Abstract

This paper will be an in-depth look into William Glassers Choice Theory and the application of it in reality therapy This paper is designed to give an over-view of the philosophical underpinnings of Choice Theory look into the function and structure of the psyche examine healthy mental functioning and the techniques designed to achieve such and finally tease apart several criticism on Choice Theory and reality therapy The author will look into the Five Basic Needs the idea of the Quality World the process of Effective Life Direction and the personality change process for the client Finally the paper will conclude with a reflection by the author on her personal world-view and opinion of Choice Theory

Keywords Quality World Five Basic Needs Effective Life Direction Effective Behaviors Positive addiction Choice Responsibility

William Glasser was born in 1925 in Cleveland Ohio He came from a hard-working educated family who pushed him to succeed His mother was extremely controlling while his father let everyone choose their own path in life His parents personalities would later contribute to the underpinnings of his theory He went to college to become an engineer and later chose to go into psychology While working at his internship at the Ventura School for Girls he realized the more they were told they were incapable the more incapable they became He began a program to teach the girls responsibility and show them they had choices in life Their behaviors dramatically improved He developed his theoretical approach by 1977 and called it Control Theory By the late 1990s he had changed the name to Choice Theory since Control Theory had many negative connotations to it Choice theory revolves around the idea that every behavior is purposeful and people have a choice over their behavior Everyone has five basic needs they want to attain in their life If people can attain these needs in responsible and well-balanced ways they are considered to have a healthy mental wellbeing Fall Holden Marquis 2010 While this theory seems to be logical rational simple and client-centered can it be extrapolated across all people and all cultures What about people with severe mental disabilities And what happens when there is not more than one choice to choose from In this paper these questions the philosophy behind Choice theory and the personality change process will all be addressed

Theories of Change

Epistomology

There are three fundamental aspects to choice theory They are basic needs responsible living and the Quality World According to Glasser we are all born with five basic needs survival lovebelonging power fun and freedom Survival is the need for both physical and psychological survival Lovebelonging is the most important need to fulfill This is the need for sexual intimacy friendships and comfort from others Power is the need for accomplishment and competence Everyone wants to be good at something and when a person accomplishes something recognition for that is also important Fun is the quest for enjoyment Everyone wants to have that playful deep intimacy with other people Finally there is freedom Freedom is the ability to make a choice In order to have true freedom it must be relatively unrestricted and there has to be several choices to choose from Glasser 1965

In order for people to obtain these five needs they translate them into wants In order to achieve these wants people participate in what Glasser calls total behavior These behaviors are thinking both voluntary and involuntary thoughts doing observable actions feeling emotions that are exhibited and physiology the biological processes All of these behaviors work together in order to fulfill certain needs as they arise Glasser 1990 used the analogy of a front wheel car The persons brain is the car and each of the different behaviors are the wheels People have more control over their thinking and their actions so those are the front wheels of the car The rear wheels are biology and feelings because people have less control over those behaviors The person makes the choice in which behaviors to engage in and how to engage in them to meet their needs

Choice theory talks about how there are responsibleirresponsible and effectiveineffective ways to attain the basic needs Glasser is a huge proponent for living a responsible life Responsibility is the ability to fulfill ones needs and to do so in a way that does not deprive others of the ability to fulfill their needs Glasser 1965 Someone who is responsible works hard to attain his needs but also does what is best for the others around him Not only is he helping others but he is gaining self-worth along with way Glasser 1965 Everyone has choices to make in their life in order to live responsibly Part of living responsibly is being able to not make excuses for ones behaviors and live in reality Reality is made up of perceptions Perceptions include what people want to percieve from the world around them people actually percieving the actioneventobject and finally the person attributing a certain value to what they have percieved Wubbolding 2000

