“Love and Marriage”: Reality Therapy and the Shortfalls of Behavioral Marital Therapy by Paul Burkhart
“ . . . ‘till death do us part.” This is the final line of the typical protestant marriage vow. The inbred desire for this sort of union with another person is something as old as the earth itself. From God saying “[i]t is not good for the man to be alone,” in Genesis 2:18 (ESV) to the countless number of romantic comedies seen every year in theatres, the infatuation the world has with “the one” is quite apparent. Still, even as the culture’s desire for Sinatra’s “love and marriage” ideal increases, the divorce rate increases right along with it. As the sighs and butterflies hit the younger generation of today, the older generation of yesterday faces a legacy of arguments, anger, and bitterness to leave behind them.
As the world grows smaller and faster, people are losing more and more control and intimacy in their lives, resulting in unhealthy marriages across the nation. The number of couples seeking counseling to remedy these painful circumstances is rising every year, yet the divorce rate does not slow, stagnate, nor decline. What is the problem? Most marital counseling (and the rest of psychotherapy for that fact) employs the concept of eclecticism, where several different therapeutic approaches are thrown together and used at the doctor’s discretion. This is because the entire psychological world has been unable to rally behind one particular therapy or perspective on humans, their nature, and the way they interact, thus resulting in graduate programs that teach each therapy as merely individual tools in the counselor’s tool belt that he or she can choose from at will and at their choosing. The problem is every therapy derives from a different “perspective” on human beings and their psychological workings. Because of this, the eclectic “hybrid” therapies of today are filled with various perspectives on the very nature of man that are both confusing and conflicting. This is not the proper environment for effective marriage therapy.
Of all the therapies employed today, Behavioral Marital Therapy (commonly referred to as BMT) is the most common “pure form” (non-eclectic) therapy used and is the foundation upon which most eclectic approaches are built. It is based upon the theoretical foundation known as “Behaviorism.” BMT has ruled marriage counseling since the mid-50s and is very much ingrained in the mind of the stubborn psychological world. The divorce rate is enough to prove the inadequacy of this therapy despite the psychological world’s expectations. However, there is a therapy and theoretical foundation that seems to get it right; still in its relative infancy in the world of psychological therapies, it has already been successfully applied to more areas of society than any other therapy before it. It is called Reality Therapy and its theoretical foundation is known as Choice Theory. Thus, does BMT really work? If not, then why not? Finally, if it does not work, what therapy does work and why? Although most of the marriage counseling world still stands firmly behind Behavioral Marital Therapy, Reality Therapy is the more effective therapy for marriage counseling as seen through the ways each therapy views the couple, attempts to change behavior, and how they each treat thoughts and emotions.
Behavioral Marital Therapy & Reality Therapy: Theoretical Bases
Behaviorism and Choice Theory both have their theoretical focuses on Behavior, but Behaviorism’s focus is too narrow, while Reality Therapy’s focus correctly acknowledges cognition. Behaviorism, the psychological perspective that ruled the first half of the twentieth century, is quite straightforward in its ideas that humans are comprised of nothing more than mental associations and that people can control these simply through behavioral changes. As its founder John B. Watson said, “[i]ts theoretical goal is the prediction and control of behavior. Introspection forms no essential part of its methods” (qtd. In Myers, 290). Behaviorism believes psychology should be an objective science where only observable stimulus-response and learned associative behaviors are addressed in the counseling process and subjective mental processes are never taken into account at all. Orthodox Behaviorists believe that human beings are born as a “tabula rasa,” or “clean slate,” free of personality traits, behavioral tendencies, and mental associations. It is through life that humans gain behaviors and personality traits by gaining stimulus-response reactions and learning various consequences certain behaviors incite. John B. Watson once claimed that if given 50 new born babies, he could make them into whatever he wanted: Nobel Prize winners, teachers, saints, or murderers. Contemporary Behaviorism has ceded some to the idea that cognition plays a certain role in the associations, primarily through anticipation and expectation of the conditioning.
