Stages of Change Behavior Modification Therapy
How We Approach Treatment for Addiction and Alcoholism
There are four main stages: pre contemplation, contemplation, preparation and action. Additional stages of maintenance and relapse are also sometimes included. As in any aspect of life that is difficult to approach, changing lifestyles, or habits, or beliefs or self-image can be a daunting task. Sometimes it may even seem impossible. And as in any aspect of life, of living, changing the way in which we do things takes a process. There are steps that we must take in order to make lasting changes. To help make sense of this process, two alcoholism researchers, Carlo C. DiClemente and J. O. Prochaska, developed a model of change that they called "The Stages of Change". This model involves six stages that take a person from the beginning - learning to identify a problem - to the end - living without that problem. The Stages of Change model helps providers to understand addiction, and helps people with addiction learn to recognize their place in the change process as a means of striving towards recovery.
In this stage, an individual may not even recognize that she or he has a problem. People are not
yet thinking about changing their behavior directly, and may believe that other people are
overreacting to them and their behaviors.
Reasons to be in pre contemplation can be broken down into four categories;
• Reluctant: May not have enough information to identify the problem
• Rebellious: Are so habituated to their behaviors that they become hostile or resistant.
• Resigned: Believe in the inability to change and thus remain stuck
• Rationalizing: Take the time to think out their behaviors and justify their choices. The problems does not belong to them
This is the openness to consider that a problem exists, and that there may be a need to change one's behaviors in order to correct that problem. A commitment to change has not yet been made; there is not yet direct action although one may undertake to learn more about the nature of the problem.
The person has made a decision to stop using, to make a change. Sometimes this Stage is referred to as Preparation, as the person begins planning a course of action to initiate change in her life.
The person recognizes and admits that a problem exists, and has developed a plan to make changes. He modifies his behaviors, environment, relationships, and experiences to overcome the problem. He puts the plan he made in the Determination stage into action.
Maintenance, Relapse and Recycling
Change has been achieved - a pattern of addictive behaviors has been replaced with sobriety and strides into recovery. In Maintenance, the person recognizes the benefits of successful change, however, work must still be done as the risks remain for returning to old behaviors. It has been said that "Relapse is part of recovery" and as such, the person must be on guard against triggers to relapse. If a relapse does occur, the person must re-enter a Stage such as Contemplation or Determination. In some cases, the person returns back to Pre contemplation. This does not equal failure, but merely the need to re-engage the process of change from the beginning.
At some point in the Maintenance Stage, the threat of relapse truly is reduced. When triggers arise, such as personal crisis or financial hardship, the person has a support system in place and resources available to maintain sobriety in a recovery lifestyle. Substances no longer emerge as the first, second, third or tenth response to crisis.
Adapted from Prochaska, J.O., & DiClemente, C.C. (1984). The Trans theoretical Approach: Crossing traditional boundaries of therapy. Homewood, IL: Dow Jones-Irwin Ref: Oregon court government