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Understanding Reality-Based Therapy for Addiction

Reality-Based Therapy for drug addiction is increasingly becoming an effective part of programs designed to help people overcome substance abuse or alcohol problems. This type of therapy is distinct from other therapies in a number of ways, including maintaining a focus on the present and future, the near-avoidance of the past, and purposeful but gentle questioning that is designed to elicit logical answers that – ideally – will compel an action to change. Applied properly, reality based therapy for addiction will seek to mirror environments that an addict will normally be exposed to. This combination of psychoanalytical and real-world approach has resulted in many recovery successes and shows significant promise for the long term future of drug addiction treatment.

One striking problem with Reality-Based Therapy is that the term is often used arbitrarily by those in the health care fields with the assumption that patients or clients understand its meaning. The fact of the matter is that for most individuals the term amounts to nothing more than industry jargon and may impair a patient’s ability to understand their treatment program effectively. Therefore, developing an understanding of what this type of therapy is and how it works related to drug addiction treatment is essential for both therapists and recovering addicts or alcoholics.

Reality-Based Therapy is A Simple Concept

Reality-Based Therapy is a surprisingly simple concept but one that can be difficult to describe and apply. The therapy was developed by therapist William Glassner. The WikiEd entry for Reality Therapy attempts to summarize what the therapy sets out to accomplish:

“The bare bones of Glasser’s theory are that people are required to live in a world full of other human beings, and every individual must learn to satisfy his own needs in a way that does not encroach upon on another person’s needs.” And; “Reality therapy attempts to help people control the world around them more effectively so that they are better able to satisfy their needs.” (1)

In many cases, control is what substance abuse is really all about. People use drugs or alcohol because they don’t feel in control of their lives, or they use in order to control emotions, thoughts, boredom, pain, loneliness, mental illness and other personal issues. In lay terms, reality therapy helps people to reach a medium ground between being in control of what they are able to control, and accepting that some things will remain out of their control – especially other people. This an extremely effective treatment modality because it forces recovering addicts to take responsibility for precisely the actions and behaviors they have control over and nothing more – a traditionally difficult task in a demographic that suffers inherently from denial issues.

Reality therapy helps to keep patients focused by addressing issues that the addict or alcoholic can control now and in the future. The general idea here is that the past is gone and out of control of the patient and that at no time should events that are in the past be allowed to control events or behaviors in the present or future. The Wikipedia entry on reality therapy states:

“While traditional psycho-analytic and counseling often focus on past events, reality therapy and choice theory solutions lie in the present and the future. Practitioners of reality therapy may visit the past but never dwell on it. In reality therapy, the past is seen as the source of our wants and of our ways of behaving, not as a cause. This is because it is our present perceptions that influence our present behaviour and so it is these current perceptions that the reality therapy practitioner helps the client to work through.” (2)

This type of addiction treatment therapy relies on a working relationship between patient and therapist that seeks to uncover the most important relationships in the life of the patient and set about developing a plan to reconnect and improve them. In cases where patients have lost all of their human connections and relationships a primary focus of the therapy will become to help the recovering addict develop new ones. This is a critical part of reality therapy, as Glassner’s main operating principle of the therapy was that people are intrinsically seeking human connections above all else.

Eliciting this type of response from someone in the throes of Post Acute Withdrawal Syndrome is a difficult task that can only be carried out by a therapist who is fully versed in reality therapy as it is applied to addiction and alcoholism treatment. There are a number of ways to achieve success with this type of therapy, but one of the most effective of those is to allow the patient to come to their own logical conclusions:

Reality-Based Therapy Hotline 1-800-706-9190

“By posing questions that have only realistic answers, a patient will be able to uncover for themselves the true nature of their drug and alcohol use. These questions seek to obtain a complete picture of what is happening in the client’s life by guiding the client away from the problem and looking instead at potential resolutions to the problem.” (3)

According to Glassner, there are a number of specific points that therapists must address in order to achieve success with reality based therapy for addiction. This includes:

  • Focus on the present
  • Avoid discussing symptoms and complaints
  • Focus on what patients can do directly – think and act
  • Avoid criticizing, blaming and/or complaining
  • Remain non-judgmental and non-coercive
  • Teach patients that excuses stand in the way of making needed human connections
  • Focus on specifics (4)

In addition to these specific points, many addiction treatment programs use reality based therapy on a more down-to-earth level. This includes providing service and therapy to patients in the same environment that they live in and gently forcing them to take responsibility for their own lives while in treatment. By requiring patients to cook and clean for themselves, to attend appointments and to shop, an environment is created that will closely mimic the real world that the patient will return to when treatment is over.

To learn more about how reality based therapy can help you or a loved one beat the disease of addiction forever, call the number at the top of your screen now.

(1) WikiEd Reality Therapy, William Glassner
(2) Wikipedia Reality Therapy
(3) Davis, Debbie Reality Based Addiction Treatment
(4) The William Glassner Institute Reality Therapy

About The Contributor
The editorial staff of Recovery First is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More