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When and How to Use the Reality Therapy Approach to Counseling

September 17, 2021
MSW Reality Therapy

Developed in 1965 by Dr. William Glasser, reality therapy dismisses concerns about things beyond a person’s control, such as other people’s behavior, negative experiences or past events, and instead focuses on things within a person’s present ability or present reality to control.1

Explore the history and basic principles of reality therapy—when and how to use it and what the therapist's role is in this “here and now” approach to counseling.

Glasser’s 5 Basic Psychological Needs

Reality therapy believes that humans are always striving to meet personal needs. Symptoms of mental distress occur when one or more of the five basic psychological needs identified by Dr. Glasser are not being met. The five basic psychological needs include:1

  • Survival: Feeling fulfilled regarding food, shelter and sexual needs
  • Satisfaction: Feeling happy, having enjoyment and pleasure
  • Love: A sense of belonging in a significant relationship, family or community
  • Power: Feeling a sense of self-worth or self-confidence
  • Freedom: Having a feeling of autonomy, a sense of independence and achieving personal boundaries

Dr. Glasser maintained that individuals achieve greater success at fulfilling these five basic psychological needs by choosing to change their own actions rather than attempting to change someone else's behavior. By helping people recognize their unmet personal needs, professionals using reality therapy can devise a plan to help their clients meet those needs. Therapists encourage their clients to refrain from negative behaviors, such as making excuses or blaming and criticizing others, and instead guide them to adopt positive behavioral changes instead.1

An Overview of Reality Therapy

A fundamental goal of reality therapy is to help people fulfill Glasser's five basic psychological needs through successful relationships. The symptoms of mental distress, according to Dr. Glasser, are manifestations of unfulfilling relationships and as such are not significant in this approach to counseling. Instead, the reality therapy approach is based on the premise that changes in personal behavior will help improve personal relationships, fulfilling personal needs to reduce the symptoms of mental distress.1 Successful reality therapy sees clients take responsibility for their actions and choose more responsible behavior.2

The Reality therapy approach is directly based upon choice therapy, which was also developed by Dr. Glasser. In choice therapy, Glasser refers to his five basic needs as "genetic instructions," or basic needs that are driven by human DNA. By applying the essential principles of choice therapy, reality therapy seeks to help individuals understand the reality of their choices and guide them to choose more successful behaviors. These essentials include:2

  • Behavior: Past behaviors are categorized as organized. Unsuccessful organized behaviors become reorganized in reality therapy with guidance from the counselor.
  • Control: Individuals are controlled only by themselves. The idea that an individual is controlled by external factors is dismissed as ineffective for producing behavior changes.
  • Accountability: Taking control of behavior choices leads to taking responsibility for choices, increasing an individual's accountability for their behavior.
  • Actions: Overall behavior is made up of an individual’s actions. Current actions are evaluated to assess how effective they are for meeting needs. Individuals may need help planning new actions that are more successful.
  • Here and Now: Present behavior is directly related to present unmet needs. Responsibility and action are not influenced by the past. Only the present reality is significant for successfully meeting present needs.

Although reality therapy is widely hailed and practiced around the world, little research has been undertaken to assess its effectiveness. Additionally, some members of the psychiatric community reject reality therapy because it rejects the notion of mental illness.2

When and How Is Reality Therapy is Applied

Reality therapy can be used when disconnects occur within various relationships and situations, such as:2

  • Educational settings
  • Employment situations
  • Relationships with peers
  • Spouse or partner counseling
  • Family therapy
  • Parenting challenges
  • Friendship disconnections
  • Addiction therapy
  • Individual therapy

When individuals are experiencing disconnects or failing to connect with the people in their life, reality therapy offers ways to help individuals reconnect or create successful new connections. By focusing on disconnectedness as the root problem, reality therapy recommends identifying who the person is disconnected from and help them choose behaviors that will enable reconnecting. If reconnecting is not feasible, the individual will need to find a satisfactory new connection.3

The Therapist’s Role in Reality Therapy

In reality therapy, the therapist's primary role is to guide an individual's self-evaluation by asking questions about the effectiveness of their present behavior for meeting their needs. As ineffective behaviors are identified, the therapist guides the client to plan specific, simple new actions and behaviors, framing the new choices in positive terms. The therapist may also help guide the client through a rehearsal of the new behavioral choices.2, 4

Some specific steps recommended for the reality therapist include:3

  • Focus on the “here and now,” rather than on the individual's past.
  • Focus on the specific disconnect, identifying the relationship in need of reconnection.
  • Discourage complaining, blaming and criticizing, as these are considered ineffective and harmful choices of behavior.
  • Encourage positive thinking, because feelings and symptoms of mental distress only change when behaviors change.
  • Guide the client's self-evaluation, e.g.: “Are my actions helping me to get closer to the person/people I need?”
  • Suggest new behavior choices, allowing the client to choose satisfactory new behaviors that are more effective.
  • Suggest simple plans, encouraging the client to put the new behavior choices into action in simple, specific ways.
  • Follow plans with evaluations, encouraging the client to self-evaluate the effectiveness of the new choices of behavior/action.
  • Be patient, remaining non-judgmental and non-coercive while guiding the client's self-evaluations, new behavior selections and plans of action. The client may require more than one plan or more time with a chosen plan to effectively reconnect.
  • Encourage new connections, especially if the disconnect is realistically unlikely to resolve. If so, the client will need help choosing a plan for finding a new connection.

What You Learn Matters

Learning about a variety of treatment options can help you make a difference in the life of your clients. If you are a rising counselor or social worker interested in learning new skills, consider how an online Master of Social Work from Yeshiva University can help you find and refine the theories and approaches that most effectively suit your counseling style. Our MSW online program offers a variety of specializations, advanced clinical training and your greatest opportunity to boost your career by putting your purpose and passion into action. Get training in advanced clinical practice with individuals and families, group work and community practice.


1. Retrieved on September 16, 2021, from goodtherapy.org/learn-about-therapy/types/reality-therapy
2. Retrieved on September 16, 2021, from healthline.com/health/reality-therapy
3. Retrieved on September 16, 2021, from wglasserinternational.org/courses/professional-development/reality-therapy/
4. Retrieved onSeptember 16, 2021, from apa.org/pubs/books/4317235