How do people know what to do in order to achieve their needs In 1998 Glasser talked about the idea of a Quality World This is the idea that every person has an inner picture album in which describes all of their ideas about what the world is and should be Glasser believed there were three subsets the person that is most desired the things most desired and the systems of belief that determine our behavior The Quality World lies within the percieved world which lies within the real world The pictures people have inside of the mind are developed because of the people in their lives their past experiences and peoples future goals in which they believe will best help them attain their needs and wants The pictures and ideas are dynamic and are constantly changing over time Fall Holden Marquis 2010 The ideas within the Quality World can contridict each other and every person has a different Quality World which explains why people do not always agree Also every characteristic of the Quality World exists in terms of priorities These priorities similar to the pictures in the Quality World change depending on the needwant of the person at the time The pictures within the world can also be unrealistic or unattainable When this is the case it is the counselors job to work to make them realistic Wubbolding 2000 Wubbolding 2000 added to the theory and talks about how the pictures can be blurred and sometimes cannot be understood at the moment This explains the indecisiveness of many people when major life events occur

Mental Well-Being

Client wellness or their mental well-being all comes down to the idea of them being able to meet their five basic needs in a responsible and effective manner The most important basic need is the need for lovebelonging Clients who are able to give love and receive love unequivocally have a much healthier mental state Glasser 1965 In addition to being able to have love and belonging mental well-being requires being able to attain and balance all of the rest of the five needs A client will have a good well-being if they are in control of their car and are able to focus on every aspect of that car clearly without blaming bumps in the road on anything other than their control

Another sign of client well-being is when they have effective life direction Wubbolding 2000 said this has three different stages The first stage is I want to change and I want to grow up This stage is when the client realizes they have made some mistakes in their life and they want to take the proper steps to change those and live more responsibly The second stage is effective behaviors This is the stage in which the client takes action The first effective behavior in this step is to set goals for oneself that are assertive and altruistic Taking responsibility and achieving long-term goals allows for more effective behaviors overall The next step in the second stage is to have positive thinking behaviors The clients must think highly of themselves and be confident in their abilities They must think in positive I statements such as I can Thirdly the client must have healthy emotional and physical behaviors They must be able to trust be hopeful be happy and also take care of their physical body by eating well and exercising The final stage is positive addictions It is very hard to accomplish for long periods of time These positive addictions give a natural high to the client but cannot take up too much time or mental capacity in order to complete Wubbolding gives the example of someone who is a frequent runner Wubbolding 2000 If a client is able to complete and maintain these three stages is able to have healthy relationships and is able to balance their basic needs they will have a healthy well-being

Personal and Social Disturbances

People do not act irresponsibly because they are ill They are ill because they act irresponsibly Glasser 1965 Choice theory is all about responsible vs irresponible living and behavior Responsible living means being able to meet all of the basic needs without interferring with others People who are mentally unhealthy are living irresponsible lives Fall Holden Marquis 2010 Glasser believed that these behaviors stemmed from loneliness and the feeling of being unworthy Glasser et al 1976 Glasser did not believe that anyone has a mental illness They are simply living irresponsibly and they must make changes to do so

Reality therapy is opposed to any type of diagnosing or labeling of the patient It is believed that diagnosing a patient will be a major road block in the therapy and their ability to change The responsibility is taken away from the patient and heshe becomes that illness and can suddenly explain away their behavior Clients need to understand that it does not matter what happened in the past nor what the label is that has been associated with them They are the sole ones responsible for the change in their behavior and that they are completely capable of that change Glasser 1965 To illustrate this to the client reality therapists do not refer to symptoms as passive They change them into verbs to show the client they have control A client is not depressed They are choosing to depress A client is not angry they are angering Fall Holden Marquis 2010

Glasser believed that there were three reasons why people refused to change First a client may keep engaging in a symptom because it keeps another far worse symptom under control By focusing on the first symptom it allows the client to ignore and suppress the consequences that would happen if the worse symptom were to arise Second it gives the client attention they are craving and brings people to them If someone has severe anxiety they are anxietying then maybe they are receiving help from their family who may otherwise not pay attention to them Lastly it allows them to avoid what they are afraid of If someone chooses to depress because they do not want to give a presentation at work the people around them might believe that person is incapable of doing it and therefore the person avoids doing what they are afraid of Fall Holden Marquis 2010

