2 nd Edition Chapter 11 Reality Therapy and Choice Theory Mario De La Garza MEd University of North Texas Historical Context 1950s mental health professionals began honoring peoples ability to choose and control thoughts feelings and behavior ID: 652355
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Theoretical Models of Counseling and Psychotherapy, 2nd Edition Chapter 11: Reality Therapy and Choice Theory
Mario De La Garza, M.Ed.
University of North TexasSlide2
Historical Context1950s: mental health professionals began honoring people’s ability to choose and control thoughts, feelings, and behaviorFree will accepted more than determinismMental health professionals began being more active in the therapeutic relationshipSlide3
William GlasserMother was extremely controlling; father epitomized choice theoryStudied engineering and psychologyEventually entered medical school at Case Western ReserveTrained in psychoanalysis, but disagreed with Freud’s theorySlide4
William GlasserHad no interest in clients’ pastWorked 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 TheorySlide5
Philosophical UnderpinningsGlasser 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 approachesSlide6
Function of the PsycheFive basic needs:SurvivalLove and belongingPowerFun
Freedom
All individuals seek to fulfill needs to avoid pain of not having them met.
Strength of needs varies among peopleSlide7
Function of the PsychePeople translate needs into specific wants.Total behavior: thinking, doing, feeling, and physiologyResponsible or irresponsible
Effective or ineffective
A person’s behavior represents one’s best effort to get a need met.Slide8
Structure of the PsycheBrain is the controlling system for the organismAutomobile metaphor:Engine – basic needsSteering – unique wantsFront wheels – thinking and doing
Back wheels – feeling and physiologySlide9
Structure of the PsycheQuality world (inner picture album) – what a person perceives will fulfill and continue to fulfill the basic needsPeopleThingsIdeas/beliefsSlide10
Role of the EnvironmentFamily factors supply initial need fulfilling opportunities for a growing childFamily has a significant impact on individual’s quality worldChurch, school, neighborhood, culture, and geographic location also influence need satisfactionSlide11
Healthy FunctioningBehaving responsibly – meeting one’s own needs without preventing others from meeting theirsForm and maintain connections with othersThere is a balance of need fulfillmentEffective life direction
“I Want to Change and I Want to Grow”
“Effective Behaviors”
“Positive Addictions”Slide12
Unhealthy FunctioningThe lack of satisfying present relationshipsDisconnection between individuals and othersNOT mental illnessPeople choose behaviors to deal with their loneliness and isolationSlide13
Personality ChangeTake responsibility for choicesChoose to changeRealize myriad of optionsChoose new total behaviorAssess efficacy of new total behaviorSlide14
Client’s RoleBe willing to focus on and change behaviorBe willing to accept here-and-now focusBe willing to learn choice theoryBe willing to build a relationship with therapist
Be willing to persist in the relationship when challengedSlide15
Counselor’s RoleContinuously practicing the AB’s Focusing on the presentUsing humorUsing empathic confrontationDon’t accept excuses
Don’t argue or criticize
Don’t give up quicklySlide16
WDEP systemWantsDirection and DoingEvaluationPlanSAMI2C
3Slide17
Interface with Recent Developments in Mental HealthNature/NurtureGenes and environment impact but DO NOT dictate behavior; choice dictates behaviorDSM 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 problemsSlide18
Interface with Recent Developments in Mental HealthManaged Care and Brief TherapyDiagnosing and medication are antithetical to the pure version of reality therapyTherapy 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 congruentSlide19
Interface with Recent Developments in Mental HealthDiversity IssuesA 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 effectSlide20
ContributionsSignificant contributions to educationFormulation of basic genetic needs and quality world as well as WDEP systemSlide21
LimitationsLacks comprehensive evidence based research support on effectivenessGlasser’s hard line stance that mental illness does not exist is difficult to conceptualize in today’s societySlide22
ReferencesFall, K. A., Holden, J. M., & Marquis, A. (
2016).
Theoretical models of counseling and psychotherapy
(3rd
ed.). New York, NY: Routledge.