Sometimes, making positive changes starts with being accountable and taking responsibility for your actions and behaviors.

Portrait of man with flowers growing out of his eyesShare on Pinterest
Vasilina Popova/Getty Images

Psychotherapy is a primary treatment for managing mental wellness and addressing many mental health conditions. Among its many virtues, therapy can help with:

  • strengthening communication
  • improving mood
  • learning coping strategies
  • managing stress, anxiety, and depression

Cognitive behavioral therapy (CBT) is one of the more popular forms of psychotherapy and is often used to help change unhelpful thinking patterns and behaviors.

Reality therapy may be considered the “controversial cousin” of CBT.

Unlike more conventional forms of therapy, reality therapy specifically focuses on an individual’s current state and places less importance on past experiences or the presence of mental health conditions.

Reality therapy emphasizes the impact of choice in your actions, which creates accountability for your behaviors. According to reality therapy theory, unhelpful behavior may arise when your five basic needs are unmet.

The principles and techniques of reality therapy guide you toward self-evaluation. It may help you reframe thoughts as plans, and the expected end result may motivate you to follow through.

Introduced by William Glasser in 1965, reality therapy is a form of counseling that views a person’s behaviors as choices.

According to Glasser’s theory, psychological symptoms are not a result of mental health conditions, but rather consequences of unfulfilled basic needs.

Choice theory

Choice theory states that an individual can control only their own behavior. You have little power over others’ thoughts and actions.

According to choice theory, there are five fundamental needs that humans are genetically wired to seek:

  • survival
  • love and belonging
  • power, self-worth, and achievement
  • fun, enjoyment, sense of satisfaction, and pleasure
  • freedom and independence

Choice theory states that a person’s needs must be met through internal behaviors rather than external factors. Otherwise, a pattern of ineffective and unhelpful actions may emerge and result in unmet needs.

Traditional psychiatry and psychology tend to focus on past behaviors and their underlying causes, as well as a person’s unconscious thoughts and feelings. In comparison, reality therapy is limited to the present.

This focus on the present may cause reality therapy to miss out on seeing the whole picture.

In fact, some critics are against reality therapy because it focuses only on the present. This potentially gives a therapist power to impose their own values and beliefs on a person. It could result in molding a person’s behavior in a way that might not be authentic to their choices.

Reality therapy has also been criticized for ignoring the presence of mental health conditions and opposing medication, which could affect someone’s path toward treatment, recovery, and symptom relief.

The basic principles and techniques of reality therapy focus on:

  • Behaviors. Behaviors are categorized as organized or reorganized. Organized behaviors are unhelpful past actions that someone created to satisfy their needs. A reality therapist can help “reorganize” those behaviors into new ones that may be more helpful.
  • Control. Reality therapy focuses on internal control, with the belief that outside factors and influences do not lead to changed behavior.
  • Responsibility. Accountability for your actions is a key factor in reality therapy. Taking ownership of past choices can help you become more committed to creating new, more effective behaviors.
  • Action. Planning and creating new actions to satisfy your needs with the help of the therapist can benefit your overall behavior.
  • Staying in the present moment. People who support reality therapy believe that focusing on the present moment to cultivate new actions and behaviors to satisfy unmet needs is more beneficial than analyzing the past and its limitations.

Reality therapy uses a few techniques in order to achieve the principles above:

  • Self-evaluation. This technique addresses your willingness to make changes and set realistic, achievable goals.
  • Action planning. Your therapist can help you plan new actions that may better satisfy your needs. Typically, the goal is for actions to be simple, attainable, specific, and measurable. These new actions are often timely and focus on the result, rather than the behavior itself.
  • Reframing. Therapists often help you take an unhelpful or negative perception and restructure it into a more helpful viewpoint. This can help shift your mindset from focusing on problems to thinking about solutions.
  • Behavioral rehearsal. Exercises like role play or self-talk can help you prepare to take planned actions in line with new behavioral goals when the time comes.

Reality therapy can play a role in a variety of situations and settings. It can be used in individual or family therapy, as well as couples counseling. Friendships and parental behaviors may also benefit from reality therapy.

In the workplace, reality therapy can also help manage employees and create harmonious and constructive relationships between co-workers. It can also benefit educational performance and goals.

Because of its emphasis on present behaviors and choices, reality therapy techniques can be used to help treat substance use disorder and addiction. It can also be beneficial in correctional facilities and mental health institutions, especially in situations when moving on from past behaviors can seem daunting or overwhelming.

The main criticisms of reality therapy argue that treatment may be limited or ineffective. This is mainly because the method does not address past behaviors or recognize mental health conditions.

Supporters of reality therapy often argue that focusing on an individual’s current needs and behaviors is more suitable for cultivating the goals and actions needed to achieve fulfillment and healing.

Sometimes thought of as the controversial cousin to CBT, reality therapy views individual behaviors as choices. It sees any unhelpful or negative actions and their results as a direct consequence of your unmet needs.

According to choice theory, focusing on your current behaviors can help you create goal-oriented actions to ensure your needs are met and ultimately improve your life.

Reality therapy can help people who find it challenging to move forward by focusing on the here and now. However, reality therapy isn’t for everyone and has been criticized for being limiting.

It places less importance on past experiences and behaviors, and it does not emphasize mental health conditions and their effects. Reality therapy is also opposed to prescribing medication for mental health disorders.

If you’re interested in participating in reality therapy, check out Psych Central’s guide to finding a therapist near you.

When you examine your actions and behaviors through a lens of unmet needs, you can introduce new strategies that may be more helpful for creating the life you desire.