Reality testing is the psychotherapeutic function by which the objective or real world and one's relationship to it are reflected on and evaluated by the observer. This process of distinguishing the internal world of thoughts and feelings from the external world is a technique commonly used in
psychoanalysis
PsychoanalysisFrom Greek: + . is a set of theories and therapeutic techniques"What is psychoanalysis? Of course, one is supposed to answer that it is many things — a theory, a research method, a therapy, a body of knowledge. In what might ...
and
behavior therapy
Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or ot ...
, and was originally devised by
Sigmund Freud
Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating pathologies explained as originating in conflicts ...
.
Purpose
Within
psychotherapy
Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome prob ...
and
counseling
Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes.
This is a list of co ...
settings, practitioners use reality testing to influence the patient or client to recognize their negative thoughts, evaluate the thoughts logically rather than emotionally, and then determine whether the thoughts are valid (ie: internally consistent and grounded in reality). The focus of reality testing is not necessarily concentrated on the source of the behavior or thought, but rather on the fact that current thoughts are occurring and influencing behaviors in the here-and-now. After undergoing this technique, the patient or client is often able to see that the thoughts they have been experiencing are, in fact, not valid or based on reality, and should therefore not be used as the basis for life decisions. Reality testing can be used in this way to help facilitate corrective emotional experiences by disconfirming and altering previously held negative or unrealistic expectations in favor of more adaptive functions.
Psychotherapy methods such as
rational emotive behavior therapy
Rational emotive behavior therapy (REBT), previously called rational therapy and rational emotive therapy, is an active-directive, philosophically and empirically based psychotherapy, the aim of which is to resolve emotional and behavioral pr ...
and
cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (su ...
rely heavily on the client's ability to frequently self-examine internal thoughts and assess their preceding influence on perceptions, judgments, and behaviors. Continual reality testing directed by therapists can help educate clients on how to habitually examine their own thought patterns and behaviors without the ongoing need for a therapist. Constant and prolonged exposure to a multitude of corrective experiences can lead clients to form their own internal and enduring changes in thoughts, expectations, feelings, and behavior.
[Pachankis, J. E., & Goldfried, M. R. (2007). ''An integrative, principle-based approach to psychotherapy: the art and science of psychotherapy'', 49-68.] Reality testing has also been identified as a curative factor when implemented within a group therapy setting. In group counseling, clients can use the perspectives of other group members as the basis of reality testing and receive instant feedback through group discussions, roleplaying, and other group activities.
Characteristics
Therapists using reality testing techniques typically rely upon the client's mental processes of attention, perception, memory, and judgment in order to help guide them to the formation of logical conclusions about how their internal experiences are related to external reality.
Limited reality testing capabilities can sometimes be a function of a
mental disorder
A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitt ...
. People exhibiting limited reality testing might lack the insight and ability to distinguish between the external and internal world as a factor of
psychosis
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior t ...
. For example,
hallucinations
A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combinati ...
and
delusions
A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some ...
are often taken as signs of a failure of reality testing.
Reality testing has been identified as being one of the common therapeutic principles of change.
[Goldfried, M. R. (1980). Toward the delineation of therapeutic change principles. ''American Psychologist'', ''35'', 991-999.] Principles of change are shared by all theoretic orientations of therapy, and include strategies such as: promoting client belief in the effectiveness of therapy, the formation and maintenance of a
therapeutic alliance
A therapeutic alliance, or working alliance, is a partnership between a patient and his or her therapist that allows them to achieve goals through agreed-upon tasks.
The concept of therapeutic alliance dates back to Sigmund Freud. Over the cour ...
with the client, facilitating client awareness of the factors influencing their problems, and encouraging the client to engage in corrective experiences.
Emphasizing ongoing reality testing in the client's life has been demonstrated to be among the principles of change that can be used to explain and account for the underlying effectiveness of therapeutic counseling techniques, regardless of theoretical ideals. For this reason, aspects of reality testing can be incorporated in a variety of therapeutic treatment plans.
See also
References
{{reflist
Treatment of mental disorders