How Does Change Happen

Choice theory is applied through the use of reality therapy Reality therapy focuses on the responsibility of the client and they relationship between the counselor and the client When the client comes into therapy they must be willing to take responsibility for the behaviors before any change process can begin Glasser did not mean that every action or behavior in the past was the clients fault He wants the client to realize that they have not been living responsibly and that leads to the wanting to change Glasser 1965 The client must also be able to focus in the present and not dwell in the past Fall Holden Marquis 2010 Unlike Glasser many reality therapists today believe that it is ok to look at what happened in the past but the important aspect is focusing on how that affects the present Lastly in order to change the client must be willing to form relationships and work at maintaining them Fall Holden Marquis 2010

In reality therapy the client and the counselor work together to facilitate change Lovebelonging is the most important need for a client to fulfill They must first fulfill this need before they fulfill any other Because of this it is extremely important for the counselor to be the facilitator of the relationship Therapy is a place for the client to learn how to build healthy relationships in the outside world In order to accomplish this the counselor must be courteous determined enthusiastic firm and genuine with the client The counselor must model the healthy aspects of a relationship for the client Fall Holden Marquis 2010 The counselor must be able to look at the clients worldview through their eyes The counselor not only needs to empathize but they also need to be able to walk in the clients shoes and see things from their perspective in order to help build that relationship Glasser et al 1976

Counselors can facilitate the therapy sessions and help the client change in many different ways First they must always focus on the present If the client dwells in the past they will never be able to move forward Glasser encouraged the use of humor in sessions in order to bond with the client as well Glasser 1965 Many counselors might believe that confronting their clients about their inconsistencies or their irresponsibility might hurt the relationship However Glasser believes it is a very important part of the change process A counselor must use empathatic confrontation with the client They should not argue or critisize the client but they also should not accept excuses made by the clients Fall Holden Marquis 2010 Glasser believed that if a counselor were to accept the excuses of the client and give into their false reality it would be giving them psychiatric kicks These kicks are similar to what the client would get with alcohol or drugs It temporatily makes the client feel better but can be determental to their change in the end Glasser 1965

Overall the counselor must be consistent and effective They have to fully understand reality therapy in order to be able to execute it correctly and facilitate change Also they have to work with the client to make them more responsible and more focused in reality In addition they must work with the client to help them make small sacrifices now to help with the overall change to a healthier more responsible life

Skills and Techniques

Techniques and the Process of Reality Therapy

Wubbolding 2000 simplified the stages of reality therapy into the letters WDEP The first stage is the Wanting stage This is when the counselor talks with the clients and they work out the wants needs and perceptions of the client Every person is unique so the questions the counselor asks has to also be unique to the client The second step is DirectionDoing In this stage the counselor inquires into the life direction of the client The most popular question asked is what are you doing This makes the question client specific focused in the present focused on the client and focused on the behavior The third stage is Evaluation This stage is when the client does a self-evaluation This is believed to be the most important step of the process The counselor does not just try to find out about the wantsneeds of the client but they also want the clients to make judgements on themselves The final stage is to Plan The plan that the counselor works out with the client has eight characteristics simple attainable measurable immediate involves counselor controlled by client consistent and committed Once all of these stages are complete the counselor may go back through them until the counseling relationship is terminated These stages are used to form behaviors and eradicate behaviors Wubbolding 2000

Reality therapy uses many different techniques from other disciplines and theories during these stages They use interviews meditation self-evaluation questions and visualization just to name a few As discussed in the psychopathology section one major technique that is unique to reality therapy is changing symptoms from being passive to active Suddenly they become verbs and show the client the control they can have Fall Holden Marquis 2010

