Reality Play Therapy is something I find essential to integrate into my Play Therapy practice. Check out more on Reality Play Therapy HERE and HERE. The 5 Needs described in Choice Theory are foundational to my parenting work with families.
The 5 Basic Needs according to Reality Therapy and Choice Theory are:
Physiological need for survival and sustaining life including physical health, shelter, nourishment, and feelings of safety and being secure.
Love and Belonging
The drive and need to connect with others including friends, family, classmates, pets, spiritual communities, sports groups, online communities, etc.
The desire to matter, have competence, the ability to achieve and make a difference. This need encompasses self esteem and the desire to have an impact.
The need to have age appropriate independence, choice, and autonomy. Being able to make choice without restriction, which also includes creative freedom.
The need for pleasure, PLAY, humor, relaxation, and relevant learning.
One of the most important things in working with children (and humans) is identifying what is underneath the behavior. And often, more than one need can be at play. If we can explore with children (as the expert in their world) what needs they were attempting to meet in a non judgmental way we can then begin to empower children to evaluate how effective or helpful their choice was.
Let’s face it, most often children come into therapy for unhelpful choices. One of the basic premises in Choice Theory is that our thoughts and choices lead to our physiological responses and feelings. So, children come into therapy for overwhelming and uncomfortable feelings and physiological responses that are a product of thinking and choosing.
So....if we want to shift thinking and behavior then we have to explore what needs the behavior was attempting to meet!
If this seems like something you want to start using in your practice grab this FREE DOWNLOAD to help support you in explaining the basic needs to children and families as well as a set of questions to help clients and families explore how well each basic need is being met!
I learned about Reality Therapy in my grad school program and was instantly hooked! It is described as a brief counseling approach and a client centered form of Cognitive Behavioral Therapy. The client centered nature of the approach is so important for children, who often perceive they do not have much control over their lives or have adults and systems making the rules leading to high levels of powerlessness.
Reality Therapy allows children to become empowered to take control over their lives, make decisions, and evaluate the effectiveness of choices. Through Reality Therapy children (and parents) can learn about what needs are driving their behavior in a compassionate way and help the adults in their lives have a deeper and nonjudgmental understanding for what drives behavior.
Reality Therapy was developed by Dr. William Glasser and is based on Choice Theory. Choice Theory is based on the premise that we only have the power to control ourselves and limited power to control others. Choice Theory is the springboard for Reality Therapy, which is the interventions and implementation of Choice Theory in therapy.
Want to learn more? Check out this overview of how Reality Therapy works!
Reality Therapy believes that all behavior is purposeful to meet needs. The 5 basic needs include:
All behavior is Total Behavior:
Distress and psychological symptoms are caused by:
The goals of reality therapy are:
The fun part about this? Reality Therapy is a wonderful theory that can be integrated with Play Therapy in a theory called Reality Play Therapy! Techniques such as drawing, Sand Tray, puppets and so much more can help children explore how they meet their basic needs, gain control over their choices, evaluate choices, and process and explore different ways of thinking and acting!
It’s something I have been working into my Play Therapy practice with children and adults since I first learned about it in graduate school and helps children and parents both have compassion for themselves as well as empower children to change and have power over choice!
Drop a comment below and let me know if Reality Therapy is new to you or an intervention you have been using in your Play Therapy Practice!
Cognitive Behavioral Therapy is an umbrella term.
Cognitive Behavioral Therapy (CBT) is a form of therapy that focuses on thoughts, feelings, and behaviors and has been found to be effective in treating mental health diagnoses such as anxiety, ADHD, depression, separation anxiety, trauma, phobias, and the list goes on!
Overall CBT believes:
Dr. Aaron Beck is widely recognized as the Father of Cognitive Behavioral Therapy and founded, with Dr. Judith Beck the Beck Institute. Check out this quick introduction to Cognitive Behavioral Therapy.
