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REALITY THERAPY:Role of the Counselor, Strengths, Limitations

<< BEHAVIORAL APPROACHES:Use of reinforcers, Maintenance, Extinction
GROUPS IN COUNSELING:Major benefits, Traditional & Historical Groups >>
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Theory and Practice of Counseling - PSY632
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Lesson 37
REALITY THERAPY
Behavioral Approaches (Link to previous lecture)
Evaluation: Strengths
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Effectiveness: This approach has variety of techniques effective to deal with various problems.
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Efficiency: The technique is shorter, and also requires less training on the part of the administrator.
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Empirically supported techniques
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Breadth of application: Behavioral approaches are effective for different types of patients, and
applicable to different situations. For Example, it is used effectively with ADHD, conduct disorder,
eating disorders, substance abuse, phobia, impulse control, psychosexual dysfunction, etc.
Critics of Behavior Modification
The approach is criticized to be dehumanizing and overly controlling. One question is often raised
whether it is ethical for one human to control another's behavior?
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Reinforcement and real life?
Another question is that what happens when the reinforcers stop, for example, when the person
leaves the mental hospital or clinic? The person may become so dependent on extrinsic rewards
that the appropriate behaviors quickly disappear.
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Does not deal with the total person.
The approach does not promote any inner growth; just relieves symptoms or provides a few skills.
Also it is not beneficial for nonspecific or existential problems.
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Best demonstrated only under controlled conditions.
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Does not consider developmental stages:
Skinner and others believe that acquisition of learning has universal characteristics, and do not pay
much attention to developmental stages.
REALITY THERAPY
What is Reality Therapy?
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Reality Therapy is a relatively new counseling theory that emphasizes change people can make in
their actions and thoughts.
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It has a phenomenological base and an existential heart, which maintains that people's inner words
will determine what behaviors they choose.
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It is action oriented, concrete, didactic, directive, behavioral and cognitive.
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Overall, reality therapy emphasizes the fulfillment of psychological needs and is preventive in
nature.
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Developed by Dr. William Glasser in 1965.
William Glasser
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William Glasser was born in Cleveland, Ohio, USA, in 1925; the third and youngest child in a close-
knit family. He played the band, and had a strong interest in sports.
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He finished work for a Master's degree in 1948, but his doctoral dissertation was rejected. He then
entered medical school at Western Reserve University, graduating with a medical degree in 1953.
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After obtaining a medical degree, he finished his psychiatric residency from UCLA, USA, in 1957.
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He had doubts about psychoanalysis. His faculty supervisor Harrington helped him develop some
concepts of reality therapy. In the 1960s he began to formalize his approach to counseling. He
indicates that "conventional psychiatry wastes too much arguing over how many diagnoses can
dance at the end of a case history".
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Glasser's first book, Mental Health or Mental Illness? (1961), continued many of the ideas that were
later more formally expressed in Reality Therapy: A New Approach to Psychiatry (1965).
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Shortly after the publication of Reality Therapy, Glasser founded the institute of Reality Therapy in
Canoga Park, California.
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He applied reality therapy to various areas, as propagated many of his books given below:
Schools Without Failure (1969)
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The Identity Society (1972)
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Positive Addiction (1976): he asserted that individuals can become stronger instead of
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weaker from so-called addictive habits. Two examples of habits that improve physical and
mental health are jogging and meditation.
Control Theory (1984) which argues that all behavior is generated from inside persons.
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Two of Glasser's more recent books, Stations of the Mind (1981) and Control Theory: A New
Explanation of How We Control Our Lives (1984), reflect his theoretical stance and emphasizes
how the brain influences our perceptions.
View of Human Nature
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A major tenet of reality therapy is its focus on consciousness: human beings operate on a conscious
level; they are not driven by unconscious forces or instincts.
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A second belief about human nature is that there is a health/growth force within everyone which is
manifested on two levels:
Physical Orientation
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There is need to obtain life-sustaining necessities such as food, water, and shelter and use
them. According to Glasser, human behavior was once controlled by physical needs for
survival, such as breathing, sweating, digesting, etc. Survival is associated with old brain,
because it is automatically controlled by body.
Psychological Orientation:
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Belonging: the need for friends, family and love.
Power: the need for self-esteem, recognition, and competition.
Freedom: the need to make choices and decisions.
Fun: the need for play, laughter, learning, and recreation.
