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Choice Theory/Reality Therapy and Spirituality

John and Bob Wubbolding 2017 B

Counseling and psychotherapy theories are wildly variable and surprisingly convergent. What do I mean by this? Well, despite the fact that Sigmund Freud and Francine Shapiro and Steven Hayes and Marsha Linehan have very different ideas about what helps people change for the better, there’s also a boatload of commonality.

Based on my narrow range of experience and knowledge, nowhere is there more commonality than the theoretical outposts of Adlerian theory (i.e., Individual Psychology) and Choice Theory/Reality Therapy. Both of these approaches include a broad theoretical concept related to an individual’s personal and cultural construction of how they view themselves, others, and the world (i.e., Adlerians say “Lifestyle” while Reality Therapists say “Quality World”); both perspectives view individuals as pulled forward by internal values (and not driven by Freudian conflicts); both perspectives view behavior as purposeful, and perhaps not coincidently, they also view psychopathology as purposeful.

All this theory-speak is way for me to introduce this post as a continuation of my spirituality and counseling/psychotherapy theories series. What’s especially interesting about this post (IMHO) is that I’m writing about spirituality and Reality Therapy. I mean, how can a form of therapy that explicitly emphasizes “reality,” accommodate “spirituality?” We’ll see about that . . . maybe.

Chapter 9 of Counseling and Psychotherapy Theories in Context and Practice focuses on choice theory and reality therapy. Many people may not perfectly understand the definitions of choice theory and reality therapy. As a quick refresher, here’s an excerpt from the beginning of Chapter 9, followed by the brief spirituality section.

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Reality therapy is often oversimplified and confused with confrontational therapeutic approaches. In this chapter we describe and explain the nuances and clarify the confusion.

What is Choice Theory and Reality Therapy?

Glasser developed reality therapy in the 1960s. Later, recognizing that he needed a theoretical foundation for his therapeutic approach, he began exploring cybernetics and control system theory (Powers, 1973; Wiener, 1948). Initially, Glasser used control theory to explain reality therapy. Later, he adapted the theoretical model and shifted to using choice theory (Glasser, 1998).

Choice theory is based on the idea that conscious behaviors are chosen in an effort to satisfy one of five internal basic human needs (Wubbolding & Brickel, 2017). The human mind or brain acts as a “negative input control system,” providing feedback to individuals so that they can correct behaviors and continue getting what they need and want (Wubbolding, 2012, p. 13).

Reality therapy is a present-focused, directive therapeutic approach designed to help individuals identify and satisfy their needs and wants more consistently and adaptively. As Wubbolding (2012) has written, “If choice theory is the track, reality therapy is the train that delivers the product” (p. 5).

Choice Theory, Reality Therapy, and Spirituality

In the 1989 Spring issue of the Journal of Reality Therapy, Brent Dennis, a certified reality therapist, wrote an article titled, “Faith: The fifth psychological need.” Glasser (1989) responded later that year. Glasser noted that he found the discussion interesting, but that there is “no possible way to resolve an argument about belief” (p. 29). He concluded with a statement embracing inclusiveness toward whatever anyone might place in their quality world. Consistent with this perspective, contemporary reality therapists have published book chapters on how to help interfaith and multicultural couples succeed in their partnerships and marriages (Minatrea & Duba, 2012; Olver, 2012). It’s interesting however, that Glasser described faith as residing in an individual’s quality world; he did not embrace it as a new psychological human need.

In an article on integrating reality therapy into Malaysian Islamic culture, Jusoh and Ahmad (2009) described many ways in which choice theory is consistent with Islam and can be practiced in Asian cultures. Specifically, they focused on the WDEP and SAMI2C3 systems and emphasized their compatibility with Islamic concepts. They concluded that “choice theory and reality therapy have universal attributes, and these can be interpreted in any religion or culture” (2009, p. 7). This statement seems consistent with Glasser’s (1989) inclusive statement on spirituality as a potential human need.

Overall, aside from the content briefly summarized here, little information exists on the integration of spirituality into reality therapy. However, given the growing international flavor of CT/RT, progress in this area seems inevitable.

 

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A Tasty Sample of Reality Therapy

With WubboldingAs far as I know, reality therapists don’t typically use food or eating metaphors. My use of it here might be a leftover from my Gestalt therapy chapter revision, because Gestalt theory happily incorporates swallowing, biting, and other oral dimensions. Then again, maybe it’s just time for lunch.

