Key Takeaways
Reality therapy helps you focus on what you can control. It’s about making choices and changes that move your life forward.
This approach focuses on the present moment. You’ll learn to notice what’s working and take small, realistic steps toward your goals.
Over time, reality therapy can help you feel more confident and connected. It builds motivation and supports healthier relationships.
Reality therapy is a type of counseling that helps you focus on what you can control: your choices, your actions, and how you handle challenges. It’s considered a form of cognitive behavioral therapy (CBT), as it helps you recognize the connection between your thoughts, feelings, and behaviors. Instead of spending time on the past, it looks at the present and future to help you take small, practical steps toward change.
The goal is to build healthier relationships, take responsibility for your decisions, and create a life that feels more balanced. With a therapist’s support, you can start to notice what’s not working and make choices that better match your needs and values.
What is reality therapy?
Reality therapy is a counseling approach that helps you understand how your choices shape your life and relationships. It’s built on choice theory [1], which says that all behavior is an attempt to meet our five basic human needs [2]:
Love and belonging: Feeling connected and accepted by others
Power: Having a sense of achievement or influence
Freedom: Being able to make your own choices
Fun: Finding joy and enjoyment in life
Survival: Meeting basic needs like food, shelter, and safety
This type of therapy focuses on the present moment, not past mistakes or regrets. You and your therapist work together to look at what’s happening right now and what can change moving forward. Instead of asking, “Why did this happen?” reality therapy asks, “What can I do next?”
The goal is to help you feel more capable and confident. By taking small but intentional steps, you can learn to make choices that bring you closer to the life you want.
How reality therapy works
Reality therapy is centered on the idea that you can’t control other people — only your own thoughts, feelings, and actions. It helps you look at your current behaviors and decide whether they’re helping you get closer to what you want.
One key part of this approach is the W.D.E.P. model [3], which stands for:
Wants: What do you really want right now?
Doing: What are you doing to get it?
Evaluation: Is what you’re doing working?
Planning: What can you do differently moving forward?
Therapists use these questions to guide conversations and help you see patterns in your choices. For example, if you want closer relationships but keep pulling away when you feel hurt, your therapist might help you explore new ways to connect instead of withdrawing.
Reality therapy also focuses on accountability and self-awareness. You’re encouraged to take responsibility for your actions — not as a form of self-blame, but as a way to recognize your own power to create change. Over time, this helps build confidence and healthier relationships.
Techniques and tools used in reality therapy
Reality therapy gives you practical tools to make meaningful changes in your everyday life. It’s less about analyzing problems and more about taking action that helps you grow.
Some common techniques your therapist might use include:
Goal setting and planning: You’ll work together to create small, realistic steps that move you toward what you want.
Self-evaluation: Your therapist might ask questions like, “Is this behavior helping you reach your goals?” to help you reflect on your choices.
Action focus: Reality therapy emphasizes doing, not just talking. You’ll practice new ways of handling challenges and take steps toward healthier behavior.
Role playing: Your therapist might help you rehearse conversations or decisions so you can feel more confident applying them in real life.
Accountability: You’ll track your progress and talk openly about what’s working and what’s not, without judgment.
Some therapists use the W.D.E.P. model to guide this process [4], helping you stay focused and intentional about change
Each technique encourages self-awareness and growth in your actions and relationships — one small step at a time.
What reality therapy can help with
Reality therapy offers many benefits for people who are feeling stuck or disconnected. Because it focuses on choice and responsibility, it’s especially helpful for people who want to build healthier patterns in their daily lives and relationships.
Therapists often use reality therapy to support people with:
Relationship struggles: Improving communication, resolving conflict, and rebuilding trust.
Anxiety and depression: Breaking unhelpful patterns and creating realistic steps toward change.
Low motivation: Finding purpose and building habits that lead to progress.
Unhealthy substance use: Identifying triggers and choosing healthier ways to cope [5].
Anger or impulse control: Learning to pause and respond in calmer, more effective ways.
Behavioral challenges in teens or young adults: Building accountability and decision-making skills [4].
The benefits of reality therapy can extend beyond these areas. It can also work alongside other forms of counseling or medication. However, because it focuses mainly on present choices and behaviors, reality therapy may be less effective on its own for people who need deeper trauma work or intensive mental health treatment.
Still, this flexible approach helps many people focus on what’s within their control and take steady steps toward a more balanced and fulfilling life.
What to expect in reality therapy sessions
Reality therapy sessions are practical and focused on action. Instead of exploring the past, your therapist will help you focus on what’s happening right now and what can change moving forward.
In this type of therapy, you’ll spend less time talking about symptoms [2] and more time exploring choices and behaviors. Your therapist may encourage you to:
Focus on the present, not the past
Avoid criticizing, blaming, or comparing yourself to others
Take responsibility instead of making excuses — even when those excuses feel valid
Use your energy to change unhelpful thoughts and behaviors
Set specific, realistic goals and make concrete plans to reach them
During your first session, your therapist may ask questions like, “What do you want most right now?” or, “Is what you’re doing helping you get there?” These questions help you clarify your goals and see where change is possible.
Reality therapy is a short-term, collaborative process. You and your therapist work together to practice new skills, reflect on what helps, and adjust your approach along the way. With time, these small but consistent changes can make life feel steadier, healthier, and more fulfilling.
Clinician's take
When clients start taking more responsibility for their choices, I remind them that growth and self-blame are not the same thing. Taking ownership is a sign of strength — and compassion is what helps that growth last.
Find care with Rula
Reality therapy offers a practical way to understand your behavior and create meaningful change. By focusing on personal responsibility and healthy connections, you can build a life that feels more stable and fulfilling. If you’re struggling to make that shift alone, professional support can make the process easier and more effective.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
