Addiction is a serious public health problem in the U.S., with millions of people struggling with substance use disorders. For many sufferers, dealing with addiction is a seemingly endless cycle of rehab and relapse.
If you or a loved one is battling addiction and looking for an effective treatment strategy, the “stages of change” model has successfully empowered patients from all walks of life to overcome their substance use issues and not only get on with their lives but thrive.
Here’s everything you need to know about the six steps in the stages of change to open the door to making an informed decision for yourself or getting help for an addicted loved one.
What is the “Stages of Change” Model in Addiction Recovery?
The “stages of change” model in addiction recovery (also known as the “transtheoretical model”) was developed in the 1970s by James Prochaska and Carlo Di Clemente as a novel approach toward understanding and transforming human behavior.
The basic theory behind the stages of change model is that changes in behavior can be tracked through six distinct phases. By monitoring movement through these stages, this treatment protocol can evaluate a person’s progress toward recovery.
Unlike other techniques, this approach avoids confrontational and aggressive tactics and instead relies on motivational techniques and transparency to encourage patients to reflect on their situations and seek positive changes in their lives.
What are the Stages of Change in Addiction?
There are six distinct phases comprising the stages of change, or transtheoretical, model in addiction:
- Precontemplation – at this stage, the patient is not yet aware or refuses to consider that there is a need to change their behavior
- Contemplation – signs of addiction are evident, and the patient is now open to the possibility that modifying their behavior may produce positive changes in their life
- Preparation – affirmative plans are made for changing certain aspects of behavior
- Action – at this stage, the patient’s plans are put into action (for example, checking into rehab or seeking therapy)
- Maintenance – affirmation of plans and recommitment to action are the objectives of this stage
- Relapse – the reality of addiction is that relapses occur, and the key to recovery is that it does not derail the commitment to changing behavior
The stages of change in addiction form a system with components that can be rearranged to suit the particular needs of an individual patient. It is adaptable to different needs, which makes it an effective tool for aiding those dealing with substance use issues.
Stages Of Change In Addiction: 6 Steps Explained
Although they are often viewed as forming a cycle or sequence, people move through the six stages of change in different ways. Some patients progress through them in sequential order, while others jump between phases or sometimes occupy several stages simultaneously.
Taken as a whole, the stages of change form a structured protocol for treating addiction in a manner that recognizes the individual nature of each patient’s challenges while avoiding a one-size-fits-all approach.
Each phase serves a unique purpose and works in tandem with the others to provide a comprehensive treatment solution. The initial objectives of the stages of change model are to
These are the stages of change in addiction explained in detail:
The Precontemplation Stage
The precontemplation stage is commonly viewed as the entry point into the stages of change model in addiction. During this phase, the person suffering from a substance use issue is not yet a patient and commonly exhibits the following behaviors or attitudes:
- The addiction in question has not produced any negative consequences
- The person views the addiction as an enjoyable or pleasant activity with no harmful effects
- The person does not recognize the addiction as an issue requiring treatment
At this point in the model, treating the addiction is not on the person’s radar because it is not yet seen as a problem requiring action.
The Contemplation Stage
The contemplation stage in the stages of change model is a critical point on a patient’s path to recovery. At this stage, a person accepts the possibility that a behavior change is needed and may be receptive to:
- Gathering information about their addictive tendencies and the potential consequences of continuing their behavior
- Becoming familiar with the basics of addiction and facing the reality of living with this disease
- Learning about treatment options and how they can lead to recovery
- Changing their addictive behavior through reduction, moderation, or abstinence
Because contemplation typically involves candid self-reflection and recognition that intervention may be needed, supportive interaction during this stage is crucial. The use of confrontational or aggressive techniques may steer people in need of support away from the resources that are available to help them.
Thinking about one’s situation does not necessarily lead to immediate action. People in the contemplation stage can remain there for a long time, even spending years pondering their addiction without acting on their thoughts. Some patients can even revert to the precontemplation stage and ignore their problem altogether.
