Reality therapy is a commonly used therapeutic approach among mental health professionals. This approach follows the principles and beliefs associated with choice theory. One of the most powerful aspects of choice theory is the belief that our behaviors are chosen and that we can control our own behaviors. Choice theory further explains that the choices we make are motivated, or driven, by our 5 basic needs.
The five basic needs associated with choice theory and reality therapy include:
- Love and belonging
Take a moment to think about a client that you have been working with. If you were to think about which of the five basic needs was the driving force in them coming to their sessions with you, which do you feel would be the more prominent? Has this need been addressed in your therapy sessions or do you find yourself focusing on another topic? How can you use this perspective in your clinical work?
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While we may each have similar needs, there will of course be individual differences. The differences you find within your clients will undoubtedly impact the focus of your sessions and their clinical goals.
Clinicians who utilize reality therapy may find themselves focusing on helping clients connect and reconnect with important people in their lives. By doing this, you will often observe a decrease in the presence of symptoms that your client is experiencing.
With reality therapy, clinicians work to keep the focus on the present moment. You may find yourself focusing on topics other than their symptoms and complaints. This is because, with reality therapy, it is believed that distress is the result of coping with dissatisfaction within personal relationships.
In collaboration with their client, reality therapists work with their clients to make specific and realistic plans. When it comes to goal setting, it is important that we talk to our clients about the characteristics of realistic and attainable goals. This can be especially relevant if you have a client who has talked about repeated difficulty reaching their personal goals
Getting Ready for Your First Reality Therapy Session with a New Client
Since reality therapists encourage clients to be in the present moment, it is important that we are able to do the same. By giving ourselves time to prepare for our session, we can model this skill for our clients. Clients can often sense subtle signs of stress or changes in our behavior which can shift how they behave and participate in sessions.
Taking a few moments to check in with yourself and assess your own needs can help you remain in the moment with your client. Sometimes just checking if we are hungry, thirsty, or need to stretch can make a difference.
You may find that taking short breaks to focus on your own wellness during the day is beneficial. This can include going for a walk, listening to music or a podcast, watching a funny video, engaging in meditation, or practicing breathing techniques. There will, of course, be details from the clinical setting that you work in that will influence your ability to engage during your work day, which is why we recommend regular self-care practices. Regular self-care should be an active part of your routine outside of work to promote your own health and wellness.
Before your first session with a new client, it can be helpful to organize any paperwork you need to complete. This will vary across different clinical settings and can include documents such as an informed consent, consents of release, screeners, and assessments. You may find that with experience, this step feels second nature for you.
If you received information from a referral source, or any documents that your client was asked to complete beforehand, now would be the time to review them. This information can provide you with a basic sense of their current challenges and what led to them seeking help. Referral sources can provide valuable information including previous treatment episodes and mental health records. This can help you plan for and navigate your session so that you are able to focus on relevant topics
Common Questions to Ask in Reality Therapy
Reality therapy questions can be used for a variety of purposes. This includes learning information, promoting client engagement, and reviewing skills previously discussed. Examples of reality therapy questions to ask clients are:
- Can you tell me about the people whom you feel supported by?
- What does personal freedom mean for you? Can you share with me your experience with freedom?
- What are some fun hobbies you have?
- Do you have any special interests that keep you busy?
- How often would you say you are able to do something enjoyable?
- How do you feel your work-life balance is? Are there any changes you feel would be beneficial?
- How do you feel loved? How do you show, or express, love to others?
- Can you tell me about your personal goals?
- Tell me your thoughts about your ability to set and stick to personal goals.
- When we talk about being mindful, what does this mean for you?
- Are you able to incorporate any mindfulness practices into your daily life? If not, what are some of the barriers that are keeping you from doing so?
- What benefits do you feel using mindfulness skills can have for you and your mental health?
- If you take a moment to look at the 5 basic needs associated with choice theory, which do you feel is the driving force in your choices?
- Which of the 5 needs do you feel are adequately met in your life?
- Can you describe your ideal life? Tell me about what your family, friends, work, and social life would look like.
- Can you tell me what you are feeling emotionally? How about physically within your body?
- When you have those thoughts, how do you feel?
- Can you tell me your opinion or observation about how your thoughts impact your physical health?
- Do you feel as though your behaviors are helping you work towards your goals?
- Are you happy with the path you have taken in life?
- Do you feel as though you will be able to reach your goals one day? What signs would you see if they are not attainable?
- How will you know when progress is made?
- How committed are you to your current goal?
- Tell me about the person you would like to be.
- Do you believe that?
- How can this be fixed?
- Is what you are doing helping you get what you want? If not, what would be a better action to try?
- When would you like to start?
- What are some characteristics of a healthy relationship? Do you have a relationship that comes to mind?
- Have you thought of a plan to help with this concern?
- If you utilize worksheets in your session, this Needs Assessment Worksheet can help your client assess their different needs. After completing the worksheet, you can ask your client a variety of questions including:
- Was there anything that surprised them?
- Has their initial thought of what need they should focus on shifted?
- What is their “takeaway” from this reality therapy exercise?
- Setting goals can be an important component of reality therapy. It is important that when clients are setting goals for themselves their goals are realistic and attainable. For some, using a SAMICCC Goals Worksheet can help them assess their goals. Reality therapy questions to ask clients after reviewing this sheet can include:
- Did anything surprise you while you were using this worksheet?
- What changes can you make to your goal to improve it?
- Are you committed to this goal?
Final Thoughts On Asking the Right Questions in Reality Therapy
Thank you for taking the time to read our reality therapy questions! We recognize that as clinicians, we each have individual differences and preferences that can impact how we approach our work. The diversity found among professionals is a strength within the counseling field because we are able to help more people than if we operated with a cookie-cutter approach.
When it comes to your first session with a client, your primary focus will be on developing the therapeutic alliance and learning about their current challenges. Depending on your clinical setting, you may have the opportunity to space your initial assessment out over more than one session. If you are using reality therapy in your work, it can be helpful for clients to know a bit about how this will impact their sessions and work with you.
If you have an interest in learning more about reality therapy and its benefits, we encourage you to look into related Continuing Education credit and training opportunities available to you. Both of these opportunities can help you build your competence with reality therapy so that you can apply it to your clinical work.
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Reality therapy. GIFCT. (n.d.). https://wglasser.com/reality-therapy-2/