Stages of Change Model

Precontemplation

Individuals in this stage do not recognize that they have a problem and are not seeking to change their substance abusing behavior. Resistance to change is the hallmark of this stage. Precontemplation is described as "seeing solutions but not seeing the problem." Precontemplators are often pressured into treatment by family members and friends, who are well aware of their problems and often frustrated with their drug use. If referred, the precontemplators may benefit from nonthreatening information to raise awareness of a possible problem, or potential for change, or to provide other support for change.

Contemplation

A person in this stage is aware of a problem, and is seriously thinking of overcoming it, but shows no commitment to change as of yet. Contemplators can often get "stuck" in this stage for quite some time while they are evaluating the pros and cons of their problems and the possible solutions. Contemplation is described as "knowing where you want to go but not quite ready yet." Many contemplators are ambivalent concerning change and have indefinite plans to take action in the next 6 months. Client education is an effective tool for contemplation and ambivalence.

Preparation

At this stage, individuals are intending to take action in the next month but have unsuccessfully taken action over the past year. Individuals are prepared for action in this stage, with some small behavioral changes, like drinking less or smoking less, but they have not quite reached their goal. They may seek treatment and ask for help to reach these goals.

Action

In this stage, people modify their behavior, experiences, or environment to overcome problems. Action involves overt behavior change and requires considerable commitment, time, and energy. Modification of targeted behavior to an acceptable criterion and significant overt efforts to change are the hallmarks of action. Individuals in this stage make comments such as "I am really working hard at change."

Maintenance

In this stage, individuals are working to prevent relapse and to consolidate the gains attained during action. Maintenance is continuation of change, and for addictions, maintenance must be sustained for at least [Page 854]6 months. Stabilizing behavior change and avoiding relapse are the hallmarks of this stage. Individuals in this stage may make comments such as "I may need a boost right now to help me maintain the changes I've already made."

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