Choice theory is the foundation for reality therapy. Or, as William Glasser and Robert Wubbolding (featured with me in this photo) put it, reality therapy is the train and choice theory is the track. No gustatory metaphors here either. But I’ll keep looking.

The following is a smattering of tasty revisions for the forthcoming 3rd edition of Counseling and Psychotherapy Theories in Context and Practice.

What is Choice Theory and Reality Therapy?

Glasser developed reality therapy in the 1960s. Later, recognizing that he needed a theoretical foundation for his therapeutic approach, he began exploring cybernetics and control system theory (Powers, 1973; Wiener, 1948). Initially, following Powers, Glasser used control theory to explain reality therapy. Later, he adapted the theoretical model and shifted to using choice theory (Glasser, 1998).

Choice theory is based on the idea that conscious behaviors are chosen in an effort to satisfy one of five internal basic human needs (Wubbolding & Brickel, 2017). The human mind or brain acts as a “negative input control system,” providing feedback to individuals so that we can correct out behaviors and continue getting what we need and want (Wubbolding, 2012, p. 13).

Reality therapy is a present-focused, directive therapeutic approach designed to help individuals identify and satisfy their needs and wants more consistently and adaptively. As Wubbolding (2012) has written, “If choice theory is the track, reality therapy is the train that delivers the product” (p. 5).

Reality Therapy in Action: Brief Vignettes

Similar to Adlerian therapy, reality therapy involves encouragement and intentional planning. The counselor establishes a positive working relationship and then persistently keeps the therapeutic focus on what’s within the client’s solving circle or circle of control. Maintaining a clear focus on positive actions and thoughts is what makes reality therapy an efficient and brief counseling approach.

Vignette I: Using Encouragement—Not Critical Confrontation

The following is an example of the type of confrontation often inaccurately associated with reality therapy. The counselor is confronting a teenage client on his efforts to find a job.

Counselor: Where else did you go?

Client: I tried a couple other [gas] stations, too. Nobody wants to look at me. They don’t pay too good anyway. [Screw] them!

Counselor: So you haven’t really done too much looking. Sounds like you want it served on a silver plate, Joe. Do you think looking at a couple of gas stations is really going to get you a job? (XXXX et al., 2002, p. 219)

Based on this brief exchange it appears the counselor is trying to help the client be successful in obtaining employment. Consequently, we can assume that having gainful employment (or at least making money) is a “want” (the W in WDEP) and in the client’s quality world. Although this counselor is supposedly doing reality therapy, his critical statements (“you haven’t done too much looking” and “you want it served on a silver platter”) are inconsistent with reality therapy principles. A reality therapist would use a more supportive and encouraging approach. For example:

Counselor: Where else did you go?

Client: I tried a couple other [gas] stations, too. Nobody wants to look at me. They don’t pay too good anyway. [Screw] them!

Counselor (Reality therapy response): It sounds like you really want a job and you feel very frustrated. What else could you do to help get what you want?

Notice that the reality therapist keeps the focus on what the client wants, empathizes with the frustration, and ignores the client’s desire to quit trying. This approach is encouraging because the counselor is expresses confidence in the client’s ability to act and think in ways that will move him toward his quality world.

Generally, when counselors use confrontation, the goal is to help clients engage in self-examination. The process for nearly all therapy approaches is similar—counselors help clients increase their awareness or have insights, which then leads to motivation and eventual change. Consistent with this process, Wubbolding referred to client self-evaluation as a “prelude to change” (1999, p. 196).

In working with this young man on employment issues, the following exchange uses concepts and questions adapted from Wubbolding (1999).

Counselor: Hey Joe, do you think the overall direction of your life is more of a plus or more of a minus?

Client: I don’t know. I suppose it’s kind of a neutral. I don’t have a job and I’m not really going any direction.

Counselor: That’s interesting. No direction. I guess my question about that is whether going no direction is really the direction you want . . . or whether maybe you want something else?

Client: Yeah. I’d love to have some money. Right now the economy sucks, so I don’t really see the point of looking for work.

Counselor: The odds of getting a job right now aren’t great, that’s for sure. Do you suppose the odds are better if you stay home or better if you get out and drop off a few applications?

Client: I see what you’re saying. My odds are a little better if I get out there. But I think my odds of making money are probably better if I just got out there and sold drugs, like some other guys I know are doing.

