Friday, June 7, 2013

Exploring Choice Theory and Reality Therapy

By Allan J. Hirshey

Choice Theory (CT) and Reality Therapy (RT) aren’t exactly household names, nor do they have NLP’s (Neuro-Linguistic Programming) mystique.  The “brainchilds” of psychiatrist, William Glasser, RT and CT first entered the cognitive behavior psychology scene in the early 1960’s. CT is Glasser’s theory of human behavior psychology - that we choose our behaviors to satisfy five basic internal generic driven needs (survival, love and belonging, power, freedom, and fun).  RT is the counseling process of CT.  Or simply put, CT is the “track” that guides RT, and RT is the “train” that runs on the CT “track.”
  
RT began in the early 1960’s at the Los Angeles Veterans’ Hospital, where Glasser was doing his residency in psychiatry. There, he became frustrated with low staff morale, and low patient recovery and discharge rates, blaming them on the facility’s practice of conventional (Freudian) psychoanalysis. Encouraged by his mentor, the renowned psychiatrist, D.L. Harrington, Glasser experimented with his own treatment philosophy and approaches. As a result, patient recovery and discharge rates increased, and a new form of therapy, RT, was born.

What are the differences between CT/RT and conventional (Freudian) psychoanalysis?  CT/RT reject the following Freudian principles: the existence and treatment of an identifiable mental illness; the “transference” concept, which elevates the psychiatrist to a “guru” role, while degrading the patient to a “follower” figure; probing into a patient’s childhood to uncover past mental inadequacies; “carte blanche” acceptance of immoral (patient) behavior; and the absence of teaching patients new and healthier behavior options for present and future needs.

CT is based on an earlier engineering known as Control Theory (COT), a system of brain control, developed by a scientist, William T. Powers. COT posits that the human brain functions like a thermostat/furnace, seeking to regulate its own behavior, in order to change and adjust to the world around it.  Glasser later expanded COT by adding his behavior theory (five needs), and then adapted it to the clinical and educational settings. His prior chemical engineering background made this adaptation possible. In 1996, he changed Control Theory’s name to “Choice Theory,” to distinguish his revised expanded version from Powers original engineering concept, and because CT posits that we choose our behaviors.  

CT is built on three important CT concepts - “total” behavior, the “quality world” (QW), and the “perceived world” (PW).  Throughout life, we continuously store a collection of specific want related needs in our inner minds. They are specific mental pictures of people, treasured possessions, and life experiences that are need satisfying. Moreover, they are extremely pleasurable, appealing, and high quality. The conglomeration of these pictures is the world a person wants to live in, his/her “Shangri-La.”  In CT lingo, this is called the “quality world” (QW).

During our lives, we also accumulate thousands of perceptions which are stored in the brain’s PW.  CT posits that our perceptions provide us with our inner reality - they are how we see the world.  Furthermore, we continuously seek perceptions (PW) to determine if what we want (QW picture) we are getting from the outside world (environment). Initially, the brain tells us what specific inner want (QW picture) needs to be satisfied.  Subsequently, we choose a behavior (interact with the environment) to get a desired perception (PW) or input to satisfy the specific inner want (QW picture). 

The desired perception, an outside experience or event, is then inputted into our sensory system (skin, eyes, ears, nose, and mouth).  Next, it flows through the brain’s perception system, where it’s processed by the knowledge filter, followed by the value filter. If the knowledge filter recognizes the perception, the value filter assigns it either a positive or negative value. A positive valued perception means that a person perceives (PW) that what he/she wants (QW picture) they are getting from the outside world. The need is met. 
 
Conversely, a negative valued perception means that a person doesn’t perceive that what he/she wants they are getting from the environment. Thus, the PW and QW picture don’t match, they are unaligned. Therefore, the gap (frustration) between the PW and QW picture motivates the person to interact again with the environment to close the difference. Glasser further posits that behavior is the paramount activity we do from birth till death. Moreover, he terms behavior “total”, because in addition to the doing aspect, there are three other elements - thinking (rationalizing and fantasizing), feeling (stressed-out, happy, etc.) and physiology (breathing, digesting. etc.).

