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Medically Reviewed By:
Dr. Patricia Sullivan MD MPH on 10/13/2021
The Stages of Change and Addiction
The stages of change in addiction vary among recovery specialists.
Many agree on five stages. However, if broken down methodically, individually, and completely, there are six different changes throughout recovery.
Fortunately, not everyone uses the relapse part of the sixth step.
Understanding your readiness to change by being familiar with the stages of change model in addiction can help you choose the treatments best for you.
Treatment professionals with the right training will understand your readiness and help you find and maintain the motivation to stop drinking/using.
As you continue to learn about the different stages of change in addiction, think about where you are right now and what might help you move forward best.
What stage do you currently most identify with? We are here for you and want to help you to become prepared to start your recovery.
Please call us today at (888) 906-0952 and let us help you on your journey of change. We want you to succeed as much as you do. Your life is important!
Content Sections: Stages of Change in Addiction
- What Are The Stages of Change in Addiction?
- A Close Look at All The Stages
- The 6th Stage of Change
- Stages 1 & 2
- Stages 3 thru 5
- The Transtheoretical Model (TTM)
- Tailoring Rehab Treatment to Suit Your Process of Change Matters
What Are The Stages of Change in Addiction?
Agreed upon by the majority of those in recovery, the five stages of change addiction model include:
However, in the 1980s, two well-known alcoholism researchers, DiClemente and Prochaska, watched numerous persons in many different areas such as overeating, smoking, excessive drinking, and many others and recognized one more stage rarely spoken of in a mental health setting.
This final stage, the sixth stage, is relapse or termination. A deeper look into this sixth step should be the beginning point rather than the end.
A Close Look at All Stages of Change
Individuals move through several stages of change addiction model when modifying behavior. Although the time in each stage varies with each person, the tasks to move to the next stage are not.
The principles at each stage reduce resistance, facilitate progress, and prevent relapse.
These principles include decisional balance, self-confidence, and the process of change.
Usually, less than 20% of people at risk are ready to act at any given time.
Generally, the changes of change can occur linearly, but a nonlinear progression is common. Individuals recycle through the stages often or regress to earlier stages from later ones.
The 6th Stage of Change
Relapse or termination is the sixth step in stages of change addiction recovery, recognized or not. First, alcoholism and drug addiction are chronic diseases like diabetes and high blood pressure. The return of symptoms does occur at times with high sugars, blood pressure rises, and medications stop working. Hence, relapse is very realistic in the world of recovery.
An individual may experience a temptation to drink or use again and fail to cope with it successfully. Although individuals have many prevention skills by this stage, at first, the individual may not be at a stage of preparation enough to think of these things automatically.
In many instances, the experience of relapsing and returning to recovery strengthens the person’s determination to stay in recovery.
Ultimately, the goal is to reach the termination part of the sixth stage.
Termination is where the individual in recovery no longer finds the alcohol or the drug to present temptation or threat and has the confidence in coping without fear of relapse. What an exciting idea! Working through all the stages of change in recovery can help you avoid relapse.
Change is certain, if not an incredibly strong possibility when you have worked through the stages of change effectively.
Stages of Change 1 – 2
Precontemplation is where “the Four R’s” are strongest.
These include reluctance, rebellion, resignation, and rationalization. Reluctance is the lack of knowledge to consider a change. The impact of the issue has not become fully conscious. Rebellious pre-contemplators have a heavy investment in drinking/using and making decisions of their own and do not want others to (what they perceive as) “boss them around.”
Precontemplators with resignation have given up hope about the possibility of change and are overwhelmed by the issue after making many attempts to stop before with no success. In this stage, you now believe you have all the answers, why drinking/using is not an issue, and why it can be an issue for others, but not for them.
Contemplation is second, and where the individual is willing to consider the idea, he might have a problem, and this offers hope for change. Contemplation is not an actual decision to change yet. At this point, you are ready to hear about potential treatment options because you understand your drinking/using is causing problems and have a mental list of the reasons the drinking/using is bad.
Contemplation is where you make a pros and cons list of your behaviors and the change. Mental health professionals often call this a risk-reward analysis.
Stages of Change 3 – 5
Preparation to action, determination, is where the decision to stop drinking/using is the basis of this stage. All pros and cons and risk-reward analyses have tipped the balance in favor of change. The preparation stage is where you are ready to start healing. Most of you will now make a serious attempt to stop drinking/using.
