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One of the most essential—and challenging—aspects of addiction recovery is the need to change a person’s behavior to improve their health status. Behavior change interventions, which involve a combination of program elements or strategies, are especially useful in addressing lifestyle modification for those suffering from addictions.
A change in patient lifestyle is necessary for successful management of long-term recovery, and relapse can often be attributed to lapses in healthy behavior. Patients easily understand the need for lifestyle modifications, but consistent, life-long behavior changes are difficult. That’s why behavior change interventions are important.
It may seem self-evident that improving health depends on changing unhealthy behavior. But understanding how and why people change and then motivating them to do so are entirely different.
To be effective in these endeavors, addiction counselors and therapists must know how to apply the basic principles, theories, research findings and methods of the social and behavioral sciences to inform their efforts.
When applied in light of a thorough understanding of the fundamental causes of addiction, evidence has shown that interventions create change by:
Accomplishing the goal of behavior change depends upon accurately identifying and defining substance abuse problems, assessing root causes, developing and implementing theory- and evidence-based methods and refining the interventions to ensure the intended outcomes without unwanted negative consequences.
The Stages of Change model, also known as the Transtheoretical model, is an interventional approach introduced around 20 years ago by two well-known alcoholism researchers, Carlo C. DiClemente and J. O. Prochaska. They developed the model to help professionals understand their clients with addiction problems and to help motivate them to change.
The model identifies six stages or steps through which most people will progress before changing their behavior. It shows that a person’s behavior changes gradually as they move from being uninterested (stage 1) all the way to genuinely changed conduct, resulting in overcoming (stage 6) the addiction.
The six stages of the model are:
Stage 1:Precontemplation. Individuals are not even thinking about changing their behavior. They may not see it as a problem, or they think that others are exaggerating. The lack of concern typically stems from reluctance, rebellion, resignation or rationalization.
Stage 2: Contemplation. Individuals are willing to consider the possibility they have a problem, which offers hope for change. However, they are often highly ambivalent or “on the fence” about actually doing anything.
Stage 3: Determination. Individuals in this stage appear to be ready and committed to action. Some ambivalence may remain, but it is no longer an insurmountable barrier. Preparation is key as they anticipate pitfalls and come up with solutions to move forward.
Stage 4: Action. In this stage, plans are actually carried out, often accompanied by public commitments to sobriety. If not already involved in such, many enroll in rehab programs or seek counseling at this point.
Stage 5: Maintenance. This stage represents a successful action plan, where sobriety has been firmly established, and the threat of returning to old patterns becomes less intense and less frequent.
Stage 6: Termination. The final stage is the ultimate goal in the process of behavior change. It indicates the previous behaviors are truly changed and the abused substance no longer actively tempts the individual. Instead, there is confidence that they can cope without fear of relapse.
Being familiar with the six-stage model can help you understand your readiness to change and guide you in choosing treatments that are right for you. Treatment professionals with the proper training in this model will have a better understanding of where you are in terms of readiness to confront your addiction.
Without this understanding, programs may get bogged down in ideas of “patient failure” as they attempt to move you to changes you’re not ready to make. But identifying your readiness to make change and understanding barriers that prevent change will help you and your therapist develop more effective ways to motivate you during recovery and beyond.