independently researched and documented in order to

validate the effectiveness of choice theory and reality therapy (Glasser, 2010).

In these calls to action, emphasis was placed on research focusing on the multi-dimensional

nature of reality therapy. Research has supported that reality therapy is self-empowering

and can be effective in treating a variety of issues, including schizophrenia (Kim, 2005),

PTSD (Prenzlau, 2006), marriage and family issues (Duba, Graham, Britzman, & Minatrea,

2009), adult developmental issues (Mottern, 2008), and school related issues (Mason &

Duba, 2009; Wubbolding, 2007). One response to these calls for efficacy research was

answered in a study on the effectiveness of a graduate-level, interdisciplinary course on

choice theory and reality therapy at Northeastern University (Watson & Arzamarski, 2011).

The purpose of this study was to evaluate the value placed on choice theory and reality

therapy by the students, both professionally and personally. In this study, a total of 87

students were surveyed over a 5 year period. The results of the survey indicated that

students did indeed believe that reality therapy and choice theory were effective. The study

also noted that some students felt the theory was limited by confusion caused in attempts

to understand the basic concepts, not being applicable to some fields of study or

professions, and that the therapy cannot be a stand-alone therapy. This study should be

repeated with other test groups to test its validity.

In addition to the challenge of limited scientific research, some found it challenging to

incorporate the knowledge gained in therapy to their everyday lives. It is believed that a

client can have all the intentions in the world of implementing the plan of action developed

during therapy but often they do not. According to Robert Renna (1996), sometimes the will

to follow through is just not present. Role playing cannot substitute for the real world.

Renna believes that clients must be continually motivated and encouraged to follow through

with their plan of action and commitment. It is important for the therapist to start this

encouragement as part of the WDEP process.

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 11

Despite these issues, it seems that choice theory and reality therapy have a global following

that is getting stronger everyday (Lennon, 2010). In fact, choice theory and reality therapy

are now taught and practiced on every continent except Antarctica (Wubbolding, Robey, &

Brickell, 2010). This is because choice theory and reality therapy are thought to be credible

and universal, and can be applied to any culture. Choice theory teaches that all humans

have basic needs, a quality world, choices, and purposeful behavior. Some universal

behaviors and wants include cooking, dancing, education, folklore, gestures, language,

mourning, personal naming, and property rights. So no matter where you are in the world,

more than likely, your civilization has some, if not all, of these behaviors and wants. It is

important that reality therapist become multiculturally competent so they can properly

address the needs of their multicultural clients (Wubbolding, Al-Rashidi, Brickell, Kakitani,

Kim, Lennon, Lojk, Ong, Honey, Stijacic, & Tham, 1998).

This same globalization is also involved in the push for future development. It is part of the

choice theory philosophy itself that constant improvement is sought. This means the

organization not only has to strive for validity, but it also has to strive to put more

educated faculty in place to teach choice theory and reality therapy, and increase the

quality of their resources (videos, books, etc.) (Lennon, 2010). In order for choice theory to

survive, in addition to the scientific research and validation, it needs commitment and a

thriving organization backing it (Wubbolding, Robey, & Brickell, 2010). The William Glasser

Institute for Research is going in the right direction when it formed a relationship with

Loyola Marymount University and is continuing to foster that relationship in years to come.

This relationship is still very new but is one based on sustainability. It is hoped that this

relationship serves as a model for other institutions and agencies; to embrace choice theory

and reality therapy since an academic research institution is essential to the future of choice

theory (Smith, 2010).

CONCLUSION

As demonstrated, choice theory and reality therapy are global initiatives that are hopefully

here to stay. Choice theory began as a way of explaining peoples' behaviors and has

evolved into much more than that. The basic philosophies of choice theory can be used

every day and can be a way of life or lifestyle if fully embraced all the time, not just in a

therapy session. These philosophies include the ideas that we all have choices in life, we can

only control our own behaviors, all behavior is total and purposeful, focusing on the present

rather than the past, most problems are the result of unsatisfying relationships, and we can

“fix” unsatisfying relationships by satisfying our basic needs pictured in our quality world.

