The Stages of Change Model for Recovery

Making changes to ones’ behavioral patterns or habits is often a difficult process and especially for addiction recovery patients, not fully understanding why those changes need to be made can exacerbate those initial difficulties that arise from making a lifestyle change. Not knowing about the process of change presents the unfortunate illusion that patients are not in the driver’s seat of their recovery. Control is not necessarily the issue here, as most will learn quickly that they cannot control the outcomes of their recovery. Only the daily actions that are taken through their willful decisions to change in the present prove most effective. When patients act from a position of more confidence, a confidence that stems from fully understanding the recovery process at hand, we see an increase in effective and long-term change. The Stages of Change Model was developed by researchers Carlo C. DiClemente and J.O. Prochaska to help both addiction recovery patients and the trained professionals treating those patients to better understand the behavioral patterns of recovering from addiction.

The Key to Effective Change

These stages of change can be linked to any form of lifestyle alteration—both big and small— but they have proven most effective with addictive disorders and the recovery process. The two researchers eventually classified six stages of recovery that consist of pre-contemplation, contemplation, preparation, action, maintenance, and relapse. Many may suggest that patients move linearly through each stage, but in reality, addictive disorders are more unique and constantly in flux—especially when re-entering independent sober lives—and patients may find themselves experiencing more than one stage at the same time or jumping from saying the first to the six and back to the fourth stage. The order is hardly important; rather, the purpose of cataloging these stages of change is for trained professionals to better understand what patients are experiencing as well as allowing the patients to better self-identify. By knowing what stage of recovery they may be in, they can take the necessary preventative measures or seek out further care and react appropriately. Not knowing can increase the chances of triggering a relapse.

The Stages of Change Model

We have listed six main stages of change as they relate to addiction recovery below with summaries for each. Sometimes the fifth and especially the sixth stage are not always included in every Stages of Change Model. However, we feel that patients would be better prepared if they expect the best while preparing for the worst-case scenario.

• Pre-contemplation Stage: The first stage is often before patients seek out treatment; in this stage of change, many individuals do not even think nor believe that their behavior is problematic. Denial is often common among those in the pre-contemplation stage as well as a lack of understanding about the negative consequences of their actions. Patients in the first stage of change often do not like hearing about their illicit substance misuse and will isolate themselves from support network members who share that opinion. The addictive behavior is still framed as an overall positive experience from the patient’s point of view.
• Contemplation Stage: Consequences may have caught up with patients, or they are simply beginning to recognize certain patterns in behavior that they deem as potentially negative. This is generally when bouts of sobriety are attempted. Patients in the contemplation stage begin to assess their substance misuse and can be open to discussion involving reduced consumption of illicit substances. The contemplation stage can last for many years and some individuals waver back and forth between the contemplation and pre-contemplation stages of change for many years. Patients in this stage are more open to hearing about ways to deter illicit substance misuse. In this stage, people often attempt to reduce or control addictive behavior rather than quitting altogether. Motivational and non-judgemental approaches are best when discussing these issues with patients.
• Preparation Stage: This stage is when those in addiction recovery arguably become patients. The patient is past contemplation and is seriously planning and preparing to act on the changes they contemplated in the last stage. This preparation will involve getting rid of triggers that populate their daily life. It may also involve planning the exact changes that need to be made to reduce substance misuse to effectively make lasting change. This would also be a good time to enlist a reliable support network which will prove vital later on in the recovery process. This is an initial game plan and still relatively early in the stages of change even though it is listed as the third step. The preparation can be as little as planning different social engagements to avoid bars or as big as discussing taking time away from work for inpatient rehab services.
• Action Stage: This is arguably the main event, although we would argue good preparation is the best chase for success when it comes to maintaining long-term sobriety and lifestyle changes. Patients begin to affect real change in their behaviors. This stage is often rife with anticipation, frustrations, and difficulty as even the most prepared patient can not  The actions of this stage can be as large and life-changing as moving to a different city or as small and incremental as attending weekly recovery meetings. Many will go the route of detox and inpatient services. It would be wise for patients to seek out the counsel of a trained therapist/psychiatrist or outpatient services to help navigate the difficult process of changing lifestyles.
• Maintenance Stage: This stage involves keeping up the practices that individuals began in the action stage. That means turning those healthy behavioral changes into regular habits as well as continuing to self-identify and address mental health issues through healthy coping mechanisms. In these stages, patients struggle with impulse control issues or eventually become complacent and lax about the healthy behavioral changes following initial success at sobriety. Patients should remember that addiction recovery is a lifelong process, and although many will eventually attain full remission, addictive disorders are truly never gone. Overconfidence in the fifth stage will often result in relapse.
• Relapse Stage: Although not always included in the Stages of Change Model, we have listed the relapse stage, as this point in recovery is both a very real possibility and also part of the process toward recovery. There is no shame in failing, and relapse may occur several times before patients learn how to manage the maintenance stage of change. Just liking learning any new process, there will be a learning curve until patients become successful at maintaining their sobriety long-term. The trick will be not to letting the frustrations of occasional relapse and beginning again to work against the resolve of remaining sober.

Addiction recovery is all about change and altering lifestyles through repetitive healthy behavioral actions and thought patterns. Understanding these efforts through such practices as the Stages of Change Model can increase chances of success at maintaining long-term sobriety. If you or someone you love seems caught in an endless cycle of the Stages of Change Model, then Choice House has the professional expertise to help remove them from the rut of an addictive cycle and effectively begin their new sober life. We offer men a chance at building a new sober foundation based on love and empathy as they begin to learn the necessary skills to maintain that sobriety in the long term. We offer a variety of therapeutic modalities with an emphasis on dual-diagnosis treatment methods. Our addiction recovery treatment services include a 90-day inpatient program, intensive outpatient services, and the opportunity to reside at our sober living campus. Located in the Boulder County area of Colorado, our facilities are ideally situated in the foothills of the Rocky Mountain National Park allowing us to provide patients with unique therapeutic modalities like outdoor wilderness therapy. In outdoor therapy, men begin to reconnect with themselves, nature, and fellow recovery patients through physical activities like hiking, rock climbing, and kayaking. For more information regarding Choice House facilities and treatment services, please give us a call at (720) 577-4422.