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Traditional Intervention Strategies

Conventional counseling and therapy in the past often meant a long-term commitment for clients and counselors. Building rapport, obtaining and documenting a case history, and allowing appropriate catharsis and insight constituted the focus of traditional counseling and therapy. Out of these dynamics, client change would gradually develop. Reality therapy is based on different premises. Clients are encouraged to take action in an effort to satisfy their five needs regardless of their history or insight, or even whether they feel good about taking action. In fact, reality therapy had been criticized as merely a short-term problem-solving method. Although reality therapy can be used as a long-term method, the goal is to help clients improve rapidly.

Brief Intervention Strategies

The methodology used in reality therapy consists of establishing an appropriate environment or psychological atmosphere and then applying the procedures that lead to change: the WDEP system. Together these constitute the cycle of counseling (see Figure 12.1). This cycle illustrates that the specific interventions summarized as WDEP are built on a trustful relationship. Trust-destroying and trust-building ideas (see "Tonics" and "Toxins" in Figure 12.1) are listed. The process is described as a cycle because there is no single place to start when it is applied to clients. Counselors need to use their creativity to match the system to each client.

Create a Positive Environment

An atmosphere that provides for the possibility of change is characterized by specific guidelines and suggestions about what to do and what to avoid. These are designed for use by counselors, therapists, and case managers as well as supervisors and managers in the workplace. They can also be taught to clients, parents, teachers, and others for use in improving their interactions with clients, students, employees, and children. The specific applications vary slightly, but the principles are quite consistent.

Among the behaviors toxic or deadly to human relationships are arguing, blaming, criticizing, demeaning, colluding with excuses, finding fault, and giving up on the relationship. The alternative to the quicksand of toxic or deadly behaviors is the effective use of the WDEP system. Asking about wants or goals quickly replaces endless and ineffective discussions. These procedures apply to persons from virtually any ethnic, religious, or cultural group. In speaking of this universal applicability, Jusoh and Ahmad (2009) stated, "The WDEP procedure can be used universally with the aspect of religion and culture.... WDEP in the counseling process (is) similar to Islamic concepts" (p. 3).

Cycle of of Counseling

Figure 12.1. Cycle of of Counseling

Note. Adapted by Robert E. Wubbolding from the works of William Glasser. Copyright 1986 by Robert E. Wubbolding (17th Revision, 2010). Reprinted with permission.

Cycle of of Counseling (Continued)

Figure 12.1. Cycle of of Counseling (Continued)

Note. Adapted by Robert E. Wubbolding from the works of William Glasser. Copyright 1986 by Robert E. Wubbolding (17th Revision, 2010). Reprinted with permission.

In the early stages of the development of the reality therapy delivery system, the advice was to never give up. A more realistic formulation is for a counselor to stay with the person past the time he or she expects to be abandoned. In other words, do not give up easily. Similarly, the counselor might be tempted to give up on the WDEP system if it

fails to render the desired results immediately. Wubbolding (2011) emphasized that this is because the principles appear to be easy to practice, in view of the fact that the vocabulary is uncomplicated. Yet proficient use of the skills requires repeated practice and supervision.

A positive environment, the basis for the WDEP system, not only is built on avoiding the uncongenial behaviors of arguing, criticizing, or giving up but also rests on tonic behaviors such as the global admonition to "be friends" in a professional manner. These efforts to establish an agreeable and harmonious atmosphere are sustained and nourished by the use of intervention strategies or tonic behaviors such as attending behaviors described by Ivey, D'Andrea, Bradford Ivey, and Simek-Morgan (2002). The acronym AB-CDEFG summarizes additional interventions: "Always be – courteous, determined, enthusiastic, firm, and genuine." Other tonic behaviors include the following.

Suspend Judgment

As stated earlier, all behavior is a person's best effort at a given time to fulfill his or her needs. Consequently, a counselor who keeps this principle in mind can more easily see quite harmful choices from a low level of perception, without approval or disapproval.

