Uses in Addictions

Reality Therapy has been used extensively in addictions treatment since the early 1970’s and particularly in North America where it had been widely used in conjunction with the, highly regarded, Minnesota Model of treatment plus other treatment programmes that also used the ‘Twelve Steps’ of the Anonymous Fellowships. This does not mean that Reality Therapy as a method was (or is) linked to the ‘Twelve Steps’ in any formal way, only that it is a method that has been successfully integrated with such programmes.

Applicability to Addictions Treatment

Reality Therapy is highly applicable to addictions counselling and treatment for the following reasons:

  1. There is a necessity for a very focused counselling approach, particularly in the earliest stages of recovery, whereby possibly life-threatening substance abuse behaviours can be confronted and issues of denial can be addressed. Without the need for an aggressive or forceful approach by the counsellor, Reality Therpy’s questioning style and adherence to personal responsibility can provide a very necessary focus on the client’s current (total) behaviours and, in the first instance, help them curtail their drinking, use of drugs, or other addictive behaviours such as gambling, eating disorders, worksholism, sex and love addiction, or even compulsive helping.

  2. The delivery system of Reality Therapy is readily applicable to the processes and approaches used in the vast majority of treatment programmes, and so can be readily integrated. This is the case whether such counselling or treatment modality is conducted in groups or in one-to-one counselling, or indeed, as is usually the case, some combination of the two.

  3. Reality Therapy, as a counselling approach, remains highly applicable throughout all stages of recovery (as described by Gorski, 1989, and Prochaska et al, 1992). That is, from the earliest stages, where the person begins to recognise they have problems with chemicals or other addictive behaviours, through to both ‘maintenance’ (of sobriety or abstinence) and relapse prevention, where the ability of people in recovery to meet their basic needs effectively and continuously will correlate strongly with their risk of relapse or success in sobriety.