Choice Theory
CT
“Nothing is more difficult, and therefore more precious, than to be able to decide.”
Napoleon Bonaparte
What is Choice Theory?
Choice Theory is also known as Reality Therapy and was previously referred to as Control Theory. It is based on the belief that we choose our behaviours based on how they fulfil our needs.
This can be contentious, as what about the behaviours that we feel obliged to do because of external circumstances in our life? Don’t we have responsibilities to care for family, do our paid work, etc.? Do we have control over the choice to respond in such situations
Yes, we do choose our behaviours based on our needs. For example, you may believe you have no choice but to get up in the middle of the night to comfort a crying child. CT would say this is still a choice based on your need to care for your child. Ultimately, you are choosing to love your child. If you go to the root motivation for every behaviour, you will always find an initial choice to behave that way.
We all agree that we have control over how we respond to situations. Our responses to life situations are the basis for the choices we make. Change the beliefs that are the foundation for the choices. Then you can change the behaviours, thereby improving your mood and coping skills with negative situations.
CT believes that we make choices in the here and now. It does not involve an analysis of the person's past
What is the history of Choice Theory?
CT is the work of psychiatrist William Glasser. From the late 1960s onward, Glasser proposed the belief that the presentation of mental illness is a person's best attempt to find balance in their life. They are making choices that help them balance their ability, their wants and the demands of the world around them.
Glasser was not a supporter of the use of medications for psychiatric illness. I believe that it is between a client and their doctor to decide if a biochemical basis for their negative mood and behaviour is present. If a client is on medications such as antidepressants, I will work with them to review the effectiveness and side effects of the medication.
CT has been applied in education and the business world. It is generally accepted in Ireland and is a foundation for many training courses.
To learn more about William Glasser, see here for more information
What is Choice Theory used for?
CT is useful for people who believe they have lost the ability to make positive decisions for themselves. Examples of this would be addiction or self-harming behaviour.
Because CT is based on improving the present moment, it is also suited to crises such as suicidal ideation, where the person needs to find positive reasons to live to make life-supportive decisions.
CT teaches that helpful relationships are a basis for positive well-being. Positive relationships involve people practising safe boundaries. Safe boundaries in relationships mean the people involved maintain their locus of control. That is, they do not feel threatened that the other person is trying to take away their autonomy and control them.
Regaining one's locus of control is helpful with anxiety and depression and disorders of perception, such as paranoia and obsessive-compulsive disorder.
Choice Theory in Prevail
The most common aspect of CT that I use is applying the five basic needs identified by William Glasser to the client’s presenting issue.
These basic needs are:
Survival
What does the client need to feel safe? Do they feel there is a threat to their existence, or a core part of their life?
Love and Belonging
What are the key relationships for the client? Are these relationships making his life worse or better? Does he want to restore broken relationships or replace them?
What or whom gives him a sense of purpose and meaning?
What or whom is he willing to invest in as part of his overall well-being?Power
Does the client feel she has autonomy over her own life, or at least the part of it involved in the counselling work?
Does the client feel someone or some situation is trying to take her power from her?
How important is it to the client to perceive that she has control over her situation?
Does the client have the power to make choices for herself?Freedom
Does the client have a sense of agency, independence over her choices?
Can the client live their life on their terms?
Is the client giving control of their choices over to someone else, or to the external forces causing the situation they are in?
Is the client sad because they have not been able to do what they want to do?
Fun
When was the last time the client enjoyed the choices they made?
Is the client engaged with hobbies, activities or social situations that they enjoy?
When asked about fun in their life, does the client seem confused that it is an essential aspect of life? Does the client water down their need for it?
Another aspect of CT that I use is the idea of balancing the world the client wants to live in (their Quality World) with the world they experience (their Perceived World). When their perceived world is very negative and overwhelms any experience of their quality world, the client experiences tension.
This tension may be what brings the client to therapy. The client's focus becomes the reduction of this tension.