The implications of Behaviorism in marriage counseling are quite significant. First, it promotes the belief that each partner is merely shaped by, and therefore a victim to, their external situations. Behavior is more or less not a choice but merely responding to the associations learned through life. Second, Behaviorism implies that emotions play no role in how humans act; thus, in a marriage conflict, how a person “feels” is of no significance at all to the therapy. Third, Behaviorism implies that if the therapist can be successful in changing someone’s behavior, you can change their internal attitudes; if they can just get them to do the correct things, everything else will follow. In other words, people can “behave” themselves into “feeling;” while this principle is quite psychologically sound; Behaviorism takes it to a particular extreme. H. Norman Wright in his book Marriage Counseling writes, “[w]hen couples come for counseling, the focus is upon two aspects of their life: behavior and thoughts” (124). He goes on to quote Dr. Billie Ables saying, “the therapist must not challenge feelings; rather they are important data to be given attention. Nor can they be readily legislated . . . Behaviors are easier to change than feelings” (124).
Choice Theory and its therapy component, Reality Therapy, seem similar to Behaviorism, but are different in many vital respects as seen through the several major underlying principles of Choice Theory and Reality Therapy. Human beings are innately motivated to fulfill five basic needs, all of which everyone has certain intensities for; these being survival, love and belonging, power, freedom, and fun. The need for survival has to do with how conservative, adventurous, and risky you are. About the need of love and belonging Glasser, “[i]t is important to understand that the strength of this need is measured by how much we are willing to give, not by how much we are willing to receive” (Glasser 96). Choice Theory teaches that people can control no one else but themselves, so the need for love should not be based upon how much love someone requires but rather how much they give. The need for power is related to a need for a feeling of accomplishment, self-esteem, and sense of achievement. Wubbolding states, “[h]uman beings seek to be self-regulated, to have a sense of inner control or independence” (Relationship Counseling, 244). The need for freedom is the level of need within the person to make their own decisions. Lastly, people seek out activities that are enjoyable as a result of their need intensity for fun.
The preceding five basic needs are written into the genetic code of humans and cannot be changed; based on the intensities of these needs, people come up with wants in their minds they believe best satisfy these needs. These wants are formed into mental pictures in the mind. All of these pictures come together to form a place called by Glasser as one’s “Quality World.” Glasser states it “is made up of a small group of specific pictures that portray, more than anything else we know, the best ways to satisfy one or more of our basic needs” (Glasser 45). Within every mind, there is a picture of the person, thing, or ideas that will best satisfy the individual’s needs. Because most behaviors are chosen, behaviors are chosen based on discrepancies between the outside world and one’s Quality World. Therefore, behavior originates, from the desire of the individual to bring the current outside world in harmony with their internal Quality World.
All behavior is separated into four components: actions, cognition, feelings, and physiology; these four components comprise a person’s “Total Behavior.” These components are forever connected and play off of each other. Choice Theory asserts that people cannot control their physiology and emotions, but can control their thoughts and emotions. Many studies have shown the ability for humans to change and affect their physiology and/or their emotions by changing their behaviors and thoughts. Lastly, Behavior has a purpose, and that purpose is to bring about the perception of both a person’s needs and wants having been satisfied (Relationship Counseling, 244-255).
A central precept of Choice Theory and Reality Therapy is an individual can control no one but themselves. Glasser in Choice Theory asserts there is a psychology humans embrace that destroys marriages called “external control psychology” which “is an attempt to force us to do what we may not want to do. We end up believing that other people can actually make us feel the way we do or do the things we do” (Glasser 5). He goes on to say, “[d]estroying marriages is the crowning achievement of external control psychology” (Glasser 179). This psychology is, at its heart, an attempt by one person to control another and make them do what they want. People do this by manipulating, arguing, bribing, nagging, insulting, excuse-making, blaming, instilling fear, and in some cases, just giving up on the other person. People do these behaviors in hopes of changing another’s behavior into something that will satisfy them enough to bring them closer together, not realizing these behaviors only push people away, further facilitating the vicious cycle of pain, anger, and bitterness in a relationship. When it comes to these behaviors in relationships, it seems human beings have taken on the mantra “if at once you don’t succeed, try, try again” as they repeat these behaviors, even though they never work. Choice Theory says that humans can only control themselves, so they must learn to stop pushing the people they need the most away with these ineffective people-changing techniques.
Behavioral Marital Therapy & Reality Therapy: The Therapies
The marriage therapies produced by both Behaviorism and Choice theory are vastly different, reflecting the differences at the core of their theoretical foundations. Behaviorism employs “Behavioral Marital Therapy” (BMT) as its choice therapy technique for marriages. In K. Daniel O’Leary and Hillary Turkewitz’s study, “A Comparative Outcome Study of Behavioral Marital Therapy and Communications Therapy,” the authors suggest that, “[b]ehavioral marital therapy is designed to increase productive problem solving and establish pleasing interactions through reciprocal or equitable [behavioral] changes” (O’Leary 159). In other words, the end goal of BMT is to promote healthy ways to deal with problems and encourage healthy behaviors that satisfy the needs of each individual. As expected, the focus is on behavior; not only increasing positive behaviors, but also decreasing negative ones.
