FORMULATION IN REALITY THERAPY: MAKING SENSE OF CLIENT’S PROBLEMS Bosiljka Lojk Introduction to Formulation Formulation in psychotherapy is an alternative to psychiatric diagnosis. There is the difference between psychiatric formulation as an addition to diagnosis and formulation in psychotherapy as an alternative to diagnosis. Formulation in psychotherapy is approach to understanding and explaining client’s difficulties relies on a specific theoretical frame. Even though formulations may vary given their theoretical underpinnings, they all have in common the following underlying features, in that they:      summarize the client’s core problems; indicate how the client’s difficulties may relate to one another, by drawing on psychological theories and principles; suggest, on the basis of psychological theory, why the client developed these difficulties, at this time and in this situation; give rise to a plan of intervention which is based in the psychological processes and principles already identified; are open to revision and re-formulation. (Johnston & Dallos, 2003:6) When applying the formulation, a psychotherapist explains to the client their own understanding of the client's current condition. Resulting formulation is agreed upon with the client, easy to understand, specific to that client’s condition, and allows for verifying the accuracy of initial information over time. Choice Theory – Theoretical Frame for Formulation in Reality Therapy The Reality Therapy practitioners, although familiar with the “formulation” concept (i.e., a process of transferring theoretical understanding to work with clients), did not use that term in their clinical practice and training until recently. The formulation in Reality Therapy is understood as the mutual process of exchanging, reflection and self- evaluation as a part of the moment-to-moment process in therapy. Dr. William Glasser, author of Reality Therapy and Choice Theory, abandoned the traditional medical model (i.e., “illness model”) and introduced the “mental health model” instead. Glasser referred to the symptoms diagnosed as mental illness in the DSM-IV (now DSM-V) as purposeful behavior supported by human creativity rather than mental illness diagnosed from symptoms alone and not supported by pathology. Based on Choice Theory, a fundament of Reality Therapy, Glasser defines mental health as a state of balance where individuals enjoy all aspects of their life, especially relationships with important people such as partners, family members, friends, or coworkers. According Leon Lojk, Reality Therapy is an evolutionary-systemic psychotherapy approach based on Choice Theory. In this theoretical frame the human being is viewed as an internally motivated closed loop system whose behavior is purposeful – surviving by constantly trying to achieve a balance within the life context. Human behavior is not a response to external or internal circumstances but rather an attempt to gain balance by satisfying inner instructions and those developed through lifetime experiences. The environment does not change an organism; organism alters itself and the environment. The behavior occurs as a circular causality without specific beginning or end where an organism International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 86 follows its own instructions. This theoretical view considerably differs from other theories which interpret the functioning of an organism as linear causality: cause (stimulus) – organism – response (behavior). In contrast, Choice Theory explains human organism as a complex interplay of four inseparable aspects – action, thinking, feelings, psychology – all involved in ongoing survival. This theoretical concept is known as Total Behavior presented below as a circle. Human Organism – Total Behavior The Total Behavior concept is probably Glasser's crucial contribution to psychotherapy. When explaining human behavior, Glasser is focusing on the inseparable connection between action, thinking, feelings and physiological processes, rather than on the action only as the main description of behavior, as most other theoretical approaches do. Glasser's Total Behavior concept underscores the importance of inseparable unity of mental and physical aspects of humans (i.e., behavior = organism). This approach awards humans by individuality, responsibility and freedom, regardless circumstances. While acting and thinking components of human behavior individuals can consciously choose, the related feelings and psychological processes are more automatic and not in one’s direct control. Still by choosing acting and thinking we instantly choose our feelings and physiology. Understanding all aspects of human functioning as connected and inseparable allows individuals to have a sense of control over their lives, regardless of circumstances. The outer line encircling the Total Behavior represents our perception through which we process information from the environment (select, interpret, and evaluate). International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 87 Functioning of the Human Organism To explain the functioning of human organism it is critical to understand its three crucial characteristics: a) inner instructions b) ability to monitor information in the environment and to compare it with its own instruction, and c) ability to harmonize within itself and with the environment. a) Inner instructions Functioning as a closed- loop system, human organism constantly tries to meet its own instructions in order to achieve internal balance and a balance with the external environment. Inner instructions are critical for the survival. The following example illustrates the meaning and importance