Stages of Change
The stages of change model was developed by Prochaska and DiClemente in the 1980s to help understand the process of behavior change. This model is often used to describe the stages of recovery from addiction. There are five stages: pre-contemplation, contemplation, preparation, action, and maintenance. Relapse and slip ups are not listed as stages but are often a part of the process as well. It is very important to understand that relapse and slip ups do not mean starting all over from the beginning.
1. Pre-contemplation
During this stage, an individual is not considering making any changes in their life because they have not even considered that their use could be a problem. Sharing your concerns about the individual’s use will likely move them into the next stage simply because they will have to consider if they could have a problem, though they may still choose to deny it. Presenting concerns in a compassionate way is less likely to trigger defensiveness than a harsher, more accusatory approach.
2. Contemplation
During this stage, an individual begins to recognize that they have a problem and starts to consider making changes in their life. They may feel ambivalent about change and may be uncertain about the best course of action. They may start to look for information about addiction to help them understand their problem and make decisions.
At this stage, it is important to be honest about the impacts of their use while also understanding that commitment to recovery can be a very difficult and scary decision. It is also important to help the individual explore the pros and cons of making changes in their life. Recovery works best when the individual makes the decision for themselves and not because they feel forced to do it for other people.
3. Preparation
During this stage, the individual starts to gather information and resources, make goals, and develop a plan of action. They may also start to take steps such as attending support groups or therapy sessions and making lifestyle changes. At this stage, it is important to provide positive encouragement and support. It is also important to help an individual stay motivated and on track with their goals.
4. Action
During this stage, an individual begins to take concrete steps to making changes in their life. This is when people actually cut down or stop their use. Ideally, they will develop new coping skills and strategies to manage their cravings and triggers. Typically, addictive behaviors are not just simply eliminated, they are replaced with other healthy behaviors, especially ones that provide natural ways of producing dopamine and working through difficult emotions.
At this stage, it is important to continue to provide positive support as well as nonjudgmental accountability. It is also important to help an individual stay focused on their goals and focus on their progress rather than setbacks. Remember that recovery is a long process and it can take time to make lasting changes.
5. Maintenance
This is the time when the person has achieved their goals and remains dedicated to staying on track. Typically the individual is secure enough in their sobriety that it no longer needs to be their primary focus but they still need to keep up with their healthier behaviors and take their sobriety seriously. At this point, cravings are usually relatively minimal but using again may restart the entire addiction process in the brain so some vigilance remains important.
Slip Ups and Relapse
A slip up is a relatively small amount of use that is notably less in frequency, duration, and/or amount than the old pattern of use. For example, someone who used to drink a six pack every day might have one beer one night and get back to sobriety the next day. A relapse is when the individual returns to the same pattern of use before, e.g. a six pack every day again. Both are unpleasant and undesirable, but they do not mean the person has to start all over from the beginning.
The most effective mindset for this situation is to understand that the individual can pick back up with sobriety where they left off and they have not forgotten or lost the progress they made. A good majority of people who made a full recovery went through slip ups or relapse at some point, often multiple times, but still made it through to maintenance in the end. Always aim for abstinence but don't give up if you're not perfect with it.