10 Best Reality Therapy Techniques, Worksheets, & Exercises

Reality Therapy holds clients responsible for their behavior rather than blaming their environment, parents, or culture (Wubbolding, 2017).

Unlike many other treatments, Reality Therapy claims that the various behavioral issues that bring clients to therapy are a product of the inability to fulfill their essential human needs (Glasser, 2010).

How they behave results from this failure despite the meaning and validity it has for them.

This article introduces some key concepts and goals for Reality Therapy, along with real-life examples, techniques, and worksheets for therapists to use with their clients.

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Reality Therapy: Key Concepts and Goals

As a psychiatric resident in the 1960s, William Glasser (2010) became disillusioned with classical psychoanalytic treatment and began experimenting with a very different approach, which he called Reality Therapy.

In Reality Therapy, “the helping person becomes both involved with and very real,” to the client, unlike conventional therapists, who are taught to remain objective and impersonal (Glasser, 2010, p. 6).

At that time, clinical psychology assumed a client’s neuroses arose out of unrealistically high moral standards. Glasser, on the other hand, argued that “human beings get into emotional binds, not because their standards are too high, but because their performance has been, and is, too low” (Glasser, 2010, p. 7).

One of Reality Therapy’s greatest strengths is that it can be used with any group, from war veterans to adolescents. Its aim remains the same: to create awareness of the following in the client (Glasser, 2010):

• Responsibility
  A responsible person acts in a way that creates feelings of self-worth and worth to those around them.

When unsuccessful at fulfilling their own needs, clients deny the reality of the environment. They only become successful when they face that reality and fulfill their needs within that framework.

• Right and wrong
  Being worthwhile requires clients to maintain a reasonable standard of behavior, correcting themselves when they behave poorly and crediting themselves when doing things right.

Glasser (2010) summarizes how Reality Therapy differs from conventional therapy with the following six points:

1. Reality Therapy does not accept the concept of mental illness; clients must take responsibility for their behavior.
2. Working in the present and toward the future; the client is not limited by their past.
3. Clients relate to therapists as themselves rather than as transference figures (the therapist should not relive the client’s past experiences with them).
4. Unconscious motivations or reasons are not sought or accepted as a reason for poor behavior.
5. Facing up to the morality of behavior – right and wrong – to solidify the client’s involvement.
6. Clients are taught more effective ways to meet their needs.

The goal of Reality Therapy is not simply to help clients face reality; they must also learn to fulfill their needs (Glasser, 2010).

Indeed, the American Psychological Association (n.d.) defines it as “the development of the ability to cope with the stresses of reality and take greater responsibility for the fulfillment of his or her needs.”

3 Real-Life Examples and Cases

The following two real-life examples are taken from Glasser’s (2010) own casebook and provide valuable insight into different aspects of Reality Therapy.

• Aaron was an aggressive and unhappy 11-year-old son of an emotionally detached, intellectual, divorced woman.

Despite previous therapy, no one had ever put either value judgment or limits on his destructive behavior. Glasser (2010) had no breakthrough with his troubled client until he began to emphasize Aaron’s reality and his present conduct, explaining that the way he acted was intolerable and would no longer be accepted. He told Aaron he was going to have to change.

Criticizing Aaron for his old weaknesses while praising him when he behaved well led to a strengthened therapeutic alliance, resulting in more positive behavior, improvements in his relationship with his mother, and him ultimately being discharged from therapy.

• Pat was a financially secure, married mother of two who felt something was missing in her life. Despite expecting to talk about her childhood in therapy, Glasser restricted the discussion to her present life and the world around her.

Pat appeared to revel in her protracted descriptions of her childish behavior toward her husband and wished for Glasser to take on the role of reformer, challenging her behavior. When Glasser failed to comply, she responded with criticisms of his ability and professionalism. And yet, after a year of treatment, their alliance grew. Glasser could point out her irresponsibility and help her become accountable for her life, take charge, and change.

Reality Therapy treatment plan: An example

The following example outlines a successful treatment plan for a client (modified from Wubbolding, 2017):

• Emi was a 38-year-old flight attendant with increasing anxiety about flying who had also experienced the loss of a partner through a car accident. She was increasingly concerned that her coworkers and passengers may notice her fears, and she recognized her continuing withdrawal from everyday life.

Her subsequent counseling sessions with a Reality Therapist explored four psychological needs, including belonging, inner control, freedom, and fun, and led to specific plans to satisfy those needs (modified from Wubbolding, 2017):

1. 1. Belonging
      Committing to reengaging with her friends, restarting activities she had put on hold, and visiting her parents more regularly.
   2. Inner control, power, and achievement
      Following through on plans to progress her career with the view that her partner would have been proud of her.
   3. Freedom
      Continuing the breathing exercises that she believed were helping her anxiety.
   4. Fun and enjoyment
      Taking on new educational opportunities related to her job and listening to more music for pleasure.