Reality therapy uses techniques such as confrontation, questioning, role-playing, and

feedback to help guide an individual to discover their wants and needs and to help put a

plan of action into place for change to occur. With more research and establishing more

academic relationships, choice theory and reality therapy will surely thrive for many

generations to come.

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 12

References

Brown, T. & Stuart, S. (2005). Identifying Basic Needs: The Contextual Needs Assessment.

International Journal of Reality Therapy, 24(2), 7-10.

Burdenski, T. (2010). What Does the Future Hold for Choice Theory and Reality Therapy

from a Newcomer's Perspective? International Journal of Choice Theory and Reality

Therapy, 29(2), 13-16.

Corey, G. (2013). Reality Therapy. Theory and Practice of Counseling and Psychotherapy,

9Th edition, 333-359. Belmont, CA: Brooks/Cole, Cengage Learning.

Duba, J., Graham, M., Britzman, M., and Minatrea, N. (2009). Introducing the “Basic Needs

Genogram” in Reality Therapy-based Marriage and Family Counseling. International Journal

of Reality Therapy, 28(2), 15-19.

Glasser, W. (1998). Choice Theory: A new psychology of personal freedom, 1st edition.

New York, New York: HarperCollins Publishers, Inc.

Glasser, W. (2010). My Vision for the International Journal of Choice Theory and Reality

Therapy. International Journal of Choice Theory and Reality Therapy, 29(2), 12.

Howatt, W. (2001). The Evolution of Reality Therapy to Choice Theory. International

Journal of Reality Therapy, 21(1), 7-12.

Kim, J. (2005). Effectiveness of Reality Therapy Program for Schizophrenic Patients.

Journal of Korean Academy of Nursing, 35(8), 1485-1492.

Lennon, B. (2010). Choice Theory: A Global Perspective. International Journal of Choice

Theory and Reality Therapy, 29(2), 17-24.

Litwack, L. (2007). Basic Needs-A Retrospective. International Journal of Reality Therapy,

Spring, 2007, 26(2), 28-30.

Litwack, L. (2007). Research Review: Dissertations on Reality Therapy and Choice Theory-

1970- 2007. International Journal of Reality Therapy, Fall 2007, 27 (1), 14-16.

Mason, C. & Duba, J. (2009). Using Reality Therapy in Schools: Its Potential Impact on the

Effectiveness of the ASCA National Model. International Journal of Reality Therapy, 29(2),

5-12.

Mottern, R. (2008). Choice Theory as a Model of Adult Development. International Journal

of Reality Therapy, 27(2), 35-39.

Prenzlau, S. (2006). Using Reality Therapy to Reduce PTSD-Related Symptoms.

International Journal of Reality Therapy, 25(2), 23-29.

Radtke, L., Sapp, M., & Farrell, W.C. (1997). Reality Therapy: A Meta-Analysis. Journal of

Reality Therapy, 17(1), 4-9.

International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 13

Renna, R. (1996). Beyond role play: Why reality therapy is so difficult in the real world.

Journal of Reality Therapy, 15(2), 18-29.

Sansone, D. (1998). Research, Internal Control, and Choice Theory: Where's the Beef?

International Journal of Reality Therapy, 17(2), 39-43.

Smith, B. (2010). The Role of The William Glasser Institute for Research in Public Mental

Health at Loyola Marymount University in the Future of Choice Theory. International

Journal of Choice Theory and Reality Therapy, 29(2), 35-40.

Watson, M.E. & Arzamarski, C.B. (2011). Choice Theory and Reality Therapy: Perceptions

of Efficacy. International Journal of Choice Theory and Reality Therapy, 31(1), 97-108.

Wubbolding, R. (2007). Glasser Quality School. Group Dynamics: Theory, Research, and

Practice, 11(4), 253-261.