Reality therapy is a form of counseling that views behaviors as choices. It states that psychological symptoms occur not because of a mental health condition, but due to people choosing behaviors to fulfill their needs.

A reality therapist’s goal is to help people accept responsibility for these behaviors and choose more desirable actions that enable them to connect with others.

Dr. William Glasser developed this method in 1965. He used reality therapy in psychiatric hospitals, prisons, and jails. Glasser has written many books on the subject, and the William Glasser Institute still teaches his methods today.

Though there hasn’t been much research into the effectiveness of reality therapy, it’s practiced in many cultures and countries. However, members of the psychiatric community have criticized reality therapy, as it rejects the concept of mental health conditions.

In this article, we’ll explore the ideas behind reality therapy, along with its techniques, benefits, and criticisms.

Reality therapy is based on choice theory, which Glasser also created.

Choice theory states that humans have five basic, genetically driven needs called “genetic instructions.” These are:

  • survival
  • love and belonging
  • power or achievement
  • freedom or independence
  • fun or enjoyment

In choice theory, these needs don’t exist in any particular order. But it does state that our primary need is love and belonging, which explains why mental health challenges are often related to relationships.

The theory also states that we choose our behaviors to satisfy unmet needs. And in order to meet these needs, our behavior must be determined by internal forces. If our behavior is influenced by external factors like people or situations, it will result in psychological symptoms.

Reality therapy applies the main principles of choice theory. It aims to help you recognize the reality of your choices and choose more effective behaviors. The key concepts include:


Behavior is a central component of reality therapy. It’s categorized into organized behaviors and reorganized behaviors.

Organized behaviors are past behaviors that you created to satisfy your needs. The therapist will help you recognize any ineffective organized behaviors.

After identifying ineffective behaviors, you’ll work on changing them into more effective behaviors or making completely new ones. These are called reorganized behaviors.

By presenting behaviors as choices, reality therapy can help you better manage your life experiences and actions, according to advocates of the technique.


The choice theory suggests that a person is only controlled by themselves. It also states that the idea of being controlled by external factors is ineffective for making change.

This concept emerges in reality therapy, which states that behavioral choices are determined by internal control. A reality therapist works to increase your awareness of these controllable choices.


In reality therapy, control is closely linked to responsibility. According to Dr. Glasser, when people make poor choices, they are irresponsibly trying to fulfill their needs.

Based on this notion, reality therapy aims to increase your accountability of your behavior.


According to reality therapy, your actions are part of your overall behavior. It also maintains that you can manage your actions. Hence, the therapist will focus on modifying actions to change behavior.

The method involves evaluating your current actions, how well they’re satisfying your needs, and planning new actions that will meet those needs.

Present moment

Reality therapy states that present behavior and actions aren’t influenced by the past. Instead, it claims that current behavior is determined by the present unmet needs. It uses a “here and now” approach to responsibility and action.

You can use reality therapy for many different scenarios and relationships, including:

  • individual therapy
  • family therapy
  • parenting
  • marriage counseling
  • education
  • management
  • relationships with colleagues
  • friendships
  • addiction

Traditional psychiatry and psychotherapy aim to understand the underlying causes of a person’s problems. They also focus on unconscious thoughts, feelings, and behaviors.

Reality therapy, on the other hand, emphasizes the present. The goal is to change current behavior in order to address mental health conditions and improve relationships.

Dr. Glasser believed that disconnects with others are at the core of a person’s dissatisfaction and often mental and physical symptoms.

Additionally, reality therapy rejects the idea of mental illness. Dr. Glasser believed that people aren’t mentally ill, they just choose inappropriate behaviors to satisfy their needs instead.

Not all health professionals accept reality therapy. Some criticize it due to its:

  • Opposition of mental illness. Dr. Glasser claimed that mental illness doesn’t exist, which has received pushback from the psychiatric community.
  • Potential to impose views. A reality therapist helps people develop new actions. Some say this allows the therapist to impose their values and judgments.
  • Anti-medication stance. Dr. Glasser stated that medication is never required to treat mental health conditions. Critics say he could have mentioned the benefits of conventional therapy over drugs, instead of dismissing them entirely.
  • Disregard of the unconscious. Some people say that reality therapy fails to recognize the power of our unconscious.
  • Limitation to the present. Reality therapy doesn’t aim to understand past conflicts, unlike traditional forms of therapy.

Reality therapy involves different techniques to change your current behavior. Some examples include:


A therapist will use self-evaluation techniques to help you recognize your present actions. This serves as a foundation for planning new actions.

They might ask questions like:

  • “What are your perceptions of the goals you’ve achieved and those you haven’t?”
  • “Are your current goals realistic?”
  • “How willing are you to make a change?”

Typically, a therapist will repeatedly use this technique throughout your sessions.

Action planning

After self-evaluation, your therapist will guide you through action planning. The goal is to plan new actions that better serve your needs.

Generally, these actions are:

  • simple
  • specific
  • measurable
  • attainable
  • focused on results, rather than the action to be avoided
  • immediate or time-limited


In reframing, a therapist expresses a concept in a positive or less negative way. This can help shift your mindset from problem-focused to solution-focused.

For example, you might say that you can’t stand being disrespected by others. A reality therapist may relabel the problem and say, “Feeling respected by other people is important for you.” This helps you find solutions within problems.

Behavioral rehearsal

Behavioral rehearsal involves practicing appropriate social behaviors. For example, your therapist might have you imagine or talk about these behaviors. Or, you might act out the situation with your therapist.

When the situation happens in reality, you’ll be prepared to respond with the appropriate behavior.

Seek a licensed mental health professional who is trained in reality therapy. This could be a:

You might ask for referrals from your doctor or a trusted friend. Be sure to look at their credentials and consider online reviews. Importantly, always choose someone you feel comfortable talking with. If you don’t connect with the first therapist you contact, reach out to another.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

Was this helpful?

Reality therapy views behavior as a choice. It’s based on taking responsibility for these choices and choosing more effective actions. This is said to help with psychological symptoms and mental health conditions.

However, due to its nontraditional approach, reality therapy has received a lot of criticism.

If you’re interested in this method, be sure to work with a therapist who is professionally trained in reality therapy.