The 6 Stages of Change in Addiction Recovery

Substance Use Treatment & Recovery group

Addiction is a unique disease. While it’s not a curable condition, it is treatable. Those who struggle with chemical dependency can overcome most of the effects of addiction to live a normal, healthy life.

To assist treatment providers and therapists to better help patients who are in active addiction, alcoholism researchers Carlo C. DiClemente and J. O. Prochaska developed their stages of change in drug addiction recovery, which is a model that highlights some of the underlying processes of addiction to help people overcome harmful and habitual behaviors.

These stages of change could be applied to a range of behaviors, from sex addiction and overeating to smoking and alcoholism. More specifically, the six stages of change can be used to indicate an individual’s readiness or current capacity to change their lives.

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Stage 1: Precontemplation

In the precontemplation stage, individuals are not yet considering any changes to their behavior. In fact, they may even doubt whether any of their behaviors are problematic. Instead, they believe that others are exaggerating about their actions or that they have no problem behaviors at all.

DiClemente asserts that there are four reasons to be or remain in the precontemplation stage: (1) being reluctant to change or becoming aware of one’s problem, (2) resisting being told what to do or how to behave, (3) feeling overwhelmed by the problem and giving up hope that one can change, and (4) rationalizing the behavior.

Stage 2: Contemplation

When individuals have reached the stage of contemplation, they are willing to consider the possibility that their behavior is problematic. Although this does not equate to actually admitting that the behavior is a problem, there’s hope for change in the realization that the behavior could be an issue.

Unfortunately, individuals in the contemplation stage are often very ambivalent. They’re willing to consider that a behavior is a problem, but their ambivalence prevents them from being decisive one way or another. In many cases, such individuals are willing to learn more about the problematic behavior as well as its treatment.

However, when they weigh the pros and cons of a behavior, or the pros and cons of change, both sides are often balanced. If previous attempts at change were made and met with failure, this could be a major reason for an individual’s ambivalence.

Stage 3: Preparation

The third stage — preparation, or sometimes referred to as determination — is when a decision or commitment to change has been made, and the actual change is planned to occur or begin in the very immediate future. When individuals are in the preparation stage, they brace themselves for an impending change by planning for it, ensuring that it occurs smoothly and successfully.

People in the preparation stage benefit from discussions about identifying and overcoming obstacles. It also helps them to identify individuals who are in their support networks. They also can help themselves by talking themselves through the impending change. In this stage, planning and preparation help reinforce the reality of an upcoming behavioral change, making individuals feel better, and more confident about it.

Stage 4: Action

As its name would suggest, the action stage is when an individual sets the plan for behavioral change into motion. In effect, the action stage indicates that behavioral change is actually in progress. Depending on what the behavioral change is, the action stage can last any length of time. It most often occurs between three and six months.

During this time, therapists and counselors should reinforce an individual’s ability to overcome potential obstacles by helping them to anticipate potential struggles. Additionally, they should concentrate on acknowledging the presence of their support system and focus on the immediate and long-term benefits of behavioral change.

Stage 5: Maintenance

Having been working on the behavioral change for six months, the individual transitions into the maintenance phase, which lasts for as long as the individual can sustain the behavioral change.

When working with a therapist or counselor, an individual will often focus on the times of difficulty or temptation to revert to the old behavior with the counselor helping the person find ways to make it less tempting or difficult.

Additionally, there’s a focus on acknowledging and identifying the many benefits of the behavioral change as noticing how one has improved due to the change will help to continue reinforcing it.

Stage 6: Relapse

The sixth and final stage will only occur if an individual relapses or reverts to the previous behavior. In the case of alcoholism and drug addiction, the sixth step refers to when individuals who have achieved sobriety relapse on alcohol or drugs, returning to their substance use behaviors.

In such instances, the focus of treatment would be to identify what or how the relapse behavior was triggered to prevent future relapses. Additionally, there’s a focus on the benefits of behavioral change as well as the negative effects that would result from reverting to the former behavior.

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