Counselor: I’m just trying to follow along and track what you want. It does sound like you want money. And you might be right about the drug selling scene, I don’t know much about that. But let’s be serious, do you think selling drugs would genuinely be good for you? I guess another way of asking that is, “Will selling drugs help or hurt you in getting what you want in the long run?” [This confrontation does what a reality therapy confrontation is supposed to do: It directly questions the usefulness of excuses.]

Client: I’m not saying I think selling drugs is a good thing to do. I’m just frustrated and sick of being broke and poor.

Counselor: Yeah. It’s very hard. But I’m your counselor and it’s my job to keep pushing you in positive directions. I’m asking you this because I think you can do better than how you’re doing. Is the way you’re thinking about this—that it’s too hard, the economy sucks, and you’re likely to fail—is that line of thinking helping you get a job or hurting your prospects?

Client: Yeah. I guess having a pity-party isn’t helping much.

Counselor: I’m sure having a pity party can feel good sometimes. But I’m with you on the fact that it’s not helping much. So we’ve got to try out something different.

Because the preceding questions ask the client to look at himself and self-evaluate, they’re inherently confrontational, but also supportive and encouraging. Many additional reality therapy questions that help clients self-reflect and plan are in Wubbolding’s (2000, 2017) publications.

Vignette II: Collaborative Planning

This vignette extends the previous case into the reality therapy collaborative planning process.

Client: Well. What sort of different approach do you suggest?

Counselor: If it were up to me, I’d suggest we make a very clear plan for you to try out this week. The plan would focus on how you can get what you want: a job so you can start earning money. And we’d develop this plan together and we’d be honest with each other about whether our ideas would give you the best chances to get a job.

Client: How about I go down to the Job Service and sign up there?

Counselor: That’s one good idea. It doesn’t guarantee you a job, but nothing will because you don’t have control over whether someone hires you, you only have control over your strategy or plan. Do you know what I mean?

Client: Not really.

Counselor: Thanks for being honest about that. When you make a plan or set a goal, it’s important for it to be completely within your control and not dependent on anyone else. That’s because the only behavior you can control is your own. For example, if your plan is to “get hired,” you can be doomed to frustration and anger because you don’t make the hiring decision. Instead, a good plan involves developing a detailed, step-by-step process. Your plan could be to revise your resume and then submit it along with a well-crafted cover letter to 10 places where you think your skills are a good fit. You have complete control over all that.

Client: Okay. I get it. I could do that, but I’m not very good with writing and resumes and all that.

Counselor: How can you make sure those things are in good shape then?

Client: I could get my sister to look it over.

Counselor: When could you do that?

Client: Next week, I suppose.

Counselor: What would make it possible to do that sooner, like this week?

Client: You know, you’re really kind of pushy.

Counselor: Do you think you’d do better with someone who lets you put things off until next week? Would that be more helpful in getting you a job sooner?

Client: Right. Right. Okay. I call my sister tonight and ask if she can help me as soon as she’s available.

Counselor: That’s sounds like a great start. What time will you call her tonight?

Client: Seven o’clock. I know. Why not six? Well I figure she’ll be done with dinner by seven, that’s why.

Counselor: Good planning. Maybe I don’t have to be so pushy after all.

The preceding dialogue illustrates how counselors can use gentle and persistent questioning to lead clients toward planning that’s consistent with Wubbolding’s principles (i.e., SAMI2C3). It also illustrates how reality therapists function as collaborators to help clients or students plan for success.

Concluding Comments

The mission of the William Glasser Institute is to teach all people Choice Theory® and to use it as the basis for training in reality therapy, lead management, and Glasser Quality School education (http://www.wglasser.com/). The institute has existed for more than 44 years and there are now approximately 8,000 certified reality therapists worldwide and over 86,000 who have obtained substantial advanced reality therapy training.

William Glasser passed away in 2013. Although his advocacy for conscious, noncoercive human choice is missed, there are many other contributors to the national and international dissemination of choice theory and reality therapy. As examples, Robert Wubbolding is the director of the Center for Reality Therapy. Thomas Parish is the editor of the International Journal of Choice Theory and Reality Therapy. Patricia Robey, Nancy Buck, Jim Roy, and John Brickell are prolific contributors to the CT/RT literature (Buck, 2013; Parrish, 2017; Robey, 2017; Roy, 2014, 2017; Wubbolding & Brickell, 2017).

