Are You Ready To Change Your Relationship With Substances?
When it comes to making changes in our lives, it can often be difficult to know how and where to start. Understanding the stages of change can provide clarity and motivation to make the changes needed to live a more fulfilling life. Developed by psychologists James Prochaska and Carlo DiClemente in the 1980s, the Stages of Change model provides a framework for understanding how individuals transition from contemplation to action, and ultimately, to lasting change. This model highlights the dynamic nature of change, emphasizing that it is not a single
event, but a journey through several distinct phases. In this article, we’ll explore each of these stages, and how they relate to real-life behavior changes. Note: this article is specifically focused on the Stages of Change in substance use. However, the Stages of Change does exist in all aspects of mental health and can be applied to any desired behavior change.
Pre-contemplation Stage
In the first stage, the pre-contemplation stage, individuals have little awareness that certain behaviors are causing the issues they are facing in their lives. This stage highlights the themes of denial and resistance which may prevent individuals from seeking solutions to their problems. Individuals may place blame on other people or external situations and circumstances instead of taking accountability for their behaviors, often inducing a feeling of hopelessness.
In addiction recovery, this stage of change typically involves individuals who do not see their substance use as a problem. They often believe that the people in their lives are overreacting or even contributing to their substance use. They may have experienced consequences such as DUIs, jail, or physical illness, and yet they are unable to see how their behaviors have contributed to these problems. Treatment should focus on helping the individual recognize the discrepancies between their current behaviors and their goals. The key is to gently encourage the person to move from denial to contemplation without forcing them into change.
Contemplation Stage
The contemplation stage is characterized by ambivalence, where individuals may be aware of problems caused by their behaviors, but they aren’t sure if they are willing, or even able, to change. In this stage, individuals may be considering the pros and cons of making changes, but they are torn between their desire to change and the comfort that they experience in their old habits.
When it comes to addiction recovery, individuals in this stage know that their substance use has contributed to problems in their lives, but they aren’t sure that they are ready to stop using. For example, an individual struggling with alcoholism who has gotten a DUI may make the choice to no longer drive under the influence. However, they have not made the commitment to stop drinking entirely. Since substance use is often an attempt to self-medicate, treatment in this stage should focus on helping individuals identify the personal reasons for change. The goal is
to help build motivation and confidence in their ability to move forward with making positive behavioral changes.
Preparation Stage
In the preparation stage of change, individuals have made the decision to change their behavior, and they are in the process of figuring out how to do so. People in this stage are “preparing” for change by gathering information on steps necessary for change, setting goals, and connecting with appropriate resources.
Individuals in this stage may be planning to set a date to stop using, going to detox/rehab, or attending 12-step meetings to connect with a support system. Treatment in this stage typically includes goal setting, as well as identifying any potential barriers that could prevent the individual from achieving their desired behavior change. This stage also involves the clinician providing psychoeducation on coping skills to manage triggers and cravings.
Action Stage
The action stage of change is achieved when an individual is able to effectively implement their plans and start making recognizable changes to their behaviors. This stage continues to incorporate information gathering and supportive communities, but relies more heavily on the individual to initiate engagement.
In addiction recovery, this stage may involve quitting alcohol or drugs, attending therapy or support groups regularly, and changing their environment to avoid triggers. Treatment in this stage should offer continued support and encouragement. This often involves helping the individual stay focused with additional coping skills, reinforcing positive growth and social supports, and addressing any deeper issues that contributed to addiction.
Maintenance Stage
In the maintenance stage of change, the focus has shifted from making behavior changes to sustaining the new behavior over time and preventing relapse into old patterns of behavior. The goal is to maintain the progress made during the action stage and integrate the new behaviors into daily life.
Someone in the maintenance stage is typically no longer struggling with consistent cravings or temptations but is vigilant about their triggers and committed to maintaining healthy behavior changes as a lifestyle. Treatment in this stage tends to focus on long-term strategies for maintaining the change, such as strengthening coping mechanisms, preventing boredom or isolation, and managing stress. It is also important to be mindful of signs of regression, as they can signal a need for intervention or higher level of care.
Relapse Stage (optional)
Some Stages of Change models include a 6th stage called relapse. While this stage is not a requirement, it is a common experience for many individuals in recovery from substance use. In this stage, an individual has returned to engaging in an old behavior that can lead to feelings of frustration and failure. In this stage, treatment should focus on normalizing relapse in addiction recovery and helping the individual to identify potential causes of relapse in order to avoid these triggers moving forward. Depending on the nature of the relapse, the individual may need to
start back at contemplation, preparation, or action stages.
Final Thoughts
An important thing to remember when discussing the Stages of Change is that the process of behavior change is not always linear. People may move forwards and backwards between the stages, face obstacles, or regress into old behavioral patterns. Understanding that behavior change is an ongoing task allows individuals to be more compassionate towards themselves while continuing to work towards their goals. Whether you’re working on your own behavior changes or helping someone else navigate their journey, embracing the stages of change, rather than fighting them, can be a powerful way to support and engage in the process of growth.
Equilibria is a group of licensed mental health professionals in Pennsylvania and New Jersey with multiple specialties to serve all aspects of our diverse community’s mental, emotional, and behavioral needs. We provide in person and telehealth services to individuals of all ages, families, and those in relationships. Click here to schedule an appointment today.