of instructions: if a human is submerged under the water and spends too much time without oxygen, human will die. But if fish is dropped in the water it will happily swim without a need to come up for the oxygen. These two living organisms have different inner instructions – humans need oxygen and their surviving instructions suggest they cannot breathe under the water. Fish, on the other hand, has very different inner instructions and is able to absorb the oxygen directly from the water. This example illustrates different relations closed-loop systems may have with their environment. Although external circumstances have an important role in how organisms behave, the final decision relies exclusively within an organism, and is guided by inner instructions. According to Dr. Glasser humans are born with four Basic Needs that serve as specific human instructions critical not only to survival but also to mental health: love and belonging; power; freedom; and fun. These Basic Needs must be satisfied for an individual to be mentally healthy. Based on their own experiences over time, individuals additionally develop more granular instructions that guide their functioning, referred to as individual’s Quality World. The Quality World can be described as a kind of individual’s automatic pilot. Related inner instructions are closely connected with human’s ability to monitor and compare information and register differences, described below. b) Ability to monitor and compare information and register differences Humans possess an ability to constantly monitor, select and compare information from the environment with their inner instructions. External information is filtered by inner instructions. Based on one’s Quality World, individual sets own expectations and also International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 88 assigns value to incoming information, forming perception. There is often a difference between expectations and perceptions. Reality Therapy defines that difference as frustration. Individual behavior is driven by frustration. Coming from one’s Quality World, expectations can be unrealistic or impossible to achieve, undermining individual’s stability. One’s stability can be further influenced by the value individual assigns to information and subsequent perception. The magnitude of frustration thus depends on the extent to which one’s expectations are realistic, and what perceptions one chooses in a particular situation. c) Ability to harmonize within itself and with the environment Frustration activates human ability to harmonize with the environment and achieve internal harmony. All produced behavior has an ultimate purpose to reduce frustration and establish balance. Since humans cannot tolerate the gap between expectations and perception, they constantly search for ways to achieve the balance. But efforts to reduce frustration may actually deepen it, depending on one’s understanding of behaviors and underlying beliefs. For example, individual may believe that it is possible to control external circumstances and others’ behavior directly, and thus focus their action towards that objective. Such efforts inevitably become ineffective and deepen one’s frustration. Long-lasting frustration, coupled with ineffective solutions, can result in unusual symptomatic behaviors that aim to reduce frustration. Such behaviors psychiatrists tend to diagnose as pathological. In the Reality Therapy context human organisms are viewed as highly productive and creative systems. Consequently, such behaviors are interpreted as a signal that client is not in balance, attempting to employ creativity to regain the balance. Humans are in balance when their basic needs are satisfied in three main areas of life – family, professional life, and personal life. Relationships with other people, especially with important ones, are crucial for the satisfaction of basic needs and the key to overall life balance. Dr. Glasser summarized that view in his statement: “All long-lasting psychological problems are relationship problems.” Individuals that enter therapy tend not to be well connected with others nor have satisfying relationship. Why is that? The prevalent reason is that people are inclined to believe that they are victims of circumstances and others and, following the same logic, that they can control and manage others’ behavior. Moreover, they understand relationship as an interaction between individuals and expect others to satisfy their needs and make them happy. Such understanding of human behaviour Glasser calls External Control Psychology, labelling it as the core of psychological problems. The Choice Theory perspective places one’s own behavior at the core of relationship where an individual satisfies own needs in connection with others. Individuals are fully responsible for the quality of their relationships since they have exclusive control over own behavior. Depending on the beliefs which guide their actions, individuals choose to be more or less satisfied in a given relationship. Ultimately, one can always choose to end any relationship. The main goal of Reality Therapy is to offer clients an opportunity to replace the External Control Psychology beliefs with Choice Theory beliefs. Individual beliefs are part of specific instructions that are developed with experience. Beliefs related to human behaviour are not an exception. The External Control Psychology is prevalent and it is no wonder that people have mostly developed related beliefs. Reality Therapy, on the contrary, emphasizes understanding and awareness of human behavior. Since most of human behavior is automatic, clients are not aware of their External Control Psychology