Stages of Change
One of the hardest parts of alcohol or drug addiction is asking for help. It is the ultimate lesson in humility. Most are too proud and mistakenly think that asking for help would tarnish their image. So they suffer in silence.
Substance abuse is a complicated illness that often requires some major life event such as incarceration, divorce, job loss, an overdose by a loved one or friend, or a major life trauma to want to make a change. We use the Stages of Change model as a way to assess a client’s readiness to change as well as to design interventions based on his/her current stage.
The Stages of Change, also called the Transtheoretical Model, was developed by Prochaska, Di Clemente, et al. It originally looked at the process of change in people who were quitting smoking. In this model he proposed that there are five stages that occur when someone decides to make a change.
We use this model in conjunction with other therapies and interventions, based on a client’s readiness to change. The stages are:
- Precontemplation – I don’t think I have a problem, but other people around me (family, friends, law enforcement) do.
- Contemplation – I think I may have a problem, but I’m not sure what to do about it.
- Preparation – I start doing some research, asking people what to do, look at the Cornerstone website.
- Action – I’ve been working hard at my sobriety and putting together time away from the drug.
- Maintenance – I’ve been drug/alcohol free for a while now and I’m even helping others! (The clean time is usually one year or longer depending on the drug and the severity of problem.)
It’s important to remember that someone might be in Maintenance stage regarding opiates, but in contemplation about another drug, e.g., alcohol. We might use motivational interviewing techniques to help the client resolve that ambivalence.