In Dr. Glasser’s eulogy, Wubbolding shared the following anecdote:

Quite recently, a woman approached him at his home and begged him for advice for how to deal with her 3 year-old son. He paused for a long time and then reached deep down inside his soul and gave her 2 suggestions: “Always treat him as if he is good.” And “Set up circumstances where he can only succeed.” These wise words could serve as his suggestions for all counselors. They represent for us a worldview, an attitude toward clients and his perception of all human beings. These two sentiments transcend a particular counseling system in that they summarize his legacy (September 10, 2013; http://www.realitytherapywub.com/index.php/easyblog/entry/dr-william-glasser).  

In support of Glasser’s legacy, we end this chapter with a quotation that reflects his idealism and ambition:

It is my vision to teach choice theory to the world.

I invite you to join me in this effort.

—William Glasser, Unhappy Teenagers (2002, p. 190)

R-I-P-SC-I-P: An Acronym for Remembering the Essential Components of a Suicide Assessment Interview

This post is part 1 of a follow up to requests I’ve gotten following the MUS Suicide Prevention Summit in Bozeman. A number of people asked: What’s R-I-P-SC-I-P and how do I get more information about it? The answer is that it’s just an acronym to help practitioners recall key areas to cover in a comprehensive suicide assessment interview. But because I made it up in honor of Robert Wubbolding while doing a workshop in Cincinnati (he’s created several acronyms for Choice Theory and Reality Therapy), I’m pretty much the only source.

The following is a pre-published excerpt from the Suicide Assessment chapter in the forthcoming 6th edition of Clinical Interviewing. It includes some general information, a summary of R-I-P-SC-I-P, and some guidance on how to talk with clients about suicide ideation. Much more of this is in the whole chapter, but I can’t post it here.

Suicide Assessment Interviewing

A comprehensive and collaborative suicide assessment interview is the professional gold standard for assessing suicide risk. Suicide assessment scales and instruments can be a valuable supplement—but not a substitute—for suicide assessment interviewing (see Putting It in Practice 10.1).

A comprehensive suicide assessment interview includes the following components:

  • Gathering information about suicide risk and protective factors: This should be done in a manner that emphasizes your desire to understand the client and not as a checklist to estimate risk
  • Asking directly about possible suicidal thoughts
  • Asking directly about possible suicide plans
  • Gathering information about client self-control and agitation
  • Gathering information about client suicide intent and reasons to live
  • Consultation with one or more professionals
  • Implementation of one or more suicide interventions, including, at the very least, collaborative work on developing an individualized safety plan
  • Detailed documentation of your assessment and decision-making process (Table 10.3 includes an acronym to help you recall the components of a comprehensive suicide assessment interview)

Table 10.3: RIP SCIP – A Suicide Assessment Acronym

R = Risk and Protective Factors
I = Suicide Ideation
P = Suicide Plan
SC = Client Self-Control and Agitation
I = Suicide Intent and Reasons for Living
P = Safety Planning

These assessment domains or dimensions form the acronym R-I-P-SC-I-P (pronounced RIP SKIP).

Exploring Suicide Ideation

Unlike many other risk factors (e.g., demographic factors), suicide ideation is directly linked to potential suicide behavior. It’s difficult to imagine anyone ever dying by suicide without having first experienced suicide ideation.

Because of this, you may decide to systematically ask every client about suicide ideation during initial clinical interviews. This is a conservative approach and guarantees you won’t face a situation where you should have asked about suicide, but didn’t. Alternatively, you may decide to weave questions about suicide ideation into clinical interviews as appropriate. At least initially, for developing professionals, we recommend using the systematic approach. However, we recognize that this can seem rote. From our perspective, it is better to learn to ask artfully by doing it over and over than to fail to ask and regret it.

The nonverbal nature of communication has direct implications for how and when you ask about suicide ideation, depressive symptoms, previous attempts, and other emotionally laden issues. For example, it’s possible to ask: “Have you ever thought about suicide?” while nonverbally communicating to the client: “Please, please say no!” Therefore, before you decide how you’ll ask about suicide ideation, you need the right attitude about asking the question.

Individuals who have suicidal thoughts can be extremely sensitive to social judgment. They may have avoided sharing suicidal thoughts out of fear of being judged as “insane” or some other stigma. They’re likely monitoring you closely and gauging whether you’re someone to trust with this deeply intimate information. To pass this unspoken test of trust, it’s important to endorse, and directly or indirectly communicate the following beliefs:

  • Suicide ideation is normal and natural and counseling is a good place for clients to share those thoughts.
  • I can be of better help to clients if they tell me their emotional pain, distress, and suicidal thoughts.
  • I want my clients to share their suicidal thoughts.
  • If my clients share their suicidal thoughts and plans, I can handle it!