beliefs which are at the basis of their problems. Understanding and being aware of their own beliefs enable clients to develop new effective long-term behavior. Table below displays the Total Behavior concept from the two described perspectives: International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 89 Thinking Component of Total Behavior External Control Psychology Beliefs Choice Theory Beliefs My behaviour is my response to certain circumstances. My behaviour is my choice under certain circumstances. My behaviour is a response to your behaviour and vice versa. I can make you behave the way I want and I believe that this is right and just. My behaviour is my choice, your behaviour is your choice. Your behaviour is just an information for me, what will I do with it is my choice and vice versa. My role (my duty and responsibility) is to make you behave the way I want you to behave. I believe that this is right and you should behave that way. My role (my duty and responsibility) is to create conditions. What will you do within it is your choice and your responsibility. Acting Component of Total Behaviour is in Accordance with Beliefs External Control Psychology Beliefs Choice Theory Beliefs Destructive behaviour: criticizing, blaming, complaining, insulting threatening, punishing… Connecting behaviour: supporting, encouraging, listening, accepting, trusting, respecting, balancing differences… Using excuses Using initiative Denying responsibility Taking responsibility Feelings and Physiology Are Inseparable with Thinking and Acting Components Formulation in Reality Therapy Formulation in Reality Therapy begins when clients start to tell their story and lasts till the end of the therapy. As previously underscored, formulation is a mutual process of exchanging, reflection, and self-evaluation, that is a part of the moment-to-moment therapeutic process. While aware of the difference between client’s perspective and explanation of the problem, the therapist aims to harmonize the process and avoid misunderstanding. Trust and respect are crucial for creating productive relationship with the client. However, the relationship between therapist and client is based on two different core beliefs: External Control Psychology and Choice Theory Psychology. As a result, the client can sometimes perceive therapist’s intervention as an attack on their personal values rather than a new perspective on the problem. For the therapeutic process to be successful the therapist must display ongoing sensitivity, patience and acceptance towards client. The clients’ personal involvement and participation is vital to success since they need to make progress in their quality of life. The pace of the formulation process may differ for clients that opt voluntarily to engage in therapy and those that are sent by others to see the therapist. In the former case, client tends to begin telling their story right away enabling the therapist to immediately start formulation. In the latter case, the therapist often needs to International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 90 spend some time establishing relationship with the client and working on mutual agreement how to proceed before commencing formulation. Reality Therapy is the process of using the Choice Theory beliefs in counseling /psychotherapy. The therapist shares the Choice Theory beliefs during the therapeutic process as the most important aspect of forming relationship with the client, engaging in self-evaluation throughout the process. Relationship Between Therapist and Client in RT Active listening aims and enables the therapist to recognize clients’ External Control Beliefs. Clients usually start personal story with complaining, accusing, criticizing and blaming others and circumstances for their problems. Such actions are typical for individuals who believe that external circumstances and others manage their lives. Clients perceives themselves as victims and others and/or environment as causes of all problems. Clients’ description of the situation and events where they blame others and view themselves as victims represents a harmful perception that is a significant component of frustration. Such perception masks unrealistic expectations on the part of client. The told story reflects personal dissatisfaction and imbalance, revealing loneliness and problematic relationships with important people. Clients are not ready to assume personal responsibility and use excuses for own passivity. For the therapist, this represents an opportunity to explain the situation using the Choice Theory Beliefs, and to monitor how clients accept new perspectives. In this process the therapist enables clients to become aware of own unrealistic expectations and harmful perceptions creating thus conditions for improvement and change. Therapist redirects conversation from what clients cannot change in life to what they can change – own behavior. Both therapist and the client are undergoing selfevaluation throughout the process. In the beginning the clients’ self-evaluation rests on the External Control Beliefs. Over time, with therapist’s guidance and learning new perspectives, clients adopt the Choice Theory Beliefs as the basis for self-evaluation and personal change. Case Formulation – Ana Ana was 39. She has been seeing psychiatrists since the age of 14, and over the years they have diagnosed her with different disorders, from borderline to anxiety disorder and depression, to a variety of phobias. She occasionally took medication prescribed by her psychiatrist. She came from a wealthy family of intellectuals. Ana’s parents divorced when International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 