Researchers, Dr. James Prochaska and Dr. Carlo DiClemente developed the Transtheoretical Model of health behavior change in the 1970s. From it came the Six Stages of Change model that has helped identify and measure intentional changes to behavior over the years—particularly in areas of addiction. A person who wants to change their life or change something significant, like quitting drug use, is a self-changer. They can use the stages model to track their progress in addiction recovery.
Stage 1: Pre-Contemplative
Recovery from alcoholism or disordered drug use almost always begins with impaired self-awareness that results in a denial-based failure to recognize a need for recovery. The "pre-contemplative" stage refers to a state of unmindfulness when a person is unconcerned with cautionary words from those closest to them about the adverse effects their addictive habits are having in various areas of their lives.
Stage 2: Contemplative
In the second stage, the "contemplative" stage, an individual gives considerable thought to the possibility they could have an alcohol or drug problem. It may be the first time some people feel the need to reduce their drug and alcohol use or the first time they've contemplated stopping altogether.
Stage 3: Preparation
Stage three, "preparation," is when a person no longer needs to be convinced of their disordered use of substances or alcohol. But even though a person has accepted the existence of a problem, they may still harbor ambivalence about seeking help. Friends, spiritual mentors, therapists, educators, support groups, online forums, chat rooms, and life coaches are invaluable.
Stage 4: Action
During the fourth stage, "action," a recovering person feels self-confident and believes they can affect their lives positively, like choosing the most appropriate treatment option for themself. Depending on a person's needs, they may decide to:
- Enroll in an outpatient treatment program
- Live in a sober living community
- Enter a rehabilitation facility (rehab)
- Undergo partial hospitalization (day treatment program)
Stage 5: Maintenance
In the fifth stage, "maintenance," a person reaches a behavioral milestone. As of this moment, intentional change endures in perpetuity. Here, individuals must continually prove that they can resist temptation from all the people, places, and things that trigger them to use. Though it isn't easy, maintaining sobriety is possible, especially with help from trustworthy people in the community, families, and other supporters, like peers.
This stage is just as prone to relapse as those before it. Therefore, the "maintenance" stage involves developing an effective strategy to prevent relapses and devise a plan to support the recovery afterward. Many people learn and eventually master a few practical coping skills to help reduce the likelihood of relapsing. The "maintenance" stage also stresses the fact that sobriety does not happen by itself. It is the person's responsibility to safeguard their abstinence for a lifetime against relapse with impeccable vigilance.
Stage 6: Termination
The last phase for recovery from alcoholism or substance use disorder is "termination." Here, all the stages culminate. All the attachments a person has had to substances, alcohol, or both, get severed and dissolve. Mood-altering substances can no longer enslave a person at this level of recovery. Not even a tiny, secretive desire lingers to haunt them into using again. At this stage, a person is abstinent and apathetic about old drinking habits or drug-taking.
Unfortunately, substance use disorders are a serious problem that only a handful of people can fully overcome. But it's understandable why very few health-promoting programs mention the sixth stage, let alone present it as a desirable aim for recovery. So, self-changers and many clinicians consider "maintenance" an ideal point to recognize a successful change in behaviors for people in recovery.
Abstinence is only one aspect of recovery. There are many services, and it's easy to get help. The changes of tomorrow are because of the positive changes you decide on today.