There are other types of CBT that shift to focus more on thinking and theories such as Rational Emotive Behavioral Therapy developed by Dr. Albert Ellis. These models were developed as talk therapy approaches, which…well… doesn’t work great for kids.
The awesome news is that there have been many adaptations of Cognitive Behavioral Therapy approaches and techniques to integrate play to make it more developmentally appropriate (and effective) for children.
I wanted to share three types of Cognitive Behavioral Therapy I think are essential in any child therapy practice:
Cognitive Behavioral Play Therapy:
Okay this one is a given and definitely my default when working with children! Cognitive Behavioral Play Therapy was developed by Susan Knell in 1998 who drew on influences of Dr. Aaron Beck, Dr. Albert Ellis, and Dr. Albert Bandura.
Phases include introduction and orientation, assessment, the middle (or working) stage, and termination. Susan Knell developed the model to have both structured and goal oriented activities and unstructured activities to allow for the child’s spontaneity to emerge and allows the gathering of essential information about the child’s world. Knell notes that the focus of CBPT is on “directions and goals, choice of play materials and activities, play as educational, and the importance of making connections between the child’s behavior and thoughts”. Techniques include modeling, role play, direct and indirect approaches, and classical and operant conditioning.
Want to add some Cognitive Behavioral Play Therapy tools to your toolbox? Check out these interventions, activities, and downloads here:
Dialectical Behavioral Therapy:
Dialectical Behavioral Therapy (DBT) was developed by Marshal Linehan in the late 1980’s for adults with intense emotions. Four modes of standard outpatient DBT include individual psychotherapy, DBT Skills training, in-the-moment phone coaching, and DBT Consultation Teams for therapists. Skills foundations include mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.
Dialectical Behavioral Therapy has been adapted for children in DBT-C for pre-adolescent children with severe emotional dysregulation and corresponding behavioral discontrol and requires formal DBT-C training to implement the model with fidelity.
DBT-C includes four main categories including:
One of the foundations of this model is teaching parents all the skills their child learns as well as effective contingency management techniques, focus on parent modeling of adaptive behaviors, reinforcement of skill use, ignoring maladaptive responses, validation, and acceptance. Overall this model is used to help children and families create a life worth living while validating distress as well as pushing for change.
While official training is necessary and ethical to carry out the DBT-C model with fidelity, if your agency and practice does not have the training you can use and teach the DBT skills by incorporating these skills into Play Therapy techniques.
Check out some ways to incorporate DBT skills into your Play Therapy practice HERE:
Reality Play Therapy:
I learned about Reality Therapy in my grad school program and was instantly hooked! It is described as a brief counseling approach and a client centered form of Cognitive Behavioral Therapy.
Reality Therapy was developed by Dr. William Glasser and is based on Choice Theory. Choice Theory is based on the premise that we only have the power to control ourselves and limited power to control others.
The goals of reality therapy are to help increase positive connections with others, meet our 5 basic needs, and overall help the client discover alignment or disconnect between satisfying Quality World, needs, and behaviors.
Reality Therapy believes that all behavior is purposeful to meet needs. The 5 basic needs include survival, love and belonging, power, freedom, and fun.
Distress comes when there is a disconnect between our Quality World (where we store mental pictures or representations of wants including people, places, things, values, and beliefs that are important to you) and your perceived world (our experience of the real world that comes through our five senses). Our perceived world is passed through our Total Knowledge Filter, which is a representation of everything you know or have experienced in life.
Reality Therapy has been combined with Play Therapy in research starting in 2011 with Eric Davis who combined the WDEP technique in Reality Therapy with drawing. Since then the has been research and integration of Reality Therapy and Play Therapy in a model called Reality Play Therapy.
And there you have it! Three types of Cognitive Behavioral Therapy you can integrate into your practice with children!
Drop a comment below to let me know if you use any of these theories and techniques in your practice OR if anything here makes you want to learn more!
I'm Ann Meehan, an LPCC, RPT-S, and EMDR Consultant. I help other therapists grow in their passions as play therapists, trauma therapists,and child and adolescent therapists.