INTRODUCTION: Drug dependence is a major problem in our country and in international level. Reality therapy is an internal control system that determines why and how to choose the options that are set for our lives. This study aimed to investigate the effect of reality therapy on metacognition, stress and decline in hope in drug addicts.

MATERIALS & METHODS: This study is quasi-experimental study. Samples were chosen convenient among 60 drug addicts in Jahrom in 2012. Samples were randomly divided into two groups (each group = 30) of intervention and control groups. Control group received usual care and experimental group received reality therapy.

RESULTS: Results revealed that there was significant difference between the mean scores of metacognition and hope before and after the intervention of experimental group (p < 0.05). Also, there was statistically significant difference between the two groups from these two variables (p < 0.05).but, Stress level wasn't statistically different in two groups.

DISCUSSION: Reality therapy is a method that emphasizes the accountability and the current behavior of individuals. Setting negative emotions, reality therapy promotes metacognition and, through increasing accountability to self-behavior improves hope.