Dialogue and Discussion

Client I am so unhappy with where I work and the job I am doing now I feel as if no one appreciates me and I am not doing well on the tasks they ask me to complete When I feel that way I work less hard and leave work early because I just dont feel as if it is worth it

Counselor What do you want out of your job

Client I want to feel appreciated and capable just like everyone else does

Counselor How would you know you were appreciated

Client I guess if the boss gave me some sort of recognition When I dont get the recognition I feel as if I am not doing a good job and that causes me so much anxiety

Counselor To me it seems as if you are not getting the recognition you want from your boss and therefore are choosing to anxiete When you choose to anxiete you leave work early and you do not complete the tasks given to you This behavior you are choosing to participate in is it getting you want you want out of your boss and co-workers

Client No it just makes them more distant and seemingly mad at me for not completing my job

Counselor So if the behaviors you are choosing now the behaviors of anxietying leaving work early and not completely your tasks are not getting you the result you want wouldnt choosing a different behavior be more likely to get you what you want

This client is having a problem meeting his or her need for power They are not getting the recognition they feel they deserve at work The question How would you know you were appreciated gives the counselor a look into how the clients need for power is going to be fulfilled according to the clients Quality World When the client talks about their anxiety the counselor rephrases it to choosing to anxiete Here the counselor is showing the client that the feeling of anxiety is in their power It is something they have control over In the end of the conversation the counselor is evaluating the client and showing them the behaviors they believed would work to fulfill their need have not so they might try using other behaviors to fulfill their need

Criticisms

In todays society there are many different criticisms for every theory developed The main criticisms of most theories come down to their ability to be used cross-culturally and how they view diagnosis and the DSM Choice Theory is no different Choice Theory is relatively unique when it comes to the idea that people have complete control over their choices Because of this another major criticism arises when certain situations do not allow a feasible choice

Reality therapy the application of Choice Theory has worked over the last several decades to make this therapy more applicable across cultures This therapy more so than many others has tried to adapt to be able to help other cultures Robert Wubbolding a key advocate for reality therapy has traveled all across Europe Asia and Australia teaching and adapting this therapy Through his travels Wubbolding has found that making any sort of generalizations or assumptions can be harmful to the client Wubbolding 2000 True to the beliefs of reality therapy having empathy congruence and positive regard for the client are most helpful in any counseling situations Reality therapy advocates believe it is important for every counselor to adapt their techniques to best fit the client Wubbolding 2000 For example reality therapists have done work with Native Americans and they have found that using medicine cards showing different animals that represent different behaviors and ailments helps the client be able to communicate their therapy goals They are able to identify where they believe they are now with their total behavior and where they would like to go Matthews 1996 In some Asian cultures such as Korea and Japan asking a question such as What are you doing can be extremely intrusive Instead the therapist in this type of situation would have to rephrase it in a way to be polite yet still be able to find out about the behavior of the client Wubbolding 2000 When counseling African Americans they have found that it is important to not only empathize with them but to also uplift and empower them Reality therapy is focused on entering the clients world-view and focusing on the action of the client When the therapist empowers the client they are more likely to take action and change their behaviors Mickel Liddie 1998 Despite their work with different cultures reality therapy has neglected to research and study the use of the therapy on people with sexual and gender identity confusion This seems to be one of the only areas in which reality therapy truly lacks an opinion and research in adapting its techniques Fall Holden Marquis 2010

Wubbolding believes that reality therapy can be extrapolated across cultures and has worked hard to adapt the therapy The most important idea to remember is that every person is unique and should be treated as such Stereotyping can be extremely dangerous Although the culture of the person can be exceedingly important every person has their own idea of a quality world and has unique behaviors This is what is important to focus on in therapy rather than just their culture Wubbolding 2000