If you don’t embrace these beliefs, clients experiencing suicide ideation may choose to be less open.

Asking Directly about Suicide Ideation

Asking about suicide ideation may feel awkward. Learning to ask difficult questions in a deliberate, compassionate, professional, and calm manner requires practice. It also may help to know that, in a study by Hahn and Marks (1996), 97% of previously suicidal clients were either receptive or neutral about discussing suicide with their therapists during intake sessions. It also may help to know that you’re about to learn the three most effective approaches to asking about suicide that exist on this planet.

Use a normalizing frame. Most modern prevention and intervention programs recommend directly asking clients something like, “Have you been thinking about suicide recently?” This is an adequate approach if you’re in a situation with someone you know well and from whom you can expect an honest response.

A more nuanced approach is to ask about suicide along with a normalizing or universalizing statement about suicide ideation. Here’s the classic example:

Well, I asked this question since almost all people at one time or another

during their lives have thought about suicide.

There is nothing abnormal about the thought. In fact it is very normal when one

feels so down in the dumps.

The thought itself is not harmful. (Wollersheim, 1974, p. 223)

A common fear is that asking about suicide will put suicidal ideas in clients’ heads. There’s no evidence to support this (Jobes, 2006). More likely, your invitation to share suicidal thoughts will reassure clients that you’re comfortable with the subject, in control of the situation, and capable of dealing with the problem.

Use gentle assumption. Based on over two decades of clinical experience with suicide assessment Shawn Shea (2002/ 2004/2015) recommends using a framing strategy referred to as gentle assumption. To use gentle assumption, the interviewer presumes that certain illegal or embarrassing behaviors are already occurring in the client’s life, and gently structures questions accordingly. For example, instead of asking “Have you been thinking about suicide?” you would ask: “When was the last time when you had thoughts about suicide?” Gentle assumption can make it easier for clients to disclose suicide ideation.

Use mood ratings with a suicidal floor. It can be helpful to ask about suicide in the context of a mood assessment (as in a mental status examination). Scaling questions such as those that follow can be used to empathically assess mood levels.

1. Is it okay if I ask some questions about your mood? (This is an invitation for collaboration; clients can say “no,” but rarely do.)

2. Please rate your mood right now, using a zero to 10 scale. Zero is the worst mood possible. In fact, zero would mean you’re totally depressed and so you’re just going to kill yourself. At the top, 10 is your best possible mood. A 10 would mean you’re as happy as you could possibly be. Maybe you would be dancing or singing or doing whatever you do when you’re extremely happy. Using that zero to 10 scale, what rating would you give your mood right now? (Each end of the scale must be anchored for mutual understanding.)

3. What’s happening now that makes you give your mood that rating? (This links the mood rating to the external situation.)

4. What’s the worst or lowest mood rating you’ve ever had? (This informs the interviewer about the lowest lows.)

5. What was happening back then to make you feel so down? (This links the lowest rating to the external situation and may lead to discussing previous attempts.)

6. For you, what would be a normal mood rating on a normal day? (Clients define their normal.)

7. Now tell me, what’s the best mood rating you think you’ve ever had? (The process ends with a positive mood rating.)

8. What was happening that helped you have such a high mood rating? (The positive rating is linked to an external situation.)

The preceding protocol assumes clients are minimally cooperative. More advanced interviewing procedures can be added when clients are resistant (see Chapter 12). The process facilitates a deeper understanding of life events linked to negative moods and suicide ideation. This can lead to formal counseling or psychotherapy, as well as safety planning.

Responding to Suicide Ideation

Let’s say you broach the question and your client openly discloses the presence of suicide ideation. What next?

First, remember that hearing about your client’s suicide ideation is good news. It reflects trust. Also remember that depressive and suicidal symptoms are part of a normal response to distress. Validate and normalize:

Given the stress you’re experiencing, it’s not unusual that you think about suicide sometimes. It sounds like things have been really hard lately.

This validation is important because many suicidal individuals feel socially disconnected, emotionally invalidated, and as if they’re a social burden (Joiner, 2005). Your empathic reflection may be more or less specific, depending on how much detailed information your client has given you.

As you continue the assessment, collaboratively explore the frequency, triggers, duration, and intensity of your client’s suicidal thoughts.

