Reality therapy is a form of cognitive behavioral therapy, teaching that while we cannot control how we feel, we can control how we think and behave. Based on the idea that our most important need is to be loved and to feel that we belong, and that all other basic needs can be satisfied only by building strong connections with others, reality therapy also focuses on the now, not the past.

Other forms of therapy that draw on the psychodynamic approach to treat psychological symptoms delve more into past behaviors and incidents, but reality therapy focuses on the present to help people lead a more fulfilling life. The following will lay out a brief history of this form of therapy and describe how it works, as well as who can benefit.

Humanistic Psychology

The roots of Reality Therapy can be traced back to several earlier schools of thought in psychology. One of these precursors was the Humanistic Psychology movement, which emphasized the importance of the individual’s subjective experience and the need for self-actualization. Reality Therapy shares many of the Humanistic Psychology movement’s values, such as the importance of personal responsibility and the need for individuals to take control of their own lives and their current behavior.

Behavioral Psychology

Another precursor to Reality Therapy was the Behavioral Psychology movement, which focused on observable behavior and the role of reinforcement and punishment in shaping behavior. William Glasser’s total concept of behavior, which emphasizes the importance of understanding all four components of behavior, can be seen as a synthesis of the ideas of the Humanistic Psychology and Behavioral Psychology movements.

The Birth of Reality Therapy

William Glasser: Father of Reality Therapy

Reality Therapy was developed by William Glasser in the 1960s. It is based on the idea that individuals have control over their current behavior and can learn to make choices that lead to a more fulfilling life and more personal freedom. Through self evaluation of the underlying causes of their pain, reality therapists encourage people to change behavior patterns in a solution oriented framework.

Control theory and reality therapy

The concept of Reality Therapy grew out of Glasser’s earlier work on what he called “control theory,” which emphasized the importance of personal responsibility and choice in mental health. Glasser’s legacy is still visible in the continued publication of The International Journal of Choice Theory and Reality Therapy, which publishes peer reviewed studies on the basic principles of his work as well as new findings by reality therapists who incorporate new psychology techniques.

Glasser’s experiences in mental health

Glasser’s ideas about control theory were influenced by his experiences working as a psychiatrist in the 1950s. He became frustrated with traditional psychiatric treatments, which he felt focused too much on diagnosing and treating mental illness and not enough on helping individuals (who may or may not be mentally ill) take control of their own lives.

Glasser began to develop a new approach to therapy that focused on helping individuals identify and change their own behavior, rather than trying to change their thoughts or emotions.

Evolution of Reality Therapy

Glasser’s early work on control theory eventually evolved into what he called Reality Therapy. The concept of Reality Therapy is based on the idea that individuals have five basic needs: survival, love and belonging, power, freedom, and fun.

When these five basic needs are not being met, individuals may experience emotional distress and engage in behaviors that are not helpful or healthy based on external factors in their perceived world. They may even destroy relationships and thus lack sexual fulfillment due to a lack of internal control over their actions. Reality Therapy aims to help individuals meet these unmet needs in a more constructive way, leading to improved mental health and well-being.

Choice Theory: The Core Element

One of the key principles of Reality Therapy is William Glasser’s choice theory. Choice theory emphasizes the importance of individuals taking responsibility for their own behavior and choosing to behave in a way that meets their needs in a positive way. Patients engage in self evaluation of their life experiences and identify poor choices they have made that have led to their current issues.

The therapist helps the client to identify the consequences of their choices, and encourages them to make choices that will lead to positive outcomes. Reality therapy focuses on helping clients work toward a quality world, one in which they strengthen relationships, satisfy unmet needs, and address current behaviors that prevent them from problem solving and achieving growth.

Behavioral Choices: Total & Effective Behaviors

Another important aspect of Reality Therapy is the concept of total behavior. This refers to the idea that all behavior is made up of four components: acting, thinking, feeling, and physiology. The therapist helps the client to identify which components of their behavior they have control over, and encourages them to focus on changing those components that they can control.

Effective behaviors

Reality therapy and choice theory both emphasize effective behaviors. These are behaviors that lead to a better connection with a person’s environment. Unsatisfying present relationships are often the result of ineffective behaviors.

While they are intended to address human problems in the person’s life, these ineffective current behaviors are often influenced by past events and can lead to low life satisfaction when they don’t achieve their intended results. In a therapeutic environment, clients can examine how their past behaviors have created their current reality, and how their excuses stand directly in the way of their happiness.

Key Components of Reality Therapy

As noted above, Glasser builds on the idea of the five basic needs to develop his framework of overall behavior. These essential needs guide our actions whether we want them to or not, and setting realistic goals related to these needs is a key part of reality therapy.

Action Planning

Action planning is an essential component of Reality Therapy, as Reality Therapy seeks to help clients move from insight to action and make positive changes in their lives. Action planning involves identifying specific goals, determining the steps that are needed to achieve those goals, and developing a plan of action to put those steps into practice.