91 she was 13. Her father, with whom she was very close, started a new family and stopped communicating with her. Ana was trying to reunite with him for a long time, but to no avail. Her father died when she was 17, and she only learned about it six months later. After her parents’ divorce, she had a very distraught relationship with her mother who first took her to a psychiatrist at the age of 14, due to, she claimed, her inappropriate behaviour. She was then diagnosed with borderline disorder and prescribed medication. Ana was an excellent student with above-average intelligence. At the age of 18 she enrolled in a university, and graduated at the age of 22. When she was a sophomore, her mother was diagnosed with cancer, from which she died two years later. After learning that her mother was ill, Ana attempted suicide and was hospitalized. Upon release from the hospital, her mother initiated a procedure to deprive Ana of legal capacity, which took effect immediately after graduation. Before she died, Ana’s mother brought home her long-time friends’ son, who was also in psychiatric treatment, and talked Ana into marrying him. The mother died when Ana was 24. After completing her studies, and deprived of legal capacity, Ana has been living on the pension she inherited from her mother. She claimed her marriage was never consummated. She and her husband lived in separate rooms, in the house she inherited from her parents. She didn’t leave the house for a long time and gave an impression of long-term neglect. She said that she wanted to start the therapy because of her agoraphobia problems. She arrived to therapy accompanied by her neighbour, who sexually abuses her in exchange for being her chaperon. Reality Therapy does not rely on psychiatric diagnoses. The practitioners do not treat the symptomatic behavior that clients identify as a reason for engaging in therapy. The therapeutic process rests on the following theoretical frame: a) the clients have long been frustrated and unhappy with their present life; b) they have unrealistic expectations that are not being fulfilled; c) they have been trying to reduce the frustration for a long time, but in ways that have only intensified it; d) the symptomatic behavior is a new creative attempt to restore balance; e) the main driver of the clients’ behavior are External Control Psychology beliefs. Considering that Ana has been in psychiatric treatment since the age of 14, she has obviously been frustrated for a long time. It is indisputable that she had numerous traumatizing experiences during her adolescence, which were difficult to cope with using her own strength and experience. As an adolescent, she was clearly a victim of the family circumstances and her parents' behavior. However, at the time when Ana commenced therapy she was 39 years old. At that age adults have control over their own behaviour. Even though she was not a minor anymore, the prolonged psychiatric treatment reinforced her role of a victim. Ana blamed her dissatisfaction on many life circumstances and events such as inappropriate upbringing, parents' divorce in the midst of her adolescence, strongwilled powerful and successful mother, abandonment by her father, left, various diagnoses assigned to her by multiple psychiatrists, plentiful medication she took at a young age, husband imposed on her by her mother, and finally the agoraphobia she has suffered from for over a year, due to which she does things she would not do otherwise. Ana’s story clearly revealed that she was trapped in the past, in prior relationships, other people’s will, and her own physiology and feelings over which she had no direct control. She believed that past events still controlled her life. These beliefs and outlook on life rendered her unable to take initiative and live a full life, making her unhappy. In line with her beliefs, Ana has come up with a variety of excuses that prevent her from moving forward. Her repertoire of behaviour was equally unproductive – criticizing, accusing, objecting, complaining, feeling International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 92 sorry for herself, bribing – all of which she used to try and change the external circumstances and other people. These behaviors, however, only reinforced her isolation. She viewed herself as a toy of fate and did not believe she had any choices. In reality, the past does not control Ana's behavior, but given her difficult personal history she developed a belief that her behavior was a response to the external circumstances and behavior of other people. Consequently, she directed the conversation to the past events and resulting symptoms, with a belief that it would be possible to liberate herself of the symptoms that “make her life miserable”. Evoking painful memories from the past cannot change what happened, and it contributed little or nothing to what Ana needs now – a stable and happy life. It did not even help her feel well during the therapy. Therefore, discussing past was unproductive except in situations where the therapist needed to explain to Ana how she developed the belief that she is the victim, which she was not able to grasp. The past was discussed only if it helped her feel better in the present. Ana's story suggested that she was unhappy and quite lonely. She was not able to meet her own needs in a way that would make her life fulfilled. She was unemployed and had no friends. The only relationship Ana referred to was the relationship with her husband. However, she perceived him as an intruder imposed on her by her mother, describing him in very negative terms. She barely communicated with him. They slept in separate bedrooms and have never had sexual