Do the Unexpected

Unpredictability is a quality that facilitates a helpful counseling or psychotherapy environment. Focusing on a strength, a success, or a time when the client felt good often generates the type of discussion that clients do not expect. Nevertheless, clients who are characterized by negative symptoms also, at least occasionally, choose positive symptoms (Wubbolding, 2008a, 2009). Therefore, it is helpful to discuss in detail the circumstances when clients chose effectively, felt good, and remained in effective control of their lives. Wubbolding (1984, 2000, 2011) described other ways for doing the unexpected and incorporated paradoxical techniques such as reframing, redefining, and relabeling into reality therapy. However, to be effective using these and other paradoxical techniques, one needs to invert one's thinking. Thus, causes are seen as effects; the objectionable is now a strength (Dowd & Milne, 1986; Fay, 1978; Seltzer, 1986; Weeks & L'Abate, 1982). Wubbolding (1993) stated that a depressed child can be seen as pensive, gentle, and thoughtful. An angry child can be outgoing with deep conviction. The bully is a leader and has ambition, whereas a submissive child is kind and cooperative.

Use Humor

A healthy and democratic sense of humor is a curative factor for the mental health specialist. Comedian and pianist Victor Borge once remarked that laughter is the shortest distance between two people.

Be Yourself

Though it is to be expected that students learning counseling skills will adopt the style of their teachers or that of the leaders in each theory, they also need to adapt the skills that fit their own personality and core beliefs.

Share Yourself

The creation and maintenance of a trusting relationship is facilitated by appropriate self-disclosure. According to a Swedish proverb, "A joy shared is twice a joy. A sorrow shared is half a sorrow." Although self-disclosure by a counselor can be helpful, it is best used moderately.

Listen for Metaphors

Metaphors in this context are figures of speech, analogies, similes, and anecdotes that serve to quantify problems and thereby make them manageable. Their judicious and careful use by counselors can provide clients with more behavioral choices. Kopp (1995) warned: "As with all potentially powerful therapeutic interventions, these metaphor methods require sound clinical judgment" (p. 5). Also, stories and anecdotes can be humorous and thus help clients perceive their problems and decisions in a different light. Metaphors used by clients are often overlooked by counselors, or they are paraphrased. It is better, however, to use the metaphor, to extend it, and to return to it in subsequent sessions (Wubbold- ing & Brickell, 1998). The following metaphors might be stated by clients or initiated by counselors and therapists: “I feel like a floor mat" or "I feel like I'm on a merry-go-round." Using these metaphors, the counselor or therapist can offer clients specific choices, such as "Would you like to get off the floor?" "Do you want to get off the merry-go-round?" and "What would you be doing today if you were on solid ground, away from the merry-go- round?" As with all such techniques used to enhance the counseling environment, metaphors do not constitute the essence of reality therapy. They do serve, however, to build trust between the client and the counselor.

Listen for Themes

Tying together the ideas, feelings, and actions of clients helps them to gain a sense of direction and control. The practitioner using reality therapy listens carefully for themes, such as previous attempts to solve problems, wants that are fulfilled, and what has helped and not helped the client. This technique is not exclusive to the practice of reality therapy, but in using it the counselor listens for themes that are linked to the WDEP interventions (see "Utilize Procedures: The WDEP System").

Summarize and Focus

Similar to the identification of themes, this technique helps the counselor listen carefully and communicate to clients that they are being heard. Unlike summaries used in other theories, this one concentrates on components of the WDEP system. A counselor might summarize a client's statements by responding, "You've stated that you've tried to get a promotion at work and been unsuccessful, that you've approached your boss and described what you want, that you've put in extra hours. Nothing so far has gotten you what you want." The counselor has summarized what the client has done that has not worked and has omitted many other details.

Focusing means to center the conversation on the client rather than on outside forces over which neither involved party has control. Very little can be done to cause changes in other people. Nothing can be done to change the past. Thus, it is most helpful if the counselor gently and positively assists clients to discuss their own here-and-now wants, total behaviors, plans, hopes, frustrations, and perceptions.

Allow or Impose Consequences

Professional counselors have fewer opportunities to use this element of the environment than those who wish to integrate reality therapy into their work. Probation and parole officers, halfway-house workers, and others often function in a supervisory role and are required to impose consequences. It is assumed that the consequence is reasonable and not punitive, and also that it is imposed to help rather than merely control the client.

Allow Silence

The use of silence in reality therapy, if timed properly, allows the client to conduct inner self-evaluation, reassess wants, think about what is controllable and, therefore, uncontrollable, and in general take responsibility for the direction of the session.