Many times, you will do this with the help of a treatment professional. Together, you will make a realistic assessment of the level of difficulty involved in stopping drinking/using. You can now begin to anticipate pitfalls and learn to build concrete solutions which will become part of your ongoing treatment plan.
Action or implementing the plan is next. This stage involves you making a public commitment to stop drinking/using from having external confirmation. You will enter counseling or some form of outpatient treatment, attend an AA, NA, or other support groups, or tell family members and friends about your decision.
You may even do them all. You will need to make necessary adjustments along the way as your behaviors change. The things alcohol/drugs have taken from you begin to experience restoration, hope, and self-confidence. All of which will continue your determination not to drink/use.
Maintenance is where you continue your changed behavior over a sustained length of time. New behaviors take the place of drinking/using. This stage will take between three and six months. Your change requires building new behaviors over time and continues with little intervention.
However, the real test of your change is long-term, sustained change over many years. Maintenance is your alcohol/drug-free life and is becoming firmly established. As time goes on, the threat of returning to old patterns becomes less and less frequent. You are on your way!
The TTM is an integrative, biopsychosocial model to see the process of intentional change. Models other than the five stages of change model in addiction focus on social or biological influences. The TTM seeks to include and integrate key constructs from other theories into an all-inclusive theory of change that can be applied to various behaviors, populations, and settings.
Stages of Change in The Transtheoretical Model
At the heart of the TTM are the stages of change in addiction. These are the same as the five stages of change in addiction.
The stages are:
- Precontemplation (not ready)
- Contemplation (getting ready)
- Preparation (ready)
- Action (ready)
However, TTM utilizes several other areas to enhance the already successful stages.
Those areas include:
Decisional Balance- In 1977, Janis and Mann conceptualized decision-making as a “balance sheet” of gains and losses. Also known as the pros and cons, they have become core constructs in the TTM. The decisional balance shifts from the pros of your alcoholic/addict behaviors to the cons through each stage, allowing you to begin your recovery journey.
Self-Confidence- Bandura created the self-confidence theory. TTM integrates elements of this theory by helping you reflect on your confidence in maintaining your desired behavior changes in situations that often trigger a relapse. Relapse will usually occur in situations where your feelings of temptation outweigh your sense of self-confidence to maintain your desired behavior change.
Process of Change- Although the stages of change in addiction are useful in explaining when changes in cognition, emotion, and behavior occur, the processes of change help explain HOW those changes occur.
Critical Assumptions- Health interventions can help to facilitate your change. A specific set of assumptions drives TTM theory, research, and practice.
Ten covert and overt processes are implemented for successful change and divide into two groups-cognitive and affective.
Those are as follows:
Cognitive and Affective
- Get the facts
- Pay attention to feelings.
- Notice your effect on others
- Create a new self-image
- Notice public support
- Make a commitment
- Use substitutes
- Get support
- Use rewards
- Manage your environment
Tailoring Rehab Treatment to Suit The Stages of Change Matter
Behavior change is a process that unfolds over time through a sequence of stages. Health population programs need to assist people as they progress over time. Stages are both stable and open to change, just as chronic behavior risk factors are stable and open to change. Individual health initiatives can motivate change by enhancing the understanding of the pros and diminishing the value of the cons.
Most at-risk individuals are not prepared for action and will not find help by traditional prevention programs.
Helping you set realistic goals, like progressing to the next stage, will facilitate the change process. Specific principles and processes of change need to have emphasis at specific stages for progress to occur. Having a well-trained professional to help you is critical to your overall success. You (or anyone else) won’t ever have all the answers. Asking for help is a good thing. Alcoholism/addiction lies to every individual suffering. The inability to see the truth in early recovery is another reason professionals can help you.
Studies have demonstrated greater effects for you in programs tailored to each of the TTM constructs. Your stages of change in an addiction program tailored to your pros and cons do better for you. A program tailored to your self-confidence will do better than one that does not.
A program tailored to your processes of change does better than one that does not. Your choice now is to find the program tailored to you. Which stage are you at currently? How will you get to that next stage? Which program is best for you? Who can help? We can and will help you find that program.
Give us a call at (888) 906-0952, and let us help you on your road to recovery with the program which best fits your needs. You can do this, and you deserve it!
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