Step One: Identifying Goals

The first step is identifying the client’s goals. The therapist works with the client to identify what they want to achieve and what suggest plans they can implement to achieve their most quality world. For example, a client may want to improve their relationship with their partner, so the therapist would work with them to identify specific behaviors that they can change in order to improve the relationship.

Step Two: Identifying Steps

Once the goals have been identified, the therapist and client work together to determine the steps that are needed to achieve those goals. These steps may involve changing behaviors, developing new skills, or improving relationships with others. The therapist helps the client to break down their goals into manageable, achievable steps that can be taken one at a time.

Step Three: Planning for Action

After the steps have been identified, the reality therapist and client develop a plan of action to put those steps into practice. The plan should be specific, measurable, and achievable, with clear deadlines and milestones. The therapist works with the client to develop strategies for overcoming obstacles and staying on track with their organized behaviors.

Throughout this process, the reality therapist encourages the client to take responsibility for their choices and their behavior. The client is encouraged to focus on what they can control and to take action to improve their situation, rather than blaming others or external circumstances for their problems.

Overall, action planning is among the most important reality therapy techniques, as it helps clients move from insight to action and make positive changes in their lives to achieve their highest quality world. By identifying specific goals, breaking them down into achievable steps, and developing a plan of action, clients are able to take responsibility for their choices and take control of their lives.

Importance of Relationships

No man is an island, and all of us are defined and influenced by our external relationships. Glasser believed that all human behavior is ultimately driven by a need for love and belonging, and that healthy relationships are essential for mental and emotional well-being.

In Reality Therapy, the therapist works with the client to identify and improve their relationships with others, whether it be family members, friends, or romantic partners. Clients may initially avoid discussing unsatisfying relationships because of the pain associated with them. The reality therapist works with them to choose reconnecting behaviors they can use to rebuild these relationships.

The Present Moment

Reality therapy emphasizes the present moment. A key part of choice theory is that the only moment in which an individual can take action and make choices is the present moment. Therefore, Reality Therapy focuses on helping the client to identify and change their behavior in the present, rather than dwelling on past experiences or worrying about the future.


In addition to these core elements, Reality Theory also includes a number of specific techniques and interventions that are used in therapy. One of these is the use of questioning to help the client gain insight into their behavior and thought processes. The therapist may ask questions such as, “What are you doing right now?” or “How is that working for you?” to help the client identify their behavior and its consequences.

Another technique used in Reality Therapy is the use of role-play and other experiential exercises. These exercises are designed to help the client practice new behaviors and develop new skills in a safe, supportive environment.

Who can benefit from reality therapy?

Since reality therapy is focused on present-day challenges, anyone who is recovering from addiction, mental health conditions, or eating disorders may find this therapeutic approach to be helpful.

Mental Health Conditions That Can Benefit From Reality Therapy

Reality Therapy has been shown to be effective in treating a wide range of mental health conditions, and The International Journal of Choice Theory and Reality Therapy has published multiple peer reviewed studies demonstrating its efficacy for different conditions.


Reality Therapy can be an effective treatment for depression, as it encourages individuals to take action and make positive changes in their lives. By focusing on the present moment and identifying achievable goals, individuals can learn to manage their symptoms and develop a more positive outlook on life.


Reality Therapy can also be helpful for individuals with anxiety, as it encourages them to take control of their thoughts and behaviors. By identifying specific triggers and developing strategies to manage them, individuals can learn to reduce their anxiety and improve their overall mental health.

Substance Use Disorders

Reality Therapy was found by a study to be effective in reducing symptoms of addiction and improving social functioning in individuals with co-occurring mental health and substance use disorders.

Substance Use Disorders

Reality Therapy was found by a study to be effective in reducing symptoms of addiction and improving social functioning in individuals with co-occurring mental health and substance use disorders.

Reality Therapy can be an effective treatment for substance use disorders, as it encourages individuals to take responsibility for their choices and behavior. By identifying the underlying causes of their substance use and developing strategies for managing cravings and triggers, individuals can learn to overcome their addiction and maintain sobriety.

How do I know if reality therapy is right for me?

As a form of Cognitive Behavioral Therapy, reality therapy is designed to help individuals who are struggling with behaviors, actions, and reactions that they would like to change. As a result, it’s a good fit for most individuals who are seeking recovery from addiction and other behavioral health challenges.

Athletic coaching can often incorporate elements of reality therapy, as coaches must encourage their athletes to forget about past defeats and rise to their current challenges.

The International Journal of Choice Theory and Reality Therapy also notes that Reality Therapy has been incorporated into school counseling via the ASCA National Model for School Counseling.

Reality Therapy Focuses on Results?

Reality therapy sessions are overseen by a trained therapist and can take place in individual or group settings. A typical session will explore enhancing and strengthening social connections and a sense of belonging and community, whether that takes place among the treatment group or loved ones outside of treatment.

Turning Point of Tampa’s therapists incorporate techniques from multiple therapeutic modalities and are equipped to address the challenges faced by substance use, eating disorder, and dual diagnosis patients.

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