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An Associated need is of Identity: i.e., the development of a healthy sense of self. Identity needs are
met by being accepted as a person by others. Especially important in this process is experiencing
love and worth. When this happens, people achieve a Success identity; those whose needs are not met
establish a failure identity, a maladjusted personality characterized by a lack of confidence and a
tendency to give up easily. Because "almost everyone is personally engaged in a search for
acceptance as a person rather than as a performer of a task," personal identity precedes
performance. Failure identity develops in a child if:
The child does not get love, support, and guidance during 2-5 years of age.
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There are problems in learning and relating during 5-10 years of age.
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It presents an optimistic view of human nature that learning is a life-long process.
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Control theory: people have mental images of their needs and behave accordingly. Personal actions
are based on perceptions. Human beings create behaviors, including mentally disturbing ones like
hallucinations, to satisfy internal pictures (perceptions).
Role of the Counselor
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The counselor primarily serves as a teacher and model, accepting the client in a warm involved way
while focusing him or her on the control of displayed thoughts and actions. The counselor
increases focus by using `ing' verbs like bullying, arguing, angering to describe thoughts and actions.
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There is an emphasis on choice- on what the client chooses to do. It indicates that behavior is
linked with feeling and physiology that is why other positive changes also become possible at the
same time.
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Counselor-client focus is on the areas of change and making desires a reality.
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It emphasizes positive constructive actions in bringing change.
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There is a little attempt in reality therapy to test, diagnose, interpret, or otherwise analyze client's
action except to ask questions, e.g., what are you doing now? Is it working?
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Do not concentrate on early childhood experiences, clients insightful of them, unconscious, blame,
etc.
Goals
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To help clients become psychologically healthy and rational. Become autonomous and responsible.
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To help clients clarify what they want in life, and to be aware of life goals. Poor mental health is
sometime the outcome of not knowing how to achieve goals. The counselor thus helps the client
finding out alternatives.
Willingness of the counselor to express faith in the client's ability to change
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Six criteria to judge a healthy behavior:
Behavior is competitive
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Easily completed
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Can be done by oneself
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Has value for the person
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Improvement in life-style by the practice of behavior
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Person can practice the behavior without becoming self-critical
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To help the client formulate a realistic plan to achieve personal needs.
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To have the counselor become involved with the client in a meaningful relationship.
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To focus on the behavior and present.
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Aims to eliminate punishment and excuses from the client's life. The client should not be punished
for failure by either the counselor or other people.
Techniques
This approach uses Action oriented techniques as described below:
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Teaching
"The specialized learning situation ....is made up of 3 separate but interwoven situations:
Involvement between client and counselor.
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Counselor rejects the unrealistic behavior without rejecting the person.
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The counselor teaches the client better ways to fulfill needs within the confines of reality.
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Posititiveness: the counselor talks about, focuses on, and reinforces positive and constructive
planning and behavior.
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Employing humor
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Confrontation: Asking or confronting about a behavior as a way of helping the client accept
responsibility.
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Role playing: role-playing past or future behavior.
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Feedback: The counselor provides feedback on client's behavior.
Application of Reality Therapy
The WDEP System
The focus of the therapy is on what do the clients want, what they have been doing, evaluation of the
helplessness of their behavior, and then planning their future behavior.
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W: What do you want
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D: Will this choice get you in the right direction? What you have been doing?
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E: Self-Evaluation
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P: Planning
Steps Incorporating Goals & Techniques
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Establishing a relationship
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Focusing on present behavior
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Client evaluation of his/her behavior
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Developing a contract or plan of action
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Getting a commitment from the client
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Not accepting excuses
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Allowing reasonable consequences without punish
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Refusing to give up on the client
Strengths
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A real working model for different problems, populations, and settings, e.g., for troubled
adolescents, victims of abuse, drug addicts, etc. It has been pointed out that "it is crucial for group
counselors who work in school settings to create a trusting climate within their groups (Corey,
2004)."
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Accountability and concrete outcomes.
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Emphasizes short-term treatment.
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Promotes responsibility and freedom within individuals without blame or an attempt to restructure
the entire personality.
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The approach addresses the resolution of conflict:
Conflict occurs on 2 levels: on true level it develops over interpersonal disagreements (no
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single solution); on false level it can be changed, like weight loss.
