The Transtheoretical Model of Change is currently the most complete picture we have in psychology to explain how and why individuals are able to create and sustain behavioral or attitudinal changes in their lives. By understanding this model, it’s possible to better understand the behavior of a loved one suffering from addiction.

This model is primarily based on the work of Prochaska and DiClemente who first developed it in a study published in 1983. While useful and informative when dealing with substance use it should be understood that the insight provided by this model need not be limited to the treatment of addiction. It has been shown to be descriptive of behavioral change across a wide spectrum of behaviors and individuals.

1. Pre-contemplation

Individuals in this stage often are resistant to any mention or conversation of the behavior in question.

The pre-contemplation stage is characterized by an individual having no intention of modifying his or her behavior. Often he or she is not able to acknowledge that said behavior has any negative impact on themselves or others. Individuals in this stage often are resistant to any mention or conversation of the behavior in question. He or she is not engaged in the change process in an immediate sense and may resist any effort from others aimed at getting them to quit. Often individuals in this stage are thought to be in denial. Many individuals, more often than not, is that they are aware of their behavior(s) but don’t see them as a problem yet.

2. Contemplation

The person is now more aware of the personal and social consequences of their actions.

During the contemplation stage of change, the individual in question is becoming aware that his or her behavior is problematic. He or she is now more aware of the personal and social consequences of their actions. Parallel to this, the individual is beginning to be more cognizant of the benefits of change. That said, they are often still ambivalent of undertaking the change. At times an individual will pass through this stage very quickly, while for others it may take months or years. As someone concerned with a loved one suffering from addiction you will most often find them more open to conversation and information surrounding their problematic behavior. Often for substance use disorder, the fear of the detox process (and other short term costs) associated with quitting will stay with the individual. They are thinking about quitting and want to want to stop.

3. Preparation

Preparation is one of the shortest stages, and often lasts no more than a couple of weeks

In the preparation stage of change, the person of concern is now prepared to make a change. This could also be called the research phase, as often a person in this stage will actively be attempting to accumulate information and knowledge regarding to their problem. They may be calling treatment centers and other providers, or be searching on the internet for information about their problem. They may even be attempting to take their first tentative steps toward modifying their behavior or abstaining completely.

4. Action

This is a very tenuous time, as success is largely dependent on the willpower and commitment.

This is the shortest of the stages and lasts no more than six months. The individual has begun to take decisive noticeable actions to change or abstain from the behavior in question. This is also a very tenuous time as success is largely dependent on the willpower and commitment of the individual. He or she is paying the short term costs of change, without yet enjoying many of the benefits. The individual will not yet have been able to develop many methods for staying committed to change, or coping mechanisms for when stress and temptation arise. Risk of relapse is greatest during the action stage.

5. Maintenance

By this point, someone will be able to mostly avoid temptation to relapse and will have developed healthy coping mechanisms.

After some time in the Action stage, an individual will progress into the maintenance stage. During maintenance, an individual’s behavior has changed. They will most likely be fully sober. They will likely be increasingly focused on the good that has come as a result of change, and may be determined to maintain the new state of affairs moving forward. They may feel a strong sense of self efficacy and satisfaction at having been able to change.

Addiction is a chronic disease and relapse is often a component of change. This is true of many other chronic medical conditions. Therefore, while not a necessary consequence, relapse happens often enough that it can be considered a part of the process of change. Relapse is not a personal failing. Rather than viewing it within the broader scope of chronic illness, it’s possible to empower an individual to learn from the process and not to let it derail their overall recovery.

While not specifically noted in the research, it is imperative to understand that most often it is the efforts of family and friends to support an individual in making a change that creates momentum moving through the stages. It is never too early to start a conversation. There are many methods which can be employed to do so and to help support health change in an individual and within a family system.

If you are concerned that a loved one is in active addiction and need help please consult a professional, their guidance can be indispensable. If you have questions, or concerns, and we can be helpful please don’t hesitate to contact us at Granite Mountain BHC. We are here to help.

Until next time

Your friend in service,

Rob Campbell