What is Reality Orientation? - Definition & Techniques

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  • 0:02 Definition
  • 1:02 Reality Orientation
  • 2:43 How It Might Look
  • 4:19 Criticism
  • 5:15 Lesson Summary
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Lesson Transcript
Instructor: Devin Kowalczyk

Devin has taught psychology and has a master's degree in clinical forensic psychology. He is working on his PhD.

This lesson explores the therapeutic technique of reality orientation in older individuals. In addition, we will discuss the origin and current criticisms of this type of therapy.


Usually we start off a lesson with a joke or a humorous anecdote, but I'd like to start this one off with a bit of a warning. When looking for research on reality orientation therapy, which we will discuss in more depth in a moment, make sure you focus on the 'reality' aspect. By only looking up 'orientation therapy,' you will find a lot of information on the hotly debated conversion therapy, or a therapy designed to alter a person's sexuality.

Reality orientation therapy is a progressive treatment for confused elderly patients to help them focus on their immediate surroundings. When we say 'confused elderly,' we are not talking about how your grandparents can't remember the name of your new dog because this is your fifth 'shmootzy' or something. When we say confused, we are talking about the clinical level of memory, executive functioning, and self-directed behavioral disturbances. Let's take a look at how this works.

Reality Orientation

Reality orientation therapy was originally developed to work with severely disturbed war veterans. With PTSD comes flashbacks and an inability to discern between reality and the horrific memories. This is where a person believes they are back in the thick of combat and enemies are surrounding them. While the results were limited due to the need for different types of therapy with PTSD, it did, however, show promise with confused elderly people. This has become even more important as the elderly population continued to grow older with advances in medicine.

Reorientation therapy works by presenting orientating information, such as time, place, and person. A confused person has had all their orienting information stripped from them by whatever is causing the confusion. Imagine if I locked you in a room for an unknown amount of time and then dropped you off in another country's market place. You would want to know the time, your location, and who is with you.

Without the information of where they are, what time it is, and who they are dealing with, a person has a feeling that they may be lost - they will lack a sense of control and understanding. Remember when you were a kid and the adults made decisions without your input? It is sort of like that. But, if the reality orientation is successful there can be an increase in a person's sense of control. Just like a kid who understands why they have to go to the dentist and why they have to eat their vegetables, the increase in understanding, and possibly decision making, results in a boost in self-esteem.

How It Might Look

Let's say you were running a center or home for the elderly and some of the people become easily confused and disoriented. To use reality orientation you would likely provide some simple but effective cues to help them orient themselves. First, you would prominently display in large letters the day and date. This can be done by a large poster board or easy to read signs. You don't just want a little calendar and digital clock. You need something eye catching because if you were confused about where you were, then your brain will be struggling to make sense of things.

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