intercourse. She hoped, she said, that he will move away and leave her alone. Ana spent most of her time in pyjamas watching TV because she “does not feel like doing anything else.” She did not shower, comb her hair, or cleaned her house. The only thing she would like to do is to go out, but she was afraid. Reality Therapy defines frustration as the difference between expectation and perception. For years, Ana has been progressively deepening her frustration by building unrealistic expectations and viewing her situation in a way that made her powerless and miserable. She was convinced that her life circumstances were the consequence of others’ behaviour, and that fear prevented her from taking the initiative to live a full life. Such perception of life made her unhappy. All Ana’s actions were attempts to reduce frustration, but her behaviour was unproductive and unable to restore balance in her life. Over time she developed a fear of open spaces and psychiatrists diagnosed her with agoraphobia, which she viewed as her main problem. Ana developed and kept indulging in self-destructive behavior that constantly deepened her frustration. Even though her behavior as purposeful “worked for her”, the cost was obviously very high since she remained highly frustrated and unhappy. This undesirable modus vivendi, a vicious cycle that pulled Ana down like whirlpool, became the key reason to engage in therapy. She entered the therapeutic process with a hope to alter her painful reality and create ways to live a normal life. However, Ana was focused on her feelings and psychology related to agoraphobia. These two components of behavior are not in person’s direct control and self-help is not possible. Instead, the focus must shift to activity and thinking, components of behavior that can be controlled by an individual. Once Ana would become aware of her beliefs, she would be able to create possibilities to choose more effective long-term behaviors. Ana's knowledge of psychiatry and psychotherapy was surprisingly extensive. During first session, she was trying to impress and convince the therapist that she cannot be helped, which she tried to prove with abundant paperwork from various experts. She was trying to International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 93 resolve her long-standing problems with the help of psychiatry and numerous psychotherapists of different orientations. As she has not succeeded so far, she decided to start over. Ana was fervently sticking to her diagnosis. Although she presented it as an enemy, she nurtured it as if it were her best friend. This was understandable, because the symptoms distracted her from the problems she could not resolve. Therefore, although asking for help, she defended her diagnosis relentlessly. In this process the therapist demonstrated understanding and acceptance. Ana felt that therapeutic relationship was based on respect, although she and therapist had different outlooks on her issues. When giving explanations, the therapist stayed true to the Choice Theory beliefs, but also stressed that there were other approaches and sources she could turn to. It is critical for a client to feel safe with a therapist and to be able to meet own needs. This is the only path to develop trust needed to embrace new behaviors the client would never embrace without support. During a year-long therapeutic process Ana made remarkable changes in her behavior which eliminated the symptoms she displayed at the outset. The therapist’s primary focus was to shift the conversation from the past, that could not be controlled, to present living context. This critical redirection was not easy since Ana was heavily burdened by her past. Therapist agreed with Ana to allow the past into the conversation as long as it helped create positive future. Once the conversation was shifted to the present, it became clear that Ana was lonely, with no friends, without work or any structured obligations, daily neglecting herself by wasting time in pyjamas watching TV. Such destructive behavior contributed to her solemn mood. As present, unlike past, can be changed, the therapist worked with Ana to turn her whining into action by focusing her on what she can change, rather than dwelling on what she cannot change. Overcoming the enclosed living place became the priority over conquering open space. Slowly but steadily, Ana discovered possibilities that could help her turn her life around. Although she remained sceptical, the trusting relationship with therapist enabled her to introduce small changes into her life that provided her with a growing sense of control. These new experiences helped Ana alter her engrained belief that she was the prisoner of life, and she began to believe that she could control it. With this outcome the main objective of the therapy was achieved. Thinking and acting are the components of behavior we can willingly control. Small steps led Ana to gain a sense of control over her life, even if it only meant washing her hair and body after not doing it for six months, or cleaning her bathroom after not doing it for years. One might find it difficult to label this as “psychotherapy” but these seemingly menial actions became closely related to subsequent changes in Ana’s beliefs and her ability to control her life – experiences she never had before. The therapeutic work with Ana was based on the choice theory where therapist recognizes opposing beliefs in the content provided by the clients, and gives them opportunity to test these beliefs. Ana was provided ample opportunities for continually self-evaluation the activities and beliefs she advocated. In doing so the therapist relied on client’s experiences, and