What is reality therapy?

Reality therapy is a therapeutic approach that focuses on problem-solving and making better choices in order to achieve specific goals. Developed by Dr. William Glasser, reality therapy is focused on the here and now rather than the past.

The goal of reality therapy is to solve problems, rebuild connections and begin working toward a better future. The therapist works with the patient to figure out what they want and how their current behaviors are bringing them closer (or farther) from their goals.

Central to reality therapy is a trusting relationship between patient and therapist that strives to make the patient feel safe, heard and respected. This relationship is nurtured by finding healthier ways for patients to get their basic needs met. These needs include:

  • Love and belonging
  • Power
  • Survival
  • Freedom
  • Fun

Together, therapist and patient explore the ideal solution to problems and lay out the steps to make those solutions a reality. They also make an honest evaluation of the patient’s current choices and behaviors to determine whether change is needed to achieve the patient’s goals. Throughout the process, emphasis is placed on those actions and thoughts that are within the patient’s control rather than blaming or trying to control others.


Reality therapy is a highly effective way to solve problems and set and achieve goals. With an emphasis on changing thoughts and actions, reality therapy empowers individuals to improve the present and future. As the patient begins to experience small successes their confidence improves, allowing for more advanced goal-setting and problem-solving.


Because reality therapy focuses on problem-solving, it can be effective for a variety of mental health disorders, including addiction and eating disorders. It is particularly useful for at-risk or resistant teens struggling with substance abuse, defiance, manipulation, and other emotional and behavioral issues.

by McKayla Arnold