Data by the Office for National Statistics shows that addiction across the UK is widespread.
In 2023:
Overcoming addiction isn’t just a physical act – a person needs to jump over tough mental hurdles to get there.
In order to begin to recover, there needs to be an acceptance of the problem, and a true desire to change.
This is just the beginning, and there are many stages of recovery before long-term sobriety can be achieved.
The ‘transtheoretical model’ or TTM is simply another name for the stages of change model.
The model was developed by James Prochaska and Carlo DiClemente in 1983 while working on a smoking cessation study.
The researchers studied the stages that these participants went through during their recovery process, and came up with a few addictive behaviours and mental states that these people had in common.[2]
The transtheoretical model is a person-centred approach, which looks at what the person is struggling with, and how they can move forward.
Generally, people in recovery from addiction will pass through each of these four stages in chronological order, as they go through their recovery journey.[3]
The precontemplation stage is when a person doesn’t believe they have an addiction, and therefore sees no reason to change.
Denial is a big part of addiction, so it’s normal for people to feel this way.[4]
During the contemplation stage, the person in addiction becomes aware that they have a problem, although they’re not yet ready to change.
Research has shown that for pre-contemplators who moved to the contemplation stage at one month, 7% of them advanced to action by six months.[5]
This stage is sometimes referred to as ‘determination’.
In this stage, the person begins to weigh up the pros and cons of staying in addiction vs recovering, and starts to see that change would benefit their life.
They may come up with a plan of action about how they could begin to recover.
It’s important at this stage to have a good plan in place and not be hasty about starting unprepared, as this plan what will carry them through to recovery without relapse.
Good preparation in addiction recovery involves:
It’s in the action stage that physical change truly begins to happen. The person in addiction is willing to receive assistance and support, and their willpower and confidence grow.
Some addiction specialists refer to 6 stages of change – a further two stages have been added.[6]
This stage is reached once a period of abstinence (quitting) has been achieved for six months.
Potential relapse triggers will be identified, so it’s important to have coping strategies in place.
Thoughts of relapse often stay with a person forever, so a good relapse prevention plan is vital.
This final stage is characterised by being in a secure state of sobriety. People in this stage feel no desire to return to unhealthy behaviours, and feel sure they won’t relapse.
This stage is rarely reached, and people more often stay in the maintenance stage forever.
This is why the stage isn’t always considered part of the stages of change.[7]
The aim of recovery is to prevent relapse, however addiction is a chronic relapsing disorder, so it’s important to acknowledge that this is often a part of people’s journey.
Research shows that within 12 months of abstinence, 43 percent of smokers will relapse (start smoking again).[8]
After five years of sobriety, the risk of relapse drops to 7%.[9]
Different stages of change may require different treatment approaches.
Brief interventions are short conversations that aim to motivate people to change.
Brief intervention sessions can be tailored to the stage, to meet the person in their current feelings and mental state.[10]
Motivational interviewing is another addiction treatment that focuses on building motivation and willpower to recover.
It’s useful to begin to link together the problems a person is experiencing in life and their alcohol abuse or substance abuse.
Brief interventions can be used to educate the person about the negative consequences of substance use and addiction.
For example, a person experiencing depression may be told how their addiction is worsening their mental health disorder, and this could act as a motivator for them to change.
Brief intervention can be used during this stage to challenge ambivalence in the person, and increase their knowledge of the benefits of recovery.
Brief interventions can help to introduce options for further treatment, like rehab, and twelve step meetings.
If the person is willing, a plan to enter one of these treatment programmes can begin.
In this stage, brief intervention clinicians can help the client to move forward with their action plan, and continue to build motivation to prevent relapse.
During this time, the main focus will be on relapse prevention. Brief interventions will help to identify relapse triggers, and remind patients of their coping strategies.
Treatment after rehabilitation is called ‘aftercare’.
In the event of a relapse, brief interventions can be used just as in the action and maintenance stage, to remind the patient that they can recover and help them to take steps towards regaining sobriety.
Carlo C. Diclemente, professor of psychology and director of The Habits Lab at the University of Maryland-Baltimore County describes the processes of change as:[11]
Critiques of the Stages of Change Model have suggested that the model has a few limitations:
It’s important to remember that everyone is different, so while some people may have a much easier time in recovery, others may struggle.
These struggles can be due to personality, upbringing, socioeconomic status and the adverse events or trauma they’ve faced in life.
The stages of change model helps addiction specialists to meet the person where they’re at, and adapt treatment to the person’s mentality.
People in recovery are supported and accepted within their current stage.
The stages of change model can be used to track progress, however, addiction specialists take into consideration that change is dynamic, and that a person may take a step forward or back.
Use of the model hopes to motivate people to change, and to understand that change isn’t simply physical- there’s lots of mental change that happens before the act of giving up addictive behaviours.
Treatments will be personalised to the individual person’s needs and mentality.
If you’re looking for support for yourself or a loved one, there are plenty of recovery options available.
These include:
Free recovery options include:
Rehab4Addiction offer free, non-judgemental consultations from people in recovery who understand what you’re going through.
We can help you discuss your options.
We also offer referrals to some of the top CQC-registered, private rehabs across the UK.
For more information about rehab, simply reach out to our 24/7, confidential hotline on 0800 140 4690.
[3] https://www.ncbi.nlm.nih.gov/books/NBK556005/
[4] https://onlinelibrary.wiley.com/doi/abs/10.1111/mila.12106
[5] https://www.ncbi.nlm.nih.gov/books/NBK556005/
[8] https://www.ncbi.nlm.nih.gov/books/NBK556005/
[9] https://www.ncbi.nlm.nih.gov/books/NBK556005/
[10] https://www.ncbi.nlm.nih.gov/books/NBK64942/table/A61041/
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
