What is Reality Therapy?

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  • Written By: Jessica Ellis
  • Edited By: Bronwyn Harris
  • Last Modified Date: 20 October 2019
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Developed in the 1960s, reality therapy is a form of self-improvement treatment based on changing negative behavior, habits and relationships by focusing on the present or current situations. Supporters suggest that this form of therapy promotes personal responsibility and can provide real behavioral changes in a short time of dedicated work. Detractors argue that reality therapy is overly simplistic and may ignore underlying psychological conditions or learned behaviors that may be too deeply rooted to simply change by will.

The theory's founder, Dr. William Glasser, is a board-certified psychiatrist with degrees from the University of Los Angeles and Case Western Reserve University. Famously, the doctor disagrees with the existence of many mental conditions, insisting that unless the brain is demonstrably malfunctioning, diagnosis may be disingenuous or misleading. Dr. Glasser's theories of reality therapy were first brought to public attention by his writing on the subject, including popular books such as Reality Therapy and Choice Theory.

The concept behind Glasser's theory suggests that, by and large, people are responsible for their own actions and behaviors. Most behavior is a combination of choice and control, and behavioral patterns can be altered through conscious decision making. Patients are encouraged to determine what their personal and life goals, before examining whether their behavior is improving or damaging chances of success.


The principles of reality therapy may be ideal for people who distrust traditional methods of psychiatric treatment. Rather than examining destructive behavior for its origins and assigning blame, reality therapy emphasizes focus on present issues and future goals. People unnerved by talking about their history or deep feelings may be reassured by the logic and rationality of the theory.

Dr. Glasser's theories of treatment have found many supporters among the mental health and patient communities. Television therapist Dr. Phil uses a famously tough form of the principles by constantly enforcing the concepts of personal responsibility for behavior and basing the success of treatment based on improvement or achievement of personal goals. Yet like any theory, reality therapy has attracted considerable criticism from other schools of thought.

While many agree that personal responsibility for problems is an important concept for many patients, the inflexible tenets of reality therapy may cause other conditions to go overlooked. Psychological disorders or deeply ingrained responses caused by traumatic events may not be easy to overcome. Insisting that a person is not succeeding because he or she is not trying hard enough may cause severe frustration, angst, and self-esteem problems. If the treatment in itself becomes a hindrance to improvement, therapist and patient may both need to reconsider their treatment plans.


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Post 4

My great aunt was given a lobotomy. This did not help but made her worse. In my opinion, the more old ways of dealing with the mentally ill, the worse off we are. We should leave these wild methods of the past behind us and strive for constant psychiatric improvement.

Post 3


I think I see where you both are coming from, and think you're both right. Reality should not be seen as cold and hard, I don't think this is real realism. Of course, both the patient's and the doctor's perception of reality has a lot to do with how it will be conveyed. Nevertheless, there should be a functioning perception which is also hopeful. Humans need redemption, and need to know that their pain is not in vain, but has a real purpose.

Post 2


If a therapist creates a reality which is not real, then is he really doing the patient a favor? I think that it is the job of "serious psychiatrists" to make sure that they are enabling their patients to function well in a tough world. Painting it all rosy is not doing them a favor, but is getting their hopes up to be shattered again.

Post 1

Reality therapy is presented from a myopic view of reality. If doctors do not understand the redemptive nature of reality, then foisting a cold, hard, and dark, reality on a patient will only drive them further away. Usually, it is this kind of reality which drove them crazy in the first place. Heavy-handedness should not be tolerated in the serious psychiatric community.

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