Whenever anyone has an issue they want to change about themselves, they go through steps or stages to bring about that change. Whether we want to change our diet and start working out as a New Year’s resolution, stop leaving dirty dishes around the house, or overcome alcohol and drug addiction, we all go through stages of change over a period of time.
The Transtheoretical Model of Behavior Change is a therapy intervention that assists people to make positive change in their lives through several Stages of Change. Knowing the stages of change isn’t going to get someone in shape, or get them to stop leaving dirty dishes around the house. However, having an idea of the stages of change can help friends and family assist someone who is suffering from alcohol or drug addiction get the help they need when they are ready for it.
The following are the Stages of Change and a description of each:
Precontemplation – (I don’t have a problem) This is the stage of change where someone might not be aware that a change is needed. Or they deny their behavior is a problem. There is no insight to the problem.
Maybe they haven’t weighed themselves since before Thanksgiving so they don’t know how much weight they’ve put on during the holidays. Maybe someone else has always cleaned their dishes up after them. Or maybe their drinking and using has escalated slowly over time and they don’t notice the damage it is doing to them or their family.
If confronted about change during this Stage, an addict or alcoholic might say things like, “It’s not that bad. You’re overreacting” or “I can stop anytime I want”. Initiating lasting change during this stage is difficult. Why would someone change if they don’t view the behavior as a problem? Family and friends of an alcoholic or addict can become very frustrated if their loved one is in this phase because they might deny they have a problem at all. Luckily there are professional drug and alcohol counselors that can work with individuals to get them to the next Stage of Change.
Contemplation – (I might have a problem) This is the stage of change where the person starts noticing the consequences of their behaviors; they might even have a problem.
They might notice some weight gain or not fit into a piece of clothing anymore. They might notice there aren’t any clean plates or cups to use. They might be gaining some insight into the consequences of their drinking and drug use.
Maybe they are getting tired of waking up hung over, they lose a job, or get into legal trouble. The alcoholic or addict might be more apt to look for help at this stage, but there may still be excuses such as “It’ll be different this time” or “I’ll stop/control it for a while”. They are gaining insight and admitting that there are some consequences to their behavior, and that change might be necessary at some point.
Preparation – (I have a problem. I’m going to do something about it soon.) This stage of change is where the person admits they have a problem and starts to look into ways to change their behavior.
This could mean researching diets and exercise routines to lose weight, or rearranging the kitchen cupboards to keep better track of the dishes. For an addict or alcoholic this stage includes things like attending a first AA or NA meeting, seeing a therapist or counselor, or setting a date to stop using.
Preparation is one of the better stages of change for friends and family to lend their help. With their improved insight into their problematic behavior, the alcoholic and addict are more welcoming of help given by family and friends during this stage. Providing meeting schedules, therapist recommendations, or even inpatient treatment center options will be less likely met with anger or resentment.
Action – (I’m doing something about my problem) This is the stage of change where the person is actively doing something to change their behavior. The behavior change is new and difficult but with time it can become a new pattern of behavior.
During this stage of change a person begins eating within their new diet and exercising regularly. They may begin to actively try to wash their dishes after every use. An alcoholic and addict during this stage has started a recovery program and is actively trying to change. They could be regularly working with a sponsor, seeing a therapist and completing any assigned homework, or have entered a substance abuse treatment facility and actively participate in an outpatient treatment program or group counseling sessions.
This stage can be difficult for the person attempting initiating the change. Attempting any behavior change or learning new skills and abilities can be difficult and frustrating. Positive encouragement from friends and family is important during this stage.
Maintenance – (I had a problem, but now I’m maintaining a new pattern of behavior) In this stage of change a person has been implementing the new behavior for a while and it has developed into a new habit. The effort is now spent on maintaining the pattern of behavior.
This stage usually starts anywhere from 6 months to 1 year for someone in recovery, depending on the individual and their circumstances. Being in this stage of change does NOT mean someone is cured of the old pattern of behavior. It just means that they have changed their behavior and have maintained it for a while. Their energy is less about focusing on doing the behavior; it may have even begun focusing on new habits.
New habits can be stopped and old habits can be started again however. During the maintenance stage a person has become fully invested in their new diet and exercise routine. It has become a habit and it is less of a struggle to find motivation to work out. A person has developed the habit of washing their dishes after every use. They may start the dishwasher at night and unload it in the morning. A person in recovery may have successfully completed their stay in inpatient treatment and has transitioned into an outpatient program to assist with long term recovery. They may have maintained their sobriety and have started to repair the damage done during their use.
Note that these stages may not happen in this order and the length of time spent in each phase differs for everyone. Someone in the action phase might get discouraged and revert to the precontemplation stage thinking “It really wasn’t that bad”, or “It’ll be different this time”.
At Bay Area Recovery Center our State-licensed clinicians are educated and trained to guide our clients through each stage of change, using an individualized treatment plan tailored to each person’s situation. No two people are the same, but knowing the stages of change can help identify whether the focus of assistance needs to be on gaining insight or maintaining focus.