  • Frequency: How often do you find yourself thinking about suicide?
  • Triggers: What seems to trigger your suicidal thoughts? What gets them started?
  • Duration: How long do these thoughts stay with you once they start?
  • Intensity: How intense are your thoughts about suicide? Do they gently pop into your head or do they have lots of power and sort of smack you down?

As you explore the suicide ideation, strive to emanate calmness, and curiosity, rather than judgment. Instead of thinking, “We need to get rid of these thoughts,” engage in collaborative and empathic exploration.

Some clients will deny suicidal thoughts. If this happens, and it feels genuine, acknowledge and accept the denial, while noting that you were just using your standard practice.

Okay. Thanks. Asking about suicidal thoughts is just something I think is important to do with everyone.

On the other hand, if the denial seems forced, or is combined with depressive symptoms or other risk factors, you’ll still want to use acknowledgement and acceptance, but then find a way to return to the topic later in the session.

What You Missed in Cincinnati

For me, the hardest thing about presenting professional workshops is time management. I want participants to comment, but how can I plan in advance for exactly how long their comments will be? Even worse, how can I accurately estimate the length of my own impromptu moments? It seems obvious that there’s a need for spontaneity. I don’t want to cut off potentially valuable comments from participants . . . and I don’t want to cut off my own creative musings either. Clearly, the clock is my workshop enemy.

For example, how could I know in advance that I would suddenly feel compelled to share a personal dream of mine with 85 of my new Cincinnati counselor friends? Never before had I shared with a workshop audience that 45 years-ago I dreamt I was Felix-the-Cat and then while crossing the road (as Felix), I got hit by a car . . . and died.

But then I woke up and have kept on living.

I like to think that particular disclosure is a perfectly normal thing to do when you’ve got a group of professional counselors to listen to you.

The point was to bust the myth that some teenage client have (and will talk about in counseling) that if they dream they die, it is prophetic and means they’ll die soon in real life also.

And beyond my personal dream disclosure, how would I know that one of the participants would have such passion that he would accept an invitation to come up to the microphone and share a physical relaxation technique that he uses with elementary school students.

These are just two samples of the sort of thing you missed because you weren’t in Cincinnati at the Schiff Center on the Xavier University campus yesterday.

But you also missed the start of the workshop where I decided on the spot that it was just the right time and place for me to open the workshop with a story of the most embarrassing moment in my life. It struck me as an awesome idea at the time . . . and it really was the most embarrassing moment of my life . . . until a few hours later when I shared my Felix-the-Cat dream.

There are always bigger mountains to climb.

You also missed meeting my incredibly gracious hosts from the Greater Cincinnati Counseling Association including, Butch Losey (who’s the most humble and understated guy who should be famous I’ve ever met), Kay Russ (who’s right up there with the most responsible person I’ve ever met), and Brent Richardson (who is as irreverent and insightful as ever), and Robert Wubbolding (who may be on his way to Casablanca to do a week long choice theory/reality therapy workshop by the time I post this and yet took eight hours out of his life to attend the workshop anyway).

So that’s just a little taste of what you missed in Cincinnati.

I’ll bet you wish you were there. I know I’m glad I was.

Reflections on Another Counselng and Psychotherapy Video Shoot

Yesterday I got to demonstrate skills associated with four different therapy approaches: Reality therapy, psychoanalytic therapy, cognitive-behavioral therapy, and Adlerian therapy.

Overall the video shoot went well, but I was surprised that of these four approaches, in many ways I felt most comfortable with reality therapy. I hadn’t expected that. Many people don’t “get” reality therapy and think it’s either a form of cognitive-behavioral therapy or a highly confrontational approach wherein therapists sternly confront their clients with cold, cruel, reality.

But reality therapy isn’t a form of CBT and it’s not confrontational. What I found myself doing in the reality therapy demo was following the sage guidance of Robert Wubbolding who formulated four BIG questions that stand at the heart of reality therapy. The questions would be good for everyone to memorize and can, when applied gently and persistently, help get people back onto a positive track. The questions are:

1. What do you want?

2. What are you doing?

3. Is it working?

4. Should you make a new plan?

Wubbolding has written several books on reality therapy and is taking up the torch for William Glasser, who was the original developer of this approach. In particular, I recommend Wubbolding’s books because they will help guide you in how to ask questions to help clients explore these four very important questions. I can even use them right now:

What do I want? — A good night’s sleep.

What am I doing? — Typing up this blog

Is it working? — Nope!

Should I make a new plan? — Good night!