Reality Therapy – Section I

Introduction Overview

Client is a 64-year-old twice divorced, unemployed black woman, just recently experiencing the “empty nest” syndrome. In 1975, client had one goal…graduate and join the Air Force. Her entire future was dependent upon getting her wings. She failed to get in. Devasted, with out contingency plans, she was forced to work in a factory. But, what “forced her”? The client’s plan lacked assumptions, “What if…?”. Therefore, she found herself in a vacuum, with no way to escape.

She could have gone to college, but instead “chose” to work in a factory. Choice. What was the motivation behind that choice? Was it based on her negative inner emotions of inadequacies caused by her upbringing? Reality therapy could have possibly changed the course of client’s life.

In William Glasser’s Professional Counseling and Dr. Glasser: A Relationship Based on Reality and Choice, he referred to the process of reality therapy as “steps”: ‘be friends, discuss current behavior, conduct self-Assessment, make plans, use no excuses, do not punish, and do not give up’” (Wubbolding, 2015).

We will use Glasser’s WDEP (Wants, Doing, Assessment (of self), Planning) system of reality therapy in the following sessions to guide the client into the present, explore her choices and subsequent actions, work collaboratively to devise plans to help her move forward into the future, self-evaluate her fears, identify her strengths and weaknesses, focusing on her strengths, and collaboratively set small goals to complete outside of counseling to instill confidence in what she can do. Success is contingent upon these factors.

The client has been a homemaker most of her life, with various in-between low paying jobs. Her family gave her a sense of purpose, and now that they have all moved away, 90% of her time is spent in isolation. She identifies herself as being socially inept and suffers with negative emotions stemming from early childhood experiences. She confided to her only friend that she views life as a hopeless journey. Her friend suggested that she seek counseling.

The client is the product of a blended family with aunts, uncles and cousins living together. Her mother left her when she was barely a year old. She never knew her father. She currently lives in public housing because she chooses not to live with her adult children. She doesn’t own a car, which adds to her immobilization. She rarely has visitors from her peer group, only her grandchildren. On rare occasions she accompanied her friend, who has an active social, to a restaurant for dinner. Joanna states that she feels isolated from the external world.

The client’s mother moved up North, leaving the client with her grandmother. She had one older sister, who treated the client abhorrently. When asked if she would like to expand on that thought, she became silent. After moments of patiently waiting for her response, she began by saying, “My sister hated me. She stole my self-confidence before I even knew what that word meant. She consistently told me I was ugly. “Your hair is red and ugly. Your cat eyes are ugly. Your baseball bat legs are ugly. Ugly, ugly, ugly. Every day was torture”. Realizing the pain of hurtful past experiences, client was asked if she would like to continue. After moments of what appeared to be quiet resolution, she continued. She summed up her family as “a house full of lost souls, seeking their individual identities fighting for survival”.

Client describes her grandmother as very quiet and humble. She worked as a maid for two white families in town. Although considered the head of the family, she rarely if ever issued punishments. She stated that control was given to her daughter, whom the client said ruled mercilessly, with an iron hand. Client seemed to be contemplating her next response. Asked if she would like to end the initial session and start anew the next session, she continued. She said the environment lacked basic love and affection. “There were no good nights, or good mornings…how was your day…I love you…no hugs or kisses. It was an emotionally and physically detached environment”.

Client said she did everything she could to avoid being home. She participated in all seasonal sports and hung out late nights with her childhood friend. She was labelled a wayward child. She had little or no interaction with the rest of the family. Seeming to ponder, she said at home she was a prisoner of darkness…but in the world she was free.

Client said she was taught indirectly to respect your elders, obey authority, take care of yourself, never rely on a man for anything, always make sure the house is spotless, speak only when spoken to, and never “talk back” to an adult. After a brief silence she said, “I don’t remember ever being taught what was right or wrong. It was only after you did something wrong and punished that you knew it was wrong. That was unfair.

Client was asked if there was anything further she would like to discuss. She said yes, but it was personal and very painful, and she had never talked to anyone about it. Client continued, “When I was 16, I became pregnant. My mother forced me to have an abortion. I didn’t want to, but I The memories still haunt me. I stopped caring about anything. I began to self-destruct”.

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Section II- History of Presenting Problems

Client is a 64-year-old twice divorced, unemployed black woman, just recently experiencing the “empty nest” syndrome. She explains that after an emotionally internal cleansing with her friend, she was encouraged to seek counseling. “I questioned if life really was worth living. I’m not mentally disturbed. I guess I haven’t adapted well to being alone. Over the past year I’ve suffered from insomnia, I eat poorly, and spend most of my time reading or doing crossword puzzles. I seldom leave home, spending days without venturing out. I’ve convinced myself this is a natural part of growing older. Yet, I feel so empty inside, with no direction or purpose. I feel it’s too late to reach the pinnacle of self-actualization”.

Client states that for the past year, she has a problem performing the basic functions of eating and sleeping. She lives in a somewhat isolated state, rarely going out. She spends most of this time dwelling on what she could have been, what she could have done with her life. She describes her past experiences as “a dark cloud lingering over her heart”. Her children beg her to come live with them, though she refuses. She seems to project a sense of hopelessness. She suffers physiologically as a result of her psychological state. She says her problems are rooted in her childhood but began reliving them when her family moved to another city, leaving her virtually alone and lonely. She states that she knows what she needs to do, but lack knowledge, courage and insight on how to begin. She accepted her friend’s advice to seek counseling because “I need to find peace, enjoy a season of prosperity and purpose. I want to “become”.

Client presenting problems appear to be loneliness, low self-esteem, self-worth, basic life functions, lack of motivation and being alone. She desires therapy, with hope that she can leave her past behind, come to terms with the present, so that she can move forward. It is recommended that she undergo an extensive psychological Assessment for severe depression and possible suicidal tendencies, and individual counseling to address past negative experiences. The therapist will begin client’s treatment using Reality Therapy techniques. For psychological Assessment, the psychodynamic approach of the Adlerian theory (Corey, 2015), which “stresses assuming responsibility, creating one’s destiny, and finding meaning and goals to create a purposeful life” is recommended. Ellis and Beck’s behavior therapy may be used to help resolve specific behavioral problems (Corey, 2015).