April 22, 2016

The Stages of Change

Recovery from addiction is essentially about profound change, on all levels. The Transtheoretical Model of Intentional Human Behaviour Change (DiClemente and Prochaska; 1985, 1998) is used by addictions counsellors all over the world to explain this process.

The Transtheoretical Model of Intentional Human Behaviour Change

Pre-contemplation: The active addict is unaware of any problem. Such a person would be resistant to change, and her addiction might still be largely consequence free, so that there is no perception of a need to change.

Contemplation: This stage is dominated by ambivalence. The addict is beginning to see problems associated with their drinking/using/addictive behaviours, and is considering the pros and cons for change.

Determination: The addicted person prepares to take action, usually within a specified period of time, i.e. one month. There is a motivation to change; the addict is at a decisional balance. This is the window of opportunity for family, friends and perhaps therapists to intervene with appropriate change strategies.

Action: We are defined by our behaviour, not by our intentions. This stage involves actually doing something to change the problem. The addicted person might use a self-help group (e.g. AA), professional treatment, or do it on their own.

Maintenance:  Now that changes have been made and the addict is now in a recovery process, they will need to engage in activities and behaviours that support continued recovery. If one is not maintaining change, then one is moving towards relapse.

Relapse: One of the hallmarks of addiction is relapse, and it happens to most recovering addicts at some stage. But it doesn’t have to be the end of the world — relapse is a sign that the previous recovery programme was not working and that changes need to be made. It is therefore possible to learn from the relapse and bounce back into an evens stronger recovery.