Limitations
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Too much emphasis on here and now
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Simplistic and Superficial
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Ignores biology as a factor in mental illness
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Does not deal with the full complexity of human life
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Depends on two-way communication or establishment of a good client-counselor relationship
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Approach keeps changing its focus
Skill Enhancement Activity
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Decide on specific changes you want in your life.
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You are held responsible for implementing these changes -Take ownership!
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Table of Contents:
  1. INTRODUCTION:Counseling Journals, Definitions of Counseling
  2. HISTORICAL BACKGROUND COUNSELING & PSYCHOTHERAPY
  3. HISTORICAL BACKGROUND 1900-1909:Frank Parson, Psychopathic Hospitals
  4. HISTORICAL BACKGROUND:Recent Trends in Counseling
  5. GOALS & ACTIVITIES GOALS OF COUNSELING:Facilitating Behavior Change
  6. ETHICAL & LEGAL ISSUES IN COUNSELING:Development of Codes
  7. ETHICAL & LEGAL ISSUES IN COUNSELING:Keeping Relationships Professional
  8. EFFECTIVE COUNSELOR:Personal Characteristics Model
  9. EFFECTIVE COUNSELOR:Humanism, People Orientation, Intellectual Curiosity
  10. EFFECTIVE COUNSELOR:Cultural Bias in Theory and Practice, Stress and Burnout
  11. COUNSELING SKILLS:Microskills, Body Language & Movement, Paralinguistics
  12. COUNSELING SKILLS COUNSELOR’S NONVERBAL COMMUNICATION:Use of Space
  13. COUNSELING SKILLS HINTS TO MAINTAIN CONGRUENCE:
  14. LISTENING & UNDERSTANDING SKILLS:Barriers to an Accepting Attitude
  15. LISTENING & UNDERSTANDING SKILLS:Suggestive Questions,
  16. LISTENING & UNDERSTANDING SKILLS:Tips for Paraphrasing, Summarizing Skills
  17. INFLUENCING SKILLS:Basic Listening Sequence (BLS), Interpretation/ Reframing
  18. FOCUSING & CHALLENGING SKILLS:Focused and Selective Attention, Family focus
  19. COUNSELING PROCESS:Link to the Previous Lecture
  20. COUNSELING PROCESS:The Initial Session, Counselor-initiated, Advice Giving
  21. COUNSELING PROCESS:Transference & Counter-transference
  22. THEORY IN THE PRACTICE OF COUNSELING:Timing of Termination
  23. PSYCHOANALYTIC APPROACHES TO COUNSELING:View of Human Nature
  24. CLASSICAL PSYCHOANALYTIC APPROACH:Psychic Determination, Anxiety
  25. NEO-FREUDIANS:Strengths, Weaknesses, NEO-FREUDIANS, Family Constellation
  26. NEO-FREUDIANS:Task setting, Composition of Personality, The Shadow
  27. NEO-FREUDIANS:Ten Neurotic Needs, Modes of Experiencing
  28. CLIENT-CENTERED APPROACH:Background of his approach, Techniques
  29. GESTALT THERAPY:Fritz Perls, Causes of Human Difficulties
  30. GESTALT THERAPY:Role of the Counselor, Assessment
  31. EXISTENTIAL THERAPY:Rollo May, Role of Counselor, Logotherapy
  32. COGNITIVE APPROACHES TO COUNSELING:Stress-Inoculation Therapy
  33. COGNITIVE APPROACHES TO COUNSELING:Role of the Counselor
  34. TRANSACTIONAL ANALYSIS:Eric Berne, The child ego state, Transactional Analysis
  35. BEHAVIORAL APPROACHES:Respondent Learning, Social Learning Theory
  36. BEHAVIORAL APPROACHES:Use of reinforcers, Maintenance, Extinction
  37. REALITY THERAPY:Role of the Counselor, Strengths, Limitations
  38. GROUPS IN COUNSELING:Major benefits, Traditional & Historical Groups
  39. GROUPS IN COUNSELING:Humanistic Groups, Gestalt Groups
  40. MARRIAGE & FAMILY COUNSELING:Systems Theory, Postwar changes
  41. MARRIAGE & FAMILY COUNSELING:Concepts Related to Circular Causality
  42. CAREER COUNSELING:Situational Approaches, Decision Theory
  43. COMMUNITY COUNSELING & CONSULTING:Community Counseling
  44. DIAGNOSIS & ASSESSMENT:Assessment Techniques, Observation
  45. FINAL OVERVIEW:Ethical issues, Influencing skills, Counseling Approaches