What is Reality Therapy and How Does it Work?

Reality therapy can teach you how to create the life you want and find greater satisfaction in yourself and your relationships.

Reality therapy is a fascinating method of psychotherapy that has been practiced for many decades now. 

Its techniques are controversial, but have been found to be effective in treating a number of mental wellness afflictions. 

In this post, we’ll explore the core ideas, benefits, and limitations of reality therapy as treatment.

What Is Reality Therapy?

Reality Therapy was first theorized in the 1960s by William Glasser, M.D. The theory states that by accepting responsibility over our own lives, planning intentional action, focusing on the present and not dwelling on the past, we can then achieve mental wellness

Glasser believed that there are five basic genetically driven needs: Self-preservation or survival, love and belonging, achievement, freedom, and enjoyment.

Reality Therapy prompts the individual to figure out if their innate needs are being met- and if not, how to put themselves on a path to fulfilling them. 

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The Core Ideas And Elements Of Reality Therapy 


Glasser believed that unhappiness in life is due to poor choices and behaviors on the part of the individual.

By evaluating the effectiveness of our choices and planning more effective behaviors and actions, we can minimize or eliminate negative outcomes.

To do this, the individual must first identify their dreams, desires, and goals in order to plan a path to attaining them. 

A reality therapy technique is behavioral rehearsal, whereby the therapist prompts the client to consider possible interactions and how they can effectively behave in order to produce desirable outcomes. 


“We are not at the mercy of others.” 

Reality therapists focus on instilling the idea that one has control over their own choices and behavior, and is capable of producing outcomes that lead to success.

Additionally, it is put forth that the only person we have control over is ourselves.

By identifying our goals and our level of commitment to achieving them, we can begin to plan effective actions and behaviors as a pathway to fulfillment. 

Through this process, an individual will begin to understand that fulfillment is best achieved with an internal driving force, rather than a reliance on external influences. 


Transference of responsibility is a common way of emotionally dealing with an issue, but this is ineffective as it produces no outcome but a feeling of resentment. 

By taking accountability of our lives and our choices, we can then proceed to act effectively so as to produce change. 

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Many are resistant to this mode of thinking and reframing, as we are prone to placing blame onto others- and especially onto past experiences. 


Reality therapists encourage clients to think deeply about their actions and the outcomes they produce.

This is preceded by identification of their goals and desires. 

With an awareness of their aims, therapists work with clients to consider how effective their current actions and habits are, and to plan more effective actions towards fulfillment. 

Actions should be: 

  • specific
  • measurable
  • achievable
  • results-focused

Present Moment

Reality therapy emphasizes that change is reliant on self-responsibility and the “here and now”. 

Reality therapists work with clients to help them understand that the past cannot be changed, but how we move into the future can. 

If we lose time dwelling on the past, we have less time to focus on making positive change for the present and future.

When Is Reality Therapy Used, and What Can It Help With?

Reality Therapists promote an understanding of the client’s own capacity to produce positive change in their life. 

It can be particularly useful in the counseling of couples, people suffering with addiction, and in school settings. 

For couples, it can prompt each individual to consider how their own actions affect their partner and their connection, and what their responsibilities are within the partnership.

For those suffering with addiction, reality therapy can instill a sense of hope by altering the individual’s thinking patterns in order to reframe the issue. 

By planning out actions and behaviors, the addiction-afflicted individual might come to perceive that there is a pathway out of this negative routine they’ve become lost in. 

For students, reality therapy can prompt an understanding that negative consequences can be avoided by taking responsibility to fulfill their duties and behave appropriately. 

Practicing behavioral planning means that they can alter their actions to match this reframed perspective.

Reality Therapy Vs. Traditional Psychiatry And Psychotherapy

While traditional psychiatry and psychotherapy techniques tend to focus on past experiences and traumas that have influenced present behaviors, reality therapy shifts focus to the “here and now”. 

Rather than examining external influences, diagnosing mental conditions, and prescribing medicinal remedies, reality therapy places responsibility entirely on the individual to navigate their way toward fulfillment. 