then, together, searched for new possibilities to convince the client that she was creating her own happiness. Ana learned relatively quickly that thoughts and actions had their emotional and physiological underpinning, and that the only way to control feelings was through actions and thoughts one chooses. She was ready to take a risk due to her trusting relationship with therapist. Lacking experience, clients are often hesitant to take risks and engage in novel behaviors. Ana did not have many positive experiences, and if she wanted to gain them, she had to trust therapist. In this way, she learned to trust herself and others. Trusting relationship is a powerful therapeutic tool. International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 94 Inspired by new perspective that she discovered in therapy, Ana started editing short stories she had been secretly writing for a long time, and was able to publish them six months later. Her book was a great success. This significant event opened up new possibilities to connect with the outside world such as promotion of the first book, radio interviews, talks with the press, etc. At one point her companion cancelled the therapy session. When Ana came to the session couple of days later, she was delighted. “I was faced with a decision,” she said, “to go alone or stay at home... and there was no problem at all.” She opened the door to show the therapist that she arrived by herself. She stayed in therapy for several more months. The books she subsequently published were the testament that she managed to overcome her problems. From the standpoint of Choice Theory, creative behaviors have their intended purpose, which they fulfil for as long as there is need for them. After Ana filled her life with activities which helped her expand her social network and meet the necessary conditions to establish closer connections with people, and after she became a successful writer, she started believing that she, indeed, had control over her life. References and Further Reading Gazzaniga S. Michael (2011). Who is in charge. Harper Collins Publishers Glasser William (1960). Mental Health or Mental Illness? New York: Harper & Row. Glasser William (1965). Reality Therapy. New York: Harper & Row. Glasser William (1981). Stations of the Mind. New York: Harper & Row Glasser William (1994). Kontrolna teorija, ZaloZba Taxus, Ljubljana Glasser William (1998). Choice Theory a New Psychology of Personal Freedom. New York: Harper Collins Publishers Glasser William (2000). Counselling with Choice Theory, The New Reality Therapy, New York: Harper Collins Publishers. Glasser William (2000). Fibromyalgia, hope from a completely new perspective, WGI, Inc. Glasser William (2003). Warning: Psychiatry Can be Hazardous to Your Mental Health, Harper Collins Publishers. Johnstone Lucy and Rudi Dallos (2014). Second Edition: Formulation in Psychology and Psychotherapy. Making Sense of People’s Problems Lipton Bruce (2005), Biology of Beliefs. Biologija vjerovanja (2007), TELEDISK, d.o.o. Lipton Bruce and Steve Bhaerman (2009). Spontanious Evolution, Spontana evolucija, (2010) TELEDISK d.oo, Lojk Leon (2000). Scientific Argument for Reality Therapy, Znanstvena utemeljenost realitetne terapije, Alinea, Zagreb Lojk Leon (2014). Following the development of Glasser's ideas, EIRT website, International Journal of RealityTherapy, 2017 International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 95 Lojk Leon and Lojk Bosiljka (2010). Psihoterapija na Slovenskem – Realitetna terapija, EIRT, Kranj Lojk Leon and Lojk Bosiljka (2011). Psihoterapija – Realitetna terapija, Ipsa, Ljubljana Lynch Terry, (2005). Beyond Prozac, Healing Mental Distress, Mercier Press, Douglas Village, Cork Marken S. Richard and Timothy A. Carey (2015). Controlling People: Paradoxical Nature of Being Human, Australian Academic Press Marken S. Richard, (2014). Doing Research on Purpose. St. Louis, MO, USA: New View. Maturana R. Humberto and Varela J. Francisko, (1998). The Tree of Knowledge, The Biological Roots of Human Understanding, Scherz Verlag AG. Powers William. T. (1973). Behavior: The Control of Perception, Aldine de Gruyter, NY. Powers William. T. (1999). Perceptual Control Theory, Hierarchical Perceptual Control Theory and Internal Control Psychology, International Journal of Reality Therapy. Powers William. T. (2013). Making Sense of Behaviour, Umevanje vedenja, (2016) EIRT Witeker Robert (2002). Mad in America, Perseus Group Books. Brief Biography Boba Lojk, RT psychotherapist, senior instructor at William Glasser International, has developed an original approach in teaching New Reality Therapy based on personal experiences. Along with her husband Leon she set up the five years reality therapy psychotherapist training as well as four years reality therapy counsellor training. Boba is EART general secretary and confounder of Training Centre for Choice Theory and Reality Therapy in Slovenia that in 2009 became the European Institute for Reality Therapy (EIRT). Boba is EIRT Director of Training. Her contribution is that EIRT in 2011 has been recognized by EAP as The European Accredited Psychotherapy Training Institute (EAPTI). Thanks to this recognition as EAPTI every student who becomes RT psychotherapist through EIRT’s program automatic gets European Certificate for Psychotherapy (ECP) through direct award by EAP. International Journal of Choice Theory and Reality Therapy • Spring 2018 • Vol. XXXVIII, Number 1 • 96 Copyright of International Journal of Choice Theory & Reality Therapy is the property of International Journal of Reality Therapy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
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