The Preparation Stage
The next progression from the contemplation stage is the preparation stage. Here the patient takes their first affirmative steps on the path to recovery by engaging in thoughtful planning and purposeful preparation. These positive steps include:
- Considering what type of change to pursue, for example, reducing the use of the substance, moderating it, or eliminating it completely
- In the case of an addiction to prescribed medications, consultation with the patient’s personal physician or a medical professional may be necessary
- Quantifying the level of change to target, for example, half the current amount, or using the substance only during certain times of the day (e.g., one cigarette after dinner)
- Researching available aids to support a reduction in addictive behavior
- Identifying potential triggers for addictive behavior and eliminating them
- Creating a support network of family, friends, or even fellow substance users, to let them know that the patient is addressing their addiction
As much as it involves planning, the preparation stage is also about adopting the right mindset. Acknowledging addictive behavior is one thing, but developing a thoughtfully laid-out strategy for recovering from it is a huge step forward.
The Action Stage
As the name suggests, the action stage is when affirmative steps are taken to treat addiction and change the behaviors that cause substance use disorders.
The actions that take place during this phase can take many forms. Some will be drastic, life-changing events like checking into rehab. Others, however, may be small, gradual steps toward the long-term goal of sobriety. Here are a few examples of what can occur during the action stage:
- Enrolling in a treatment program or going to rehab sessions
- Meeting with professional counselors or therapists
- Noticeable changes in behavior, such as adopting new habits or demonstrating more self-discipline
- Learning to live fully while avoiding old triggers and pitfall situations
- Finding new mechanisms for dealing with stress
There are no minor successes when it comes to the action stage in treating addiction, and each step toward recovery, whether large or small, is a victory unto itself.
The Maintenance Stage
Recovering from addiction is a process, and the maintenance stage recognizes that the battle for sobriety can be hard-fought and prolonged for many sufferers. Just as there are many types of addiction, there are many levels of maintenance. More than anything, this stage recognizes the progress that has been made and aims to keep the positive momentum moving forward.
These are the key concepts involved with this phase:
- One of the main objectives of the maintenance stage is reaffirming the commitments made during the preparation stage
- Another objective is remaining vigilant against triggers and temptations that can lead to lapses in sobriety
- Goal-setting is an important aspect of this phase and it enables the patient to see real progress and maintain it
One of the underlying concepts of the stages of change model in addiction treatment is empowering patients to take ownership of their recovery. The maintenance stage is a critical point in their journey as it tests resolve and commitment daily.
The Relapse Stage
Addiction is a battle that can be won, but the fighting is never truly over. Relapses are not uncommon, which is why it is one of the six stages of change in treating addiction.
Lapses in sobriety can vary in degree from one person to the next. Whatever the severity, the most important thing about relapses from a recovery standpoint is that the patient is funneled back into the treatment cycle (i.e., into one of the stages like action or maintenance) rather than out of the system altogether.
Frequently Asked Questions
Navigating a path from addiction to recovery can be a challenging process. Here are a few frequently asked questions:
Why Do Addicts Choose Their Addiction Over Everything Else in Their Life?
It is important to recognize that addiction is a disease. Whether the substance is a prescribed medication or an illegal drug, an addiction is a condition with powerful physical, mental, and emotional aspects that can render the sufferer powerless to recover without professional help.
What Causes Addicts to Relapse?
Unfortunately, relapses are a common occurrence in the treatment of addiction. They can be caused by a number of factors such as exposure to a trigger or substance use mechanism, interaction with fellow addicts, high levels of stress, anxiety, or emotional trauma.
Addiction takes many forms and involves a wide variety of substances. The stages of change in addiction is a structured approach to treatment that can be personalized according to individual needs. It encourages patients to take ownership of their recovery and empowers them to chart out their rehab game plan, monitor their progress, and lean on a support network when needed.