Disadvantages, Criticisms And Limitations Of Reality Therapy

One criticism of reality therapy is the potential imposition of the therapist’s own personal ideals onto the client within the action and behavior planning process. 

Another common criticism is its dismissal of past experiences, traumas, and behaviors- elements which are of vital importance to most psychotherapy techniques. 

Many experts have also also critiqued reality therapy’s dismissal of mental health conditions and use of medication.

Reality Therapy Techniques

Relationship Habits

Glasser judged the innate need to be loved and feel a sense of belonging as the most primary need of all. 

Because of this, unmet relational needs are often the greatest source of unhappiness. 

Reality therapists help the individual to evaluate the effectiveness of their choices in relation to other people and their connections.

In interactions within an intimate relationship, each individual should plan to practice supportive, encouraging behaviors, and examine where and how they fall short of such behaviors. 

Reality therapists can work with individuals and couples to develop pathways to effective relational actions and behaviors. 

Quality Vs. Perceived World

Our ‘quality world’ is a catalog of aspects in our life that make it worth living, and can provide motivation to do better. 

Quality world images relate to our basic needs but are also unique to the individual, and the attainability and level to which you desire it tend to vary. 

Our ‘perceived world’ simply refers to the way in which we perceive our world.

The way in which we do so, Glasser believed, is up to us.

We can change the way we perceive our reality, and often the way we perceive it is inaccurate. 

Comparing Place

The ‘comparing place’ refers to the comparisons we make between our quality world and our perceived world.

Reality therapy uses levels of comparison to measure this, and if these levels are balanced, it indicates the individual’s fulfillment. 

If the levels are way off, the individual likely feels frustration at the mismatch between what they desire and what they have. 

This frustration is an indicator that some alteration of behavioral patterns and actions is required in order to produce desired outcomes. 

External Vs. Internal Control Psychology

Reality therapy encourages people to develop an internal locus of control, meaning they understand that they have control over themselves, their choices, and their outcomes.  

This is opposed to the external locus of control which many people believe to exist, meaning they perceive that their life is controlled by external influences and other people. 

Once this reframing occurs, people can begin to understand and examine how their own choices lead their existence. 

Effectiveness Of Reality Therapy

There is little quantified evidence supporting the effectiveness of reality therapy, however there have been studies suggesting its positive effect in resolving particular issues. 

For relationship and family therapy, for example, studies reflect positively on the practice.

Studies have also shown that reality therapy is self-empowering for students in schooling environments. 

What To Look For In A Reality Therapist

Online Therapy Options

When seeking out a reality therapist online, be sure to inspect their online reviews and credentials. 

Do not accept reality therapy counseling from someone who is not professionally trained in the practice, as this could produce adverse results. 

Summing Up 

In summary, the core ideas and techniques of reality therapy are an excellent alternative to some of the more traditional methods of psychotherapy. 

Rather than looking toward external influences to resolve your problems in life, reality therapy shifts the focus onto the self, and what you can do to help yourself. 

Through altering your decision-making, actions, and behaviors through planning and preparation, reality therapy believes that you can fulfill your desires and dreams. 

If you are seeking a path to mental wellness that doesn’t involve diagnosis or prescription of medication, then reality therapy may be the perfect option for you. 

Thanks for reading!

And please check out some other recent articles about psychology and therapy below:

Sources used in this article:

Duba, J., Graham, M., Britzman, M., and Minatrea, N. (2009).

Introducing the “Basic Needs Genogram” in Reality Therapy-based Marriage and Family Counseling.

International Journal of Reality Therapy, 28(2), 15-19. https://digitalcommons.wku.edu/cgi/viewcontent.cgi?article=1026&context=csa_fac_pub

Mason, C. & Duba, J. (2009).

Using Reality Therapy in Schools: Its Potential Impact on the Effectiveness of the ASCA National Model.

International Journal of Reality Therapy, 29(2), 5-12. https://digitalcommons.wku.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1036&context=csa_fac_pub