For example, I need to lose a lot of weight, so I enroll in Weight Watchers. Three weeks later, my bathroom scale indicates significant weight loss.  My behavior is total, analyzed as follows: thinking (self-talk - “I want to lose weight”); doing (enrolling in Weight Watchers); physiological (dieting); and feeling (personal satisfaction and comfort of losing weight). Thus, the positive perception (PW) of what I have (less weight) matches what I want (QW picture), to be slimmer.       

CT posits that prolonged and unfulfilled intensive inner wants can cause irrational behavior - addiction, juvenile delinquency, and suicide. Worse yet, irrational behavior can infringe upon other peoples’ rights - bodily injury, property damage, and child/spousal abuse. Glasser further theorizes that love and belonging is the most critical need - being disconnected from this need is the primary cause of mental illness. However, he accepts mental illness as causing irrational behavior, but only if a pathologist verifies the existence of organic mental disease.   

In a nutshell, the application of the RT process involves a sequence of questions, followed by the development of a client “work out” or rehabilitation plan. The therapist first asks the client what he or she wants (QW).  Next, the client is asked what he or she is doing (behavior) to get what they want. Then, the client is asked if his/her current behavior is getting them what they want. Assuming that the client acknowledges needing help to satisfy certain unfulfilled needs, he/she agrees to work with the therapist to developed a realistic “workout plan. ” They work together on a “level playing field” basis.  Moreover, the therapist doesn’t probe into the client’s childhood, because RT posits that the client isn’t limited by whatever happened in the past.      

Since the early 1960’s, RT/CT have grown out of the therapist’s office into other areas such as the business world (lead management) and marriage counseling.  Moreover, Glasser’s interests in child psychiatry and schooling also led him to formulate CT/RT to fit the educational setting. In this connection he posits that alienated/at risk youth don’t experience the same amount of need satisfaction as their successful student peers.  Therefore, his vision of a “quality school” (QS) is an institution providing alienated/at risk youth with a sense of safety, belonging, self-worth, freedom, and fun (five basic needs). To this end, he encourages teachers, parents, and school principals to take CT classes in classroom and student behavioral management. 
   
Furthermore, Glasser strongly nixes external control psychology (“my way or the highway”). Instead, QS students are empowered to openly discuss discipline, behavior, and related issues without fear of intimidation. However, QS teachers can openly confront misbehaving students requiring them (in writing) to evaluate their behaviors. During this process, they follow Glasser’s formal “nine step” question and evaluation guidelines. But continuous misbehavior isn’t unlimited - it can lead to expulsion.    

Interestingly, the Sudbury School model, a QS byproduct, allows its students to decide how to spend their day.  Some QS classroom management strategies include dividing students into small academic teams, the circular desk classroom configuration, and the “castle” or “let it all out and then leave it place.” The latter is an isolated area set aside for students experiencing attention and behavior difficulties. And under Glasser’s “quality curriculum,” high school students majoring in technology and the vocational arts can elect to skip studying Shakespeare.   

In conclusion, Maslow’s and Glasser’s five needs are somewhat similar. In both cases, their physiological and love and belonging needs are the same. But whereas Maslow’s needs are hierarchical, Glasser’s needs are all considered equal, like legs balancing a chair.

Does Glasser’s QS concept work, or is it ”pie in the sky”?  Is it the teacher’s responsibility to ensure that students “ain’t misbehavin”?  Is the Sudbury School model’s basic “spare the rod and spoil the child “approach realistic?  Past studies conducted on several secondary QS programs have indicated progress in student behavior and academic achievement. However, those studies were inconclusive. So the “jury is still out” on the effectiveness issue. Secondly, there’s the matter of the cost issue. The past studies previously mentioned were conducted on specially funded QS programs during the 1990’s, when the U.S. economy was more robust. Absent private philanthropy, it’s doubtful today that the average U.S. public school system can afford to pay for more evaluations or finance new QS programs.

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A retired financial analyst, Allan has been living in Israel for eight years. Writing social science articles, learning part-time in a yeshiva, voluntary tutoring and counseling, and playing tennis take up most of his time.