Be Ethical

The American Counseling Association's (2005) ethical principle concerning serious and foreseeable harm (B.2.a) is one of many that the practitioner of reality therapy practices. A trusting relationship and a professional atmosphere conducive to helping are built around solid ethical principles. Anyone using reality therapy properly knows, understands, and practices the ethical standards of various professional organizations. Professional disclosure is often required, as in Ohio (State of Ohio, 2009). Thus counselors, therapists, and social workers must provide clients with a written description of their professional qualifications. Wubbolding (1986) and Wubbolding and Brickell (2005) emphasized that counselors and therapists should provide clients with information about the nature of reality therapy. These details help clarify the boundaries of the relationship as well as the advantages and limitations of the assistance that the practitioner can offer. Wubbolding (1990) also emphasized the importance of knowing how to assess suicidal threats and how this assessment is used in the practice of reality therapy. Informed consent, dual relationships, confidentiality, proper record keeping, and maintaining competence are among the many ethical issues impinging on the relationship between counselor and client. Remley and Herlihy (2010) stated, "Professionals individually determine the limits of their competence and practice accordingly" (p. 170).

Be Redundant or Repetitious

Often the same questions are asked in various ways. When a client is defensive and offering excuses in the form of denial, the counselor or therapist sometimes repeats the same question in a different way. It becomes a theme aimed at helping clients evaluate their own behavior. "When you made that choice, did it help?" "Did it work for you?" "What impact did that action have on you and on others?" "Did it help you enough?" "Was the action the best you were capable of ?" Such questions asked at various times become a haunting theme that gradually and supportively lessens denial and facilitates the clients' assumption of responsibility. Yet like the overall art of counseling, the skill of being redundant is developed through practice and self-evaluation.

Create Suspense and Anticipation

In a counselor's effective use of reality therapy, there can be an element of drama. A counseling session should be a significant event in the lives of clients. An authentic buoyancy on the part of the counselor and a desire to reassure can elicit a feeling of curiosity and a sense of impending success. The ability to communicate a sense of optimism is an advanced skill and is developed with practice and training.

Establish Boundaries

There are limits within which a counselor operates, and these should be clarified. The ethical principle of dual relationships is clearly part of boundary classification (Herlihy & Corey, 2006). Further, the client might wish to shield certain areas from discussion. A useful question for counselors or therapists to ask is, "Is there any topic you would prefer we not discuss?" Such questioning empowers clients to choose what they want to work on. If clients have numerous topics that are forbidden territory (which is rarely the case), the counselor can ask them if it is helpful for them to conceal or mask potential topics. In any event, the wishes of the client are paramount and are respected.

The above-mentioned guidelines are designed to help the counselor using reality therapy to establish rapport, mutual trust, and a safe atmosphere in a brief and efficient manner. They also consist of swift and positive interventions facilitating the client's expectation that the experience is worthwhile and significant. These environmental building blocks aimed at establishing and deepening the relationship provide a fundamental prerequisite for what is essentially the practice of reality therapy: the WDEP system.

Utilize Procedures: The WDEP System

The specific interventions that are the essence of reality therapy are based on the trusting relationship described earlier as environment. The procedures or determinations (Wubbolding, 2011) are most appropriately formulated as the WDEP system as described in

Figure 12.1 (C. Glasser, 1996a, 1996b; W. Glasser & Glasser, 2008; Wubbolding, 1989, 1991, 2000, 2009, 2011; Wubbolding & Brickell, 1999, 2005). They should not be seen as steps to be used sequentially or mechanically. And although they are described in simple, jargon- free language, they can be difficult to implement. For instance, a counselor working with a student referred for a school discipline problem would probably not begin with a lengthy discussion of W (wants) but rather with an exploration of D (doing): in other words, what happened to bring about the referral? Thus, in conceptualizing the entire process, it is useful to see it as a cycle that can be entered at any point.

W: Discussing Wants. Nppds. and Perceptions

Because human beings are motivated to fulfill their wants and needs, it is important for the counselor or therapist to take the time to explore the specific wants of the client. The questions might include, "What do you want from your spouse? From your school? Your job? Your career? From your friends? Your parents? Your children? Your supervisor? From yourself? What do you want from me? From your religion?" Thus, there are at least 11 generic questions that can be asked. These are multiplied threefold if the counselor asks more precisely about each category: (a) "What do you want that you are getting?" (b) "What do you want that you are not getting?" (c) "What are you getting that you don't want?" The areas for exploration and clarification become almost endless when the counselor or therapist adds, "How much do you want it?" "What would you need to give up to get what you want?" "What will you settle for?"