According to Gregory Lester, Ernest Becham, and Donald Baucom’s article “Implementation of Behavioral Marital Therapy” in The Journal of Marital and Family Therapy, there are four techniques primarily used in Behavioral Marital Therapy: problem-solving, communications training, behavioral contracting, and homework assignments (Lester et al. 189). The first step in therapy is problem-solving which has three steps: “(a) selecting and stating a problem; (b) listing possible alternative solutions; (c) agreeing on a final solution” (Lester et al. 190). The therapist teaches these techniques to the couple so that they can implement them in a real-world fashion.
Second, communications training is employed to affect each partner’s speech patterns. In the O’Leary and Turkewitz study, they write, “[w]hen the therapist intervenes during a destructive communication, the undesirable behavior needs to be labeled and a rationale for changing it given” (Lester et al. 191). In Behaviorism, labeling behaviors and giving a rationale for the label is very, very important. Behaviorism, attempting to make psychology a completely objective science creates lists of labels for certain behaviors, in this case, communication patterns, that a therapist can put on a particular behavior. Each of these labels has rationales and “healthier” alternatives to them that are presented by the therapist to the patient so as to create a solution for the negative behavior (Lester et al. 192).
The third step in the process of Behavioral Marital Therapy is the use of behavioral contracts. Lester et al. states, “[c]ontracting is useful because it helps the couple make difficult behavioral changes and increases the amount of positive reinforcement exchanged between them” (194). Contracting helps in the therapy setting because it establishes clear cut rewards and punishments in an attempt that this will create and maintain the desired behavioral changes, no matter how ingrained or difficult they may be. These contracts take two forms. One is the “Good Faith” contract where the normal problem solving procedures described above are followed, and when a solution is agreed upon, the partner making the behavioral change receives reinforcement contingent upon successfully following through with that change (Lester et al. 194). The second kind of contract is called the “Quid Pro Quo” contract. In this kind of contract, one partner agrees to make a behavioral change contingent upon a behavioral change in the other, and vice versa. The moment one person does not follow through with their end of the contract, the other person is allowed to falter on their side as well (Lester et al. 195).
The last therapeutic focus of BMT is that of homework assignments. Lester et al. states, “[h]omework is assigned because an argumentative, inefficient problem-solving style may be a well ingrained habit, and most couples need a great deal of practice in order to become effective problem solvers and contract writers” (196). In other words, when the mental associations learned by a person through their life that lead to a destructive, unhealthy marriage are well ingrained, homework may be necessary so that the therapist can see what was done outside of the session. The homework is exactly as it seems it would be: the therapist gives each partner assignments to work on, and the couple proceeds to practice these new behaviors and take detailed notes about their successes, failures, and specific events that occur. At the next therapy session, the therapist goes over the couple’s notes and critiques them or encourages them depending on what he observes.
The “delivery system” or counseling component of Choice Theory is Reality Therapy. Most therapies either have a strict outline to follow (i.e., BMT) or are completely open to the idiosyncratic preferences of the therapist (i.e., psychoanalysis and eclecticism). Reality Therapy lies between the two extremes: it has defined procedures and steps, but is an “open system” (Reality Therapy 76) where these steps are seen first and foremost as techniques to use in the proper order at the proper time to the proper person at the discretion of the therapist.
Another significant difference in Reality Therapy to nearly all other therapies is the therapist makes a deliberate effort to become a key need-fulfilling figure in the clients’ lives. In most therapies, the therapist remains emotionally distant and uninvolved with the patient, thinking it will harm the therapy process. Reality Therapy on the other hand, asserts that it takes a great relationship using (and in the process showing an example of) Choice Theory in the couple’s lives to best help their relationship problems. The therapist takes an active interest in the couples’ lives, interests, and activities. In training for Reality Therapy, humor, metaphors, storytelling, and empathy are encouraged and urged strongly for effective therapy. In this intimacy, Reality Therapy, unlike most other therapies, is not mysterious with the clients. In the first session, clients are taught all about Choice Theory and told exactly what is going to happen in the therapy and why it is. There is no mysterious uncertainty in the clients’ minds as to what the therapist will do next. In this, the therapy and patient become equals; and it is in this environment that the patients can relate, open up, and receive help.
