Rehab 4 Addiction

Recovery from addiction is no easy task. Instead, it is a huge undertaking, demanding an overhaul in your entire lifestyle and approach. Sometimes it can help to know what to expect along your journey to recovery.

Helpfully, in the late 1970s, researchers James Prochaska and Carlo DiClemente developed the Six Stages of Change or Transtheoretical Model [1] from their observations of smokers trying to quit their habit.

This model, often depicted as a wheel, highlights in easy to digest chunks, how recovery can be achieved alongside the treatment process.

The way in which people move through the stages varies widely with some progressing through them in order with others skipping, repeating and moving forwards or backwards.

Some may even find themselves in multiple stages at once. Importantly, there is no correct way in which to complete the Six Stages. This article will examine each of these stages, in turn, to help you understand what to expect along your journey to freedom from addiction.

Stage 1: Precontemplation

In this early stage, a person’s addictive behaviour tends to be positive and they might not yet have experienced any of the negative impacts of their addiction on their life. This is often because the person doesn’t have insight into their condition, meaning that they don’t see their behaviour as problematic.

This could be because they are in denial or as they haven’t yet experienced any of the unpleasant repercussions their addiction may bring, they genuinely don’t see the issue.

As such, people in this stage tend to have little to no interest in accepting advice to quit as they are not yet considering a change. Even suggesting they might have a problem that can cause the person to become angry, upset or withdraw.

People at the precontemplation stage can be broadly split into four distinct groups:

  • Reluctant precontemplator: this person lacks both the awareness of their issue and motivation to change
  • Rebellious precontemplator: this person does not like being challenged so won’t let go of their behaviour
  • Resigned precontemplator: this person has given up any attempt to change as they feel their addiction has such profound hold over them
  • Rationalising precontemplator: this person believes they already know why addiction isn’t an issue for them so aren’t interested in solutions

Stage 2: Contemplation

Moving beyond precontempation, people at the contemplation stage have now gained insight and recognise that they have a problem. This gain in insight means the person is more receptive to learning about their behaviour and may appreciate how it could eventually have consequences for them.

Whilst this is certainly progress, people here often feel like they won’t be able to commit to change and can be stuck at this stage for years. This stage might be recognised by the person saying they want to change but then not want to act on it which can lead to a certain level of anxiety.

Stage 3: Preparation

At this point, the person is ready to make real change. In response, they might take steps to visit their health care provider or reach out to a support group where they can begin their journey to recovery.

If you think you might be at this stage yourself or if you know someone with an addiction problem who is ready to make real change, both the charity Mind [2] and the Mental Health Foundation [3] has a helpful list of organisations that can help if you feel unable to visit your healthcare provider or GP.

Stage 4: Action

The fourth stage is where the work of behaviour change really begins as the person gains a solid intention to commit to change. This might happen with the help of professionals in a detox treatment setting. Here, the person will get all the help and support they need to make it through this tough stage.

The work that the person does through therapy, either in groups or as an individual will help the person understand their addiction, recognise any potential triggers for their behaviour and find ways to make lasting change.

Stage 5: Maintenance & Relapse

Like anything new and challenging, it is easy to fall off the horse again and go back to our old ways. Doing so is not something to be ashamed of, in fact, our brains are hardwired to cling to habits as this once ensured survival and helped us evolve as a species [4].

Addiction is very much a chronic, long term disorder so if relapse happens, it just indicates that more treatment is needed. Eventually, the person will grow accustomed to their new lifestyle and maintenance of their sobriety will become easier meaning fewer and fewer relapses. Similarly to previous stages, this fifth stage may last years with movement backwards or forwards.

Stage 6: Termination

As the person comes to the end of their journey out of addiction, the overall aim is to reach a point when addiction no longer has a hold over them.

The fear of relapse shrinks with every day until the person is sure it won’t happen again and they no longer experience any desire to continue their habit.

This stage is not always included in the model as it is quite rare that a person manages to entirely eliminate their addiction. As mentioned previously, addiction really is a chronic, long term condition and the majority of people stay in the fifth maintenance stage.

Again it is important to note that whilst helpful and can demonstrate that human behaviour often falls into predictable patterns, not everyone will move through the Six Stages in order, if they manage to get through all of them at all.

This is nothing to get disheartened about as it is natural to enter and exit the stages. Rather, the model provides a view of how addictive behaviour might be addressed, highlighting that there is indeed a way for somebody to emerge after addiction, confident in their new way of life.

Wherever you or someone you know are along these six stages, help is always readily available [5]

References

1. https://pubmed.ncbi.nlm.nih.gov/10170434/

2. https://www.mind.org.uk/information-support/guides-to-support-and-services/addiction-and-dependency/addiction-and-dependency-resources/

3. https://www.mentalhealth.org.uk/your-mental-health/getting-help

4. https://www.sciencedirect.com/science/article/abs/pii/S0376871616302241?via%3Dihub

5. https://www.nhs.uk/live-well/healthy-body/drug-addiction-getting-help/

boris

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.