Reality therapy is one of the only therapies to try and work with and adapt to other cultures However what happens when a culture has a specific belief about a high-power and how that high-power is controlling their life Many Native Americans fundamental Christians and fundamental Islamics believe this way Reality therapy is about making choices to change the behavior and taking responsibility for that behavior How would a therapist associated with Choice Theory handle the client believing they do not have control over their own life and their own behaviors The literature seems to suggest that Reality therapy needs to include some sort of spirituality in the basic needs Reality therapists believe that spirituality is important similar to culture in a persons quality world but it is not the only thing that needs to be focused on with the client Fall Holden Marquis 2010

Another criticism of Choice Theory is the idea that in order to meet the basic need of freedom there must be choices to make In some situations people do not have choices They simply cannot just choose another behavior or another action without having dire consequences So even though there may appear to be choices the outcomes of the choice lead it to be inaccessible Take for example an adolescent in a gang He has been a part of the gang for a while and finally realizes he wants out He has seen many people die after trying to leave the gang Despite technically having the choice to leave the gang the consequence of death makes leaving not an option As a reality therapist it would be important to be able to have the resources to give to the client so the choices they did not think they had become attainable in the end

Furthermore when it comes to the ability to make choices Choice Theory although they recognize the inability to control biology they believe mental disorders do not exist at least in the way todays society does They do not believe someone has anxiety or depression Choice theorists believe someone is choosing to anxiete or depress From Glassers point of view people have the ability to choose not to anxiete Fall Holden Marquis 2010 This is the biggest critique I personally have with this theory From my own personal experience I have lived with someone with anxiety My mother has severe anxiety and she has chosen on her own to try Glassers theory when it comes to choosing not to anxiete She can choose to not pay attention to her anxieties She can choose not to participant in anxiety driven behavior However no matter how much she tries she is not capable of changing those thoughts only the behaviors that go with them She lives as normal of a life as she can but those anxious thoughts are always on her mind She unknowningly has tried to implement some of Glassers techniques in her everyday life Do they help control the behavior Yes However I do not believe it truly fixes the root of the problem Glasser might say she is choosing this to either avoid pain bring people into her service or to avoid doing what she is afraid of Glasser 1965 Yet she will not accept help pushes herself outside of her comfort zone and faces the things she is afraid of The thoughts however are still there

Anxiety is not necessarily an imbalance in the brain but I cannot help but wonder what Glasser would say about Schizophrenia Schizophrenia is caused by too much dopamine in the brain Can a Schizophrenic control all of their behaviors Are they capable of making choices all of the time Some times yes they would be able to control their behaviors yet what about those moments when they do not have control Glasser is opposed to pharmacology and diagnosis Which to some degree I agree Yet what about those situations when someone is incapable of making a choice because of a chemical imbalance The fact that this is not really addressed is the major default I believe in Choice Theory

Diagnosis is seen as detrimental in Choice Theory and reality therapy Often time giving someone a diagnosis takes away the responsibility of choice away from the client Glasser et al 1976 Since Choice Theory is all about taking responsibility and making choices those who align with this theory do not like to diagnose While the point of responsibility is very clear in their philosophy I cannot help but wonder if it their idea might change if the dependency were not attached to diagnoses For some people a diagnosis is a crutch and becomes their identity and a way to escape responsibility However for others it can help create a plan and a way to work through their behavior to be able to change For example a child has been diagnosed with autism That child could then not take responsibility because they rely on the diagnosis On the other hand it might make it easier on the child It can help give guidelines to formulate a plan that works better with the child to change their behaviors Many reality therapists would say they would do that anyway without the diagnosis Yet in some instances a diagnosis could simply be a platform in which to build upon

Reality therapy and Choice Theory has come a long way in adapting their techniques to help people in other cultures Yet much research still needs to be done on other topics such as gender identityconfusion and diagnosis Even Wubbolding himself states that over the next few years he wants reality therapists to challenge the relationship with the DSM He wants therapists to look into the usefulness of it and if there is a way it can be constructive in reality therapy Wubbolding 2013 Overall reality therapy has come a long way in adapting but still can improve and adapt to many issues facing therapists today

References

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