Planning and following through allowed Emi to regain a sense of control and proved to be an essential part of the Reality Therapy process (Wubbolding, 2017).

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8 Popular Techniques and Interventions

Several techniques facilitate the practitioner’s focus on healthy behaviors rather than persistently examining symptoms of mental disorder, including (modified from Wubbolding, 2017):

1. Sharing yourself
   Engaging in appropriate self-disclosure enhances the counseling process and is a powerful modeling technique to complement the growing relationship.
2. Listening for metaphors and making use of stories
   Listening for metaphors, such as “I’m down in the dumps” or “I’m being walked all over,” and reusing them in conversation with the client.
3. Listening for change talk and in-control talk
   Asking open-ended questions that prompt motivational answers and listening carefully for language indicating the desire to change.
4. Listening for themes
   Helping the client verbalize a series of wants, positive and negative perceptions, and effective and ineffective behaviors to uncover core beliefs.
5. Allowing or imposing consequences
   Helping clients recognize positive and negative consequences and self-evaluate what is reasonable.
6. Allowing silence
   Recognizing that silence can be an effective technique for putting the responsibility on the client, especially when the therapist is unclear of an appropriate intervention, allowing time for both the therapist and client to self-evaluate.
7. Showing empathy
   Attempting to see the world through the eyes of the client. Also, it can be helpful for both parties to see the client as more self-actualizing and successful in the future.
8. Create anticipation
   Clients become aware that therapy is more than simply talking and that change is possible or even inevitable.

3 Best Exercises and Activities to Try

Help your clients with the following activities.

Understanding the client’s ‘wants’

Our motivation relies on the satisfaction of several basic needs. Therefore, it is crucial in therapy to help the client understand their wants and goals.

Inquiring and reflecting in therapy are valuable techniques for digging deeper into the client’s wants, helping them and the therapist form a more detailed picture on which to base future work.

Use the Understanding Client ‘Wants’ worksheet to guide questioning and reflection to understand better their ‘wants’ either during the session or as homework.

Setting goals

Planning and setting goals is an integral part of therapy. When working on and agreeing to a plan of action with the client, use the acronym SAMIC3 to consider whether all vital elements have been included (modified from Wubbolding, 2017):

• Simple – Is the plan uncomplicated and easily understood?
• Attainable – Is it realistically achievable?
• Measurable – Is it measurable?
• Immediate – Can it be carried out as soon as possible?
• Controlled – Is it (mostly) under the control of the planner?
• Committed to – Has it been committed to – written down or sealed with a handshake?
• Consistent – Is the plan consistent throughout in style and approach?

Plans can be revised as required and tracked according to their completion.

Best group activity: Self-evaluating toxic behaviors

The following activity can be performed with a single client, but it is especially helpful when used in groups, where it is possible to learn from other members’ behavior.

Reality Therapy (and choice therapy, upon which it is founded) aims to “replace ineffective external control ideas with more effective in-control self-talk leading to more satisfying action behavior, that is choice” (Wubbolding, 2017, p. 27).

However, a toxic atmosphere resulting from several different patterns of unhelpful behavior can damage the therapeutic alliance.

Use the Toxic Behaviors in Therapy worksheet as a valuable self-evaluation technique to identify and, where possible, stop damaging behaviors.

Worksheets for Counselors & Therapists

The following therapy worksheets are helpful for Reality Therapists to understand the needs and choices that make up their client’s reality.

Meeting Needs With Reality Therapy

It is important to remember that every human is born with needs, and we are motivated throughout our lives to satisfy them. When our needs are met, we feel good and experience a greater sense of wellbeing (Wubbolding, 2017).

The Meeting Needs With Reality Therapy worksheet helps us understand client needs and what actions could be taken to meet them.

Behavior Self-Evaluation

Self-evaluation is a crucial aspect of Reality Therapy, helping us consider the choices we make and how they affect our lives (Wubbolding, 2017).

The Behavior Self-Evaluation worksheet focuses on a past decision, whether it was helpful, and how we could choose differently in the future.

Expectations Versus Reality

Reality Therapy encourages clients to set realistic goals rather than ones with a high risk of failure (Glasser, 2010).

The Expectations Versus Reality worksheet includes four question groups to help your client set realistic expectations and define achievable goals.

‘Impact on Others’ Self-Evaluation

One vital area of self-reflection involves reflecting on how our behavior affects those around us (Wubbolding, 2017).

The ‘Impact on Others’ Self-Evaluation worksheet considers key aspects of our lives, how we behave in them, and our impacts on others – good or bad.

Considering how we affect others helps both client and therapist form a more complete picture of their reality.

20+ Questions to Ask Your Clients

A crucial aspect of Reality Therapy is understanding the client’s present – their reality – rather than their past (Glasser, 2010).