At the center of the therapy procedures of Reality Therapy as applied to family and marriage counseling is something known as the WDEP formulation. As Dr. Bob Wubbolding claims:
The [WDEP] procedures . . . are helping clients identify their wants (W), assisting clients to describe what they are doing and their current overall direction (D), evaluating clients wants and behaviors (E), and formulating specific plans about how to get wants and needs met with appropriate choices and behaviors (P). (Relationship Counseling 98)
“W” focuses completely on the clients’ wants; the therapist asks questions of the couple to find out what they want from everyone and everything around them, why they want it, how hard they want to work for it, what they want to avoid, and what they want to be as individuals and couples. This component not only deals with wants but also perceptions, as it is during this phase the counselor finds out how the clients perceive their control over the situation, over themselves, and over others.
The “D” step is completed in light of both the counselor and the clients clarifying all of their various wants and perceptions. This step analyzes the patients’ overall directions; namely the specific behaviors that they are doing. The therapist helps the patient see the direction their behaviors are taking them and leads right in to the evaluation stage of therapy (Relationship Counseling 105-110).
The most important and most comprehensive step is the “E” procedures. This is ideally self evaluation by the clients in light of the first two steps, but typically it involves suggestion and leading by the therapist. It is the evaluation of the clients’ wants, perceptions, behaviors, evaluations themselves, and quality world images. All of these things are evaluated for how realistic, reasonable, and effective they are. In light of the earlier clarification of their wants and their direction in the relationship, most couples in this step realize that the behaviors they are doing are not effectively achieving their desired wants, thus ushering in the last phase, the planning stage.
The “P” step refers to the planning component of Reality Therapy, where plans of behavior change are made. The plans are described using the acronym SAMIC. The plans must be Simple, Attainable, Measurable, Immediate, and Committed, Consistent, and most importantly Controlled by the couple themselves, not at all contingent upon another’s behavior (i.e., “if they . . . then I will . . .”) (Relationship Counseling 150-159).
All of these procedures are done within another context: the solving circle, which is the practical problem solving tool in Choice Theory. Glasser writes in Choice Theory, “[w]hat [couples in Reality Therapy do] is form a solving circle [in which] they no longer try to change the other; everything they choose to do is based on how it will affect their marriage . . . As a married couple, [patients] now know that it is no longer how one spouse affects the other, it is how it will affect the marriage” (94). Though seen as almost child-like at first, the solving circle is the atmosphere in which the therapy sessions take place and all subsequent mediations between the couple at their home on their own are done. It is quite literally, a circle, either drawn or imaginary, around the couple as they sit facing each other or the counselor. In the circle are three entities: the husband, the wife, and the marriage. While in the circle neither the husband nor wife can use any external control psychology; they can only talk about their own actions, and what they are willing to change in the disagreement. In the circle, the entity of the marriage takes precedent overall. If an acceptable compromise cannot be reached, it means one or both partners are holding their own interests above that of the marriage, thus they step out of the circle to symbolize their unwillingness to put the marriage before them. (Glasser 173-174).
Behavioral Marital Therapy & Reality Therapy: The Evidence and Verdict
The evidence shows that Behavioral Marital Therapy is not effective and Reality Therapy is. Behaviorsists certainly have in the past stood behind their therapy claiming it successes. Lester’s paper cites a study by N.S. Jacobson as “[finding] that couples receiving [BMT] improved significantly . . .” (190). Studies conducted by Co-author of the Lester paper Donald Baucom are also cited as showing improvement for married couples (Jacobson et al. 2000, par. 1). Jacobson et al. also mentions studies by many psychologists as showing how successful BMT is (par. 8-11). One such group of these psychologists estimated that the success rate of BMT was as high as 90% (par. 36).