All wants are related to the five needs: belonging, power or achievement, fun or enjoyment, freedom or independence, and survival. Therefore, it is useful to help clients link their wants explicitly to their needs by asking, "If you had what you wanted, what would you have?" or "If your wants were met, what would that satisfy inside?" Such questioning of a parent often elicits the following: "I want my child to keep the curfew, get good grades, stay away from drugs, do the house chores, and be pleasant to the rest of the family. If I had that, I would have peace of mind. I would know that I am a good parent." The parent has specific wants and has identified the underlying need: achievement or power.

Discussing perceptions is also an important part of W. Questions about clients' perceptions are slightly different from those specifically relating to wants. Wubbolding and Brickell (2009) stated, "Helping clients, students and institutions raise their awareness of and evaluate the contents of their perceived worlds plays a crucial role in assisting them to take better charge of their behavior, direction and destiny" (p. 50). A parent might be asked, "What do you see when you look at your child?" Asking about perceptions is especially useful in groups and in family counseling because arguments can be prevented. A counselor can intervene by reminding all present that they are discussing their viewpoints – what they see, not what "is."

Part of the W of the WDEP system is eliciting a commitment to counseling. Change and growth will occur only if the client is committed to making changes in his or her actions. Thus, it is imperative that the counselor discuss the client's level of commitment to the process and its outcomes. The question "How hard do you want to work at changing your situation?" gives the client an opportunity to look inward and reflect on the degree of responsibility he or she wishes to assume.

Wubbolding (2000, 2009, 2011) identified and developed five levels of commitment as described by clients.

1. "I don't want to be here." This statement dearly illustrates that the client is at best reluctant and often resistant.

2. "I want the outcome, but not the effort." This level indicates that the client does want to change and is perhaps willing to gain effective control and take personal responsibility.

3. "I'll try; I might." Trying to make a change for the better constitutes the middle level of commitment to change. Still, trying to get out of bed early is not the same as doing it.

4. "I will do my best." At this level, a person goes beyond trying and commits to specific action. However, such a commitment still allows the possibility of failure.

5. "I will do whatever it takes." The highest level of commitment represents an outcome centered on a no-excuses level of commitment.

The levels of commitment are developmental. The higher levels are more helpful than the lower ones. Yet for some clients, "I'll try" is a major improvement. They should not be pushed too vigorously or too quickly to move to a higher level. Rather, the skillful counselor helps clients evaluate their level of commitment and gently leads them to the next level.

D: Discussing Behavioral Direction and Doing (Total Behavior)

The counselor helps the client review his or her overall direchon by inquiries such as "Where do you think you're going if you continue on the same path?" The exploration of the overall direchon is only the embarkation point for further questioning about current total behavior. More hme and effort are needed to help clients examine their specific actions. The counselor helps the client verbalize exactly what he or she did for a specific amount of time.

E: Helping Clients Conduct Evaluations

In the cycle of counseling and in the WDEP system of procedures, the element of evaluation occupies the central position (Wubbolding, 1990, 2009; Wubbolding et al., 2004; see Figure 12.1). Like a keystone in an arch, its pivotal place supports the enhre structure. If it is absent, the arch crumbles. The practice of reality therapy is firm and effective to the degree that the counselor assists clients in evaluahng their own behavior, wants, perceptions, level of commitment, and plans. Wubbolding et al. (2004) stated, "through skillful questioning clients ask themselves whether they are living as they want to live" (p. 225).

Because of the prominent place of self-evaluation in the cycle of counseling, reality therapy is properly placed as a freestanding theory with other cognitive theories. It is here, especially, at the cardinal point of self-evaluation, that cognitive restructuring takes place. Clients look inward and examine the effectiveness of their lifestyle and its specific aspects. Only now, when they have concluded that some part of their choice system (wants, behaviors, perceptions) is not helping them or is not as beneficial as it could be, do clients see that a change is necessary and that alternative and more effective choices are available. Because of the curative role of human relationships in reality therapy, many self-evaluation questions focus on the client in relation to others. The central questions focus on whose behavior can clients control and whether their lifestyle brings them closer or farther away from the people around them (W. Glasser, 2003,2005).