Wubbolding (2017) extended Reality Therapy by including what became known as the WDEP system, capturing wants, doing, evaluation, and planning, by asking:

• What do you want?
• What are you doing?
• Is it working?
• What is your plan?

These WDEP questions help the client become aware of their needs and behaviors, the effectiveness of the latter, and how they perceive the world around them.

Become a Reality Therapist: Certifications

There are several opportunities to train and become certified as a reality therapist. We have included three below:

• The Center for Reality Therapy is a continuing education provider approved by the National Board for Certified Counselors and offers training and certification in Reality Therapy.
• The Glasser Institute of Choice Theory provides training and certification at multiple levels in both Choice Therapy and Reality Therapy.
• William Glasser Institute UK is the UK governing body for Choice Therapy and Reality Therapy and offers both training and certification.

3 Fascinating Books on the Topic

The following therapy books are three of our favorites on Reality Therapy, offering a comprehensive grounding on the techniques involved.

1. Reality Therapy: A New Approach to Psychiatry – William Glasser

With over 500,000 sales, William Glasser’s book is the definitive reference for Reality Therapy.

In his book, he contrasts his approach to psychotherapy with conventional treatments and provides a practical guide for therapists wishing to adopt his techniques.

Find the book on Amazon.

2. Reality Therapy and Self-Evaluation: The Key to Client Change – Robert Wubbolding

Robert Wubbolding takes readers on a journey through the core concepts of self-evaluation and the WDEP system of Reality Therapy.

His practical book contains guidance for therapists on building the skills and using the strategies and techniques required to help clients of all ages and from all cultures.

Find the book on Amazon.

3. Treatment Planning with Choice Theory and Reality Therapy – Michael Fulkerson

This book is a newer version of the previous ‘Treatment Planning from a Reality Therapy Perspective.’ According to the author, the book contains more current person-centered recovery principles.

The book is a primer for therapists wishing to create treatment plans in line with the Reality Therapy perspective.

Michael Fulkerson provides a valuable and practical guide that enables therapists to integrate choice theory/reality therapy with traditional treatment plans.

Find the book on Amazon.

Possible Limitations of the Approach

While Reality Therapy is a valuable approach for treating clients, it does have its critics for several reasons, including the following (Nunez, 2021; Glasser, 2010):

• Glasser claims that mental illness does not exist.
• Due to the style of therapy, there is a risk that the therapist imposes their beliefs and values on the client, impacting the goals set and the behavior deemed acceptable.
• Glasser dismisses medical intervention, yet drugs can have a vital part to play alongside other treatments.
• Ignoring the unconscious may be dismissing some essential factors involved in decision-making and behavior.
• Past conflict and trauma are ignored.

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Resources From PositivePsychology.com

We have many resources that can be helpful in Reality Therapy for communicating better and understanding current thinking and beliefs.

Our free resources include:

• The PERMA model
  The PERMA model is a helpful tool for remembering what is important for leading a life with purpose.
• Active Listening Reflection Worksheet
  This practical worksheet recognizes what is needed for active listening and helps you ensure you are applying the techniques.
• Reward Replacement Worksheet
  This exercise helps the user target behaviors for change by identifying the negative side effects.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

• Mental Contrasting Using the WOOP Method
  The four-step WOOP method enables clients to construct their goals positively and accurately.

Step one – Take slow breaths to relax and visualize a wish that is crucial to you now.
Step two – Visualize the benefit the wish will bring for you.
Step three – Consider what may block your path, including behaviors.
Step four – Write down an if–then plan to tackle obstacles that stand in your way.

• Analyzing Environmental Strengths
  Strengths are not only individual characteristics but also found in the environment, including friends, families, and colleagues.

Step one – Identify the problem or goal
Step two – Analyze your supportive social network
Step three – Consider how your social network may contribute to the problem or the goal.
Step four – Actively involve the social network.

If you’re looking for more science-based ways to help others enhance their wellbeing, check out this signature collection of 17 validated positive psychology tools for practitioners. Use them to help others flourish and thrive.

A Take-Home Message

In Reality Therapy, the client is accountable for their behavior. There is no getting out or blaming circumstances or people. Clients’ problems result from an inability to fulfill their needs.

Instead, clients must face reality, become responsible, and correct themselves when they misbehave or perform poorly.

While controversial, especially regarding not accepting the concept of mental illness, Reality Therapy is a practical, results-driven approach, creating plans in line with realistic expectations.

And while Glasser (2010) dismisses medical intervention, Reality Therapy can be seen as a set of tools that can work together with existing approaches. After all, the goal of the approach is to help find more effective ways to meet clients’ needs.

The tools, worksheets, and techniques included will help you apply Reality Therapy techniques in your sessions as a therapist. Try them out, see what works, and find new ways to help your clients make the changes they seek.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free.