Experiments by leading Behaviorists themselves showed the ineffectiveness of BMT. In June 2000, Jacobson and Baucom, the leading Behaviorists in the field of empirical studies both collaborated with others to do a reanalysis of outcome data of all the studies the preceding quotes and figures were taken from using modern uniform, empirical, and widely accepted forms of analysis. They write in their study, “[t]his is the first study where improvement percentages have been based on criteria that are psychometrically sound, clinically meaningful, and objective” (par. 36). So what were the conclusions of this study? They say in the study (please read carefully):
the mean improvement rate was 54.7% . . . the mean deterioration rate was 6.4% . . . the proportion of couples where both spouses reported improved satisfaction during the course of therapy [was] 35.4% . . . 64% - 65% of the couples treated by BMT either remained somewhat distressed or failed to change during the course of therapy . . . [after therapy,] the relapse rate was 28.8% whereas the average improvement rate was 15% . . . deterioration during the follow-up period was more common than continued progress in all three data sets . . . Slightly less than half of the couples were improved. (Jacobson et al. 46, emphasis added)
Another study by Jacobson himself along with Karen B. Schmaling and Amy Holtzworth-Munroe found similar disappointing results for BMT. They found that for complete BMT treatment, at a two year follow-up, 9% reported enhanced satisfaction, 36% reported maintained satisfaction, and 55% reported Deteriorated satisfaction. They found only 18% of couples would describe themselves as happily married after the therapy (Jacobson 1987, 191-192).
In light of Behavioral Marital Therapy’s obvious ineffectiveness, Reality Therapy presents itself as the superior therapy. So what does work if the most widely used form of therapy does not? Alexander Bassin in The Reality Therapy Reader writes, “[t]he precepts and procedures of Reality Therapy appear to be ideally suited for the practice for marital counseling . . . Reality Therapy then contributes to the notion that counseling can be relatively quick, effective, and satisfying both to the client and counselor” (Bassin 198). The theoretical base and therapy techniques of Reality Therapy completely surround the idea that unhealthy relationships are the cause of nearly all psychological pain; thus, all of Choice Theory and Reality Therapy focuses wholly on relationships and making them healthier, making it the ideal therapy for marriage counseling. Admittedly, the results that Reality Therapy has seen have been recorded more in masses upon masses of case studies, transcripts, and therapist anecdotes rather than real empirical research. In an E-Mail exchange with Dr. Bob Wubbolding himself, he writes, “[t]he major issue facing the world of [Reality Therapy] is to develop more and better research to validate the system.” There is a substantial base of empirical research on Choice Theory as applied to the health care system, prison systems, schools, the basic needs, cross cultural studies, self-esteem, minority rights, business management, and therapist relationships with patients. All of this research not only has to do with relationships just like marriage counseling does, but it has shown Choice theory to be more effective than any other psychological therapy ever applied to these areas of study (Reality Therapy, 203). These studies have seen more prison inmates prepared for life after release; it has seen problem behaviors dramatically decreasing in employees within companies; the self-esteems of both Blacks in America and women in the Middle-East drastically increasing; test scores of students moving from the lowest percentile to above average, truancy decreasing exponentially; and chronic pain and mental disorders healing without the use of drugs. No other psychological perspective can claim these successes.
The Jacobson and Baucom study concluded and stated in the last line of their study in light of their horrible findings that, “[i]t is almost inevitable that the same is true of other approaches,” but this is not true for Reality Therapy. It would seem so for most every other approach. The lay person of psychotherapy need only look at the divorce rate to see that. Other common approaches also have incredibly horrible findings. Communications therapy, psychoanalysis, and eclecticism all tout similar un-encouraging numbers for marital therapy, as they fail both in theoretical framework and practice.
Choice Theory and Reality Therapy thus far even in its short life span has shown consistent, positive, significant results in every area of application. Even without the empirical findings to back it up statistically, Glasser himself has said he would do this therapy with any couple in front of any audience in anyway and at anytime and it would work. Not only has he said that, but he has also done it on many occasions.
Behavioral Marital Therapy & Reality Therapy: Reasons Why
The reasons for BMT’s shortcomings and Reality Therapy’s successes are three-fold: how they view the couple, how they attempt to change behavior, and how they treat thoughts and emotions. BMT sees the couple as being composed of individuals that are merely products of their learned associations throughout their life; almost like an ever growing computer program of stimulus-response reactions. As the therapist sees the couple, so they will treat them; thus, BMT treats the couple like children who have no control over their life except to follow homework assignments the therapist creates for them with punishments and rewards; hoping this alters the associations that have become so ingrained in them, and thus changing their harmful behaviors. BMT therapists are taught to strictly see the couple as a “system” that needs to be fixed. They have no involvement in a couple’s life, nor do they see themselves as being in any significant role beyond that of therapist.