More specifically, evaluation contains the following elements:

1. Evaluation of behavioral direction. After helping clients describe their overall life direction, the counselor asks them to judge whether their overall direction is in their best interest.

2. Evaluation of specific actions. The questions about specific actions are geared to the descriptions provided in clients' explanation of how a specific segment of their day was spent. Did their specific action choices help or hurt themselves or the people around them? Petersen (2005) stated, "The success of reality therapy lies in the client's ability to self-evaluate that present behaviors are not getting him/her closer to what s/he wants" (p. 13).

3. Evaluation of wants. The counselor assists clients in making judgments about their wants by asking such questions as "Is what you want attainable or appropriate?"

4. Evaluation of wants. Not all wants are beneficial to the client or others. Counselors help clients explore the merits, appropriateness, and helpfulness of their wants.

5. Evaluation of perceptions or viewpoints. Rarely are perceptions changed by a simple decision to view a person, a situation, or an event differently, yet they can be changed by altering behavior (W. Glasser, 1980a, 1998; Powers, 1973, 2009). But because perceptions involve what people want, they occupy an important place in the evaluation process. So even though they are not directly changed, their desirability and appropriateness should be evaluated (Wubbolding & Brickell, 2009).

6. Evaluation of level of commitment. Clients are asked to decide whether their current level of commitment such as "I'll try" is efficacious. Will it help them achieve their goals?

7. Evaluation of new direction. As new possibilities unfold for clients, it is useful to help them determine whether those possibilities are need-satisfying. For instance, the rebellious student is asked, "How will cooperation at home benefit you and your family?" "What impact would this approach have on your friends and family?"

8. Evaluation of plans. From the beginning, even miniscule plan making was essential for the effectiveness of reality therapy. In working with a high school student, Wubbolding (1980) was able to help the student make a modest plan of action. This student had shut himself in his room on the weekends with the curtains and drapes closed. Although resistant at first, he eventually made plans to open the blinds and let the light in. He subsequently developed a healthy social life by making rudimentary changes in his overall direction. Thus, the evaluation of plans is based not on whether they solve the basic problem but on whether they address the problem and aim toward the more effective fulfillment of belonging, power, fun, and freedom.

P: Planning

According to one saying, "To fail to plan is to plan to fail." W. Glasser (1980b) stated that plans vary; some are detailed, whereas others are quite simple, Yet he emphasized that "there must always be a plan. People who go through life without some sort of a long-term plan, usually divided into a series of small plans to reach larger goals, are like ships floundering without rudders" (p. 52).

The procedure of planning is often mistakenly viewed as the essence of the practice of reality therapy. Although it is important, it is effective only if based on a client's inner self-evaluation. Plans that are truly efficacious, or at least more likely to be carried out by the client, have at least eight qualities, which can be summarized by the acronym SAMTC3 (Wubbolding, 2009):

S Simple: The plan is uncomplicated.

A Attainable: The plan is realistically doable.

M Measurable: The plan is precise and exact and answers the question, "When will you do it?"

I Immediate: The plan is carried out as soon as possible.

I Involved: The helper is involved if such involvement is appropriate. The involvement is, of course, within the bounds of ethical standards and facilitates client independence rather than dependence.

C Controlled by the client: The plan is not contingent on the actions of another person but is, as much as possible, within the control of the client.

C Committed to: The client is firm about follow through.

C Consistent: The ideal plan is repetitious. A single plan can be a start, but the most effective plan is one that is repeated.

The common denominator to all planning is persistence on the part of the counselor. This coincides with the injunction "Don't give up."

In summary, the cycle of counseling or psychotherapy is a design for understanding reality therapy and an outline for knowing how to apply it. The environment consists of specific recommendations for building a firm but friendly atmosphere in which a client can feel safe and confident while realizing that the counselor or therapist actively seeks to be of help. The WDEP formulation is not a system that is intended to be followed in a mechanical manner but rather a system from which the proper intervention is selected at a given time because of its apparent appropriateness.

Once criticized as a short-term, problem-solving, symptom-focused method, reality therapy provides an effective tool for counselors working in the world of managed care and solution-focused counseling. The goals of the WDEP system include improvement in need satisfaction, especially human relationships; positive and productive living symbolized by employment and other signs; and learning the basics of reality therapy as a range of tools for further use and self-help. Users of reality therapy often aim at achieving measurable results in 10 or fewer sessions.

 
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