Reality Therapy, on the other hand, views the couple as people who use the exact same damaging behaviors as others, nothing more. Reality Therapists do not think that, as world renowned psychologist Albert Ellis wrote in The Handbook of Marriage Counseling, “[most] individuals who come for [marriage] counseling are more or less emotionally disturbed individuals [and] some form of psychotherapy . . . is necessary for even a partially satisfactory resolution of their problems” (25). Reality Therapy views most all “emotional disturbances” as a result of unhealthy decisions, ineffective behaviors, and a lack of control the individual has over his or her own life and relationships. Thus the focus is not trying to “fix” the problem that is the patient, but rather teach them proper ways to evaluate their wants and view their actions in life.
Another huge difference in how Reality Therapy looks at the patients is it takes into account the marriage itself; no other widely practiced therapy does that. Treating the marriage as an entity in and of itself in the counseling process brings the attention away from the desires of the patients as individuals and brings them to a point a where they are seen as a couple; as a unit working together and self-sacrificing for the welfare of the unit as a whole. It is within this context that true self-sacrifice completely devoid of all external control psychology takes place most effectively. It is where patients can best see the big picture that they cannot control anyone else’s behavior but their own and even if they could, they would not want to because of the harmful effects it would have on the marriage.
BMT attempts to change behaviors with labeling, homework assignments, and contracts, which are not effective. Trying to remember the labels and “proper” substitutions for all of the possible communications and behaviors in a marriage relationship is quite impossible, as the list is constantly changing and growing with the arbitrary idiosyncratic preferences of Behavioral therapists everywhere. “Homework assignments” belittle the couple and once again take the control and choice out of their hands and into the hands of the therapist. This is a position people are not the most effective in and explains why there is such a large relapse rate once couples are no longer in the presence of the therapist. Lastly, contracts provide specific rewards and/or punishments for specific behaviors. While it useful to be able to identify specific negative and positive behaviors, these behaviors are not the “only problem” in a bad marriage. William Glasser writes, “I’m not sure there is an only problem. In a failing relationship, everything’s the problem. The beauty of [Reality Therapy and] the solving circle is not that it’s good for this or that [specific, labeled problem], but that it’s a powerful tool that any couple can use at any time” (Choice Theory 189). Also, married couples often don’t have the resources or time after therapy is over to come up with more and more contracts for every problem that arises; hence the very high percentage of couples who identify themselves as having decreased satisfaction with their marriage within two years of BMT.
Reality Therapy, similar to BMT, sees problems in a relationship as a result of negative or unhealthy behaviors; and focuses on changing theses behaviors to heal the marriage. The difference lies in the techniques. BMT, attempting to be as scientific as possible, creates rigid outlines, labels, procedures, assignments, rewards, and punishments for every step of the counseling process. Reality Therapy, however, acknowledges the human mind as a dynamic thing that is different for everyone, thus the counseling experience should mirror that. The WDEP process is not a set of rigid steps but rather techniques available to the counselor to use when appropriate or most effective. The primary behavior changing aspect of these techniques is the Plan. The Reality Therapist is taught to not turn these plans into homework assignments that punish, demean, and belittle the couple. Rather, the Reality Therapist is instructed to ask each partner, “[t]hink of and then tell me something you are willing to do this coming week that you believe will help your marriage. Whatever it is, it must be something you can do yourself. It must not depend, in any way, on what your partner should or should not do” (Choice Theory 180). In one case study by Glasser, the husband agreed to not mention money around his wife for the week even though he hated her compulsive shopping and was very antagonistic about it. She agreed to be more “affectionate” towards him. Glasser explains that he had no illusions that money or sex was the couple’s only problems – rather he just used these things in the forefront of their minds to help show how Choice Theory and the solving circle can work in a relationship. This couple came back the next week with after great success and peace in the relationship. After those first two weekly sessions, as is the normal practice of Glasser, the sessions became monthly rather than weekly. According to Glasser, most marriage counseling can be completely successfully within 5 to 7 sessions, whereas BMT in its typical form takes 2 to 3 years to complete.
One of the primary complaints against BMT is that the behaviors it focuses on are merely the symptoms of the real problems in the marriage, be it attitudes, feelings, or thoughts (Bowman 184). Once a therapist succeeds in changing those specific symptoms (behaviors) different symptoms will inevitably show up in other places stemming from the same problem. Following the metaphor of a computer program, there are three steps to a program: input, processing, and output. BMT only focuses on the output which allows room for problems to flourish in the areas of input and processing without ever being addressed by the counselor or the patients.
Reality Therapy, however, does deal with the input and processing components in order to most effectively change the output. According to Choice Theory, the disharmony between one’s wants and needs influences what goes in the input and how it is processed. Though this sounds like Reality Therapy puts a certain emphasis on emotions, it does not; the primary focus is still on behavior, not emotion. Reality Therapy teaches patients to change the way they think, act, and think about how they act in order to affect how they feel, function, and act. The negative behaviors are still the source of the conflict, pain, and bitterness in the relationship, but how the patient most effectively changes them is through thinking through a reanalysis of the behaviors in light of their needs and wants.
When good ol’ Frank sang “Love and Marriage” in 1955, he croons the following lines:
Love and marriage, love and marriage
It's an institute you can't disparage
Ask the local gentry
And they will say it's elementary
Had he sung it in 2005, Americans would most likely laugh at him and it would not be the hit it was then. The institute of marriage is not only being disparaged daily, but it is anything but elementary, as people have found out. Even the wisest man who ever lived, King Solomon realized this when he wrote to husbands in Ecclesiastes 9:9, “[e]njoy life with the wife whom you love, all the days of your vain life that he has given you under the sun, because that is your portion in life and in your toil at which you toil under the sun” (ESV). If marriages are to be made healthy again, then marriage counseling must step up to the challenge as supposedly having the answers needed to conduct healthy relationships in the 21st century. Marriage counselors have claimed to have these answers for years, but as Glasser writes in Counseling with Choice Theory, “[w]e still need what we needed thirty-five years ago: better, quicker, more understandable, teachable [marriage therapy] to replace ineffective traditional therapy” (225). Even though most of the marriage counseling world still stands firmly behind Behavioral Marital Therapy, its greatest supporters have themselves proven it ineffective. Reality Therapy is the most effective therapy for marriage counseling in the 21st century as seen through the ways each therapy views the couple, attempts to change behavior, and how they each treat thoughts and emotions.
If Reality Therapy is superior to other common traditional therapies, why has it not become the standard for all therapy and counseling? The primary reason is its young age, as Choice Theory itself is just approaching its 20 year mark. The other reason is the lack of empirical studies to validate the system. More research must be done to prove Choice Theory has the tools necessary to usher in a new era of mental, social, emotional, relationship, and marital health. The ramifications of Choice Theory blow nearly every major non-pragmatic psychologist out of the water from Skinner to Freud to Maslow to Ellis as it is to date the only psychological perspective that can and does account for and is able to explain 100% of all human behavior. No other psychological theory can claim that. With more research, the system can be validated beyond just marital therapy, but can be expanded successfully into every other facet of society.
Works Cited
Bassin, Dr. Alexander, Dr. Thomas E. Bratter, and Richard L. Rachin, ed. The Reality Therapy Reader. 1st ed.
Bowman, James T., Richard K. James, Gayle T. Roberts, and Burl E. Gilliland. Theories and Strategies in Counseling and Psychotherapy.
Glasser, Dr. William. Choice Theory: A New Psychology of Personal Freedom. 1st ed.
God. The Holy Bible, English Standard Version.
Jacobson, Neil S., Karen B. Schmaling, and Amy Holtzworth-Munroe. "Component Analysis of Behavioral Marital Therapy: 2-Year Follow-up and Prediction of Relapse." Journal of Marital and Family Therapy 13.2 (1987): 187-195.
Lester, Gregory W., Ernest Beckham, and Donald H. Baucom. "Implementation of Behavioral Marital Therapy." Journal of Marital and Family Therapy 6.2 (1980): 189-199.
Meyers, David G. Psychology. 6th ed.
O'Leary, K. Daniel, Hillary Turkewitz. "A Comparative Outcome Study of Behavioral Marital Therapy and Communication Therapy." The Journal of Marital and Family Therapy 7.2 (1981): 159-169.
Wright, H. Norman. Marriage Counseling. 1st ed.
Wubbolding, Robert. "The application of reality therapy and choice theory in relationship counseling, and interview with Robert Wubbolding." Family Journal: Counseling & Therapy for Couples & Families. Sage Publication, Apr 2002. 244-248.
Wubbolding, Robert. "RE: Reality Therapy and Choice Theory." E-mail to Paul Burkhart. 15 Jun 2005.
Wubbolding, Dr. Robert E. Reality Therapy for the 21st Century. 1st ed.
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