The 5 Stages of Change

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When an individual is actively seeking recovery from substance use disorder (SUD) and other addictive behaviors, it can be challenging to commit to behavior change. Ambivalence surrounding any kind of change is common; the uncertainty of the unknown can bring about anxiety and fear. However, the stages of change model provides a valuable framework to help individuals better identify and recognize how to move forward and commit to lasting change. Becoming familiar with this framework and how it can motivate an individual in their recovery journey can be instrumental for lasting success.

The Transtheoretical Model: The Stages of Change

According to Stages of Change Theory by authors Nahrain Raihan and Mark Cogburn, the transtheoretical model (TTM) is the standard-bearer for change. Since its development, this model has been more recently termed the stages of change. This model encompasses a five-step framework that “makes understanding human behavior one the of the easiest filters to follow." The five steps include:

  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance

The central goal of this model is to develop an action plan to help individuals mitigate their risk of relapse and, ultimately, maintain lasting sobriety. It is important to understand that the stages of change rarely involve a linear progression. Instead, behavior change often happens in a spiral or involves the recycling of stages. In other words, individuals will often travel through several of these stages multiple times or jump around between stages in their journey to achieve long-term abstinence.

It is also necessary to highlight that some programs and facilities acknowledge a sixth step – relapse – that can occur throughout any of these stages. The journal explains, “The concept of relapse is a common factor in change behavior and, as such, should be discussed and normalized.” Relapse does not mean that treatment and recovery have failed. Relapse “should be considered an excellent opportunity to revaluate one’s triggers, reassess one’s motivation for change, reassess old/new barriers to achieving the goal, and plan for stronger contingency plans.”

Stage 1: Precontemplation

In this stage, an individual is not considering changing their behavior. They may not yet be aware that their substance abuse is a problem or only recognizes a few negative consequences that result from it.

Individuals who engage in recurrent alcohol and drug use but experience little to no consequences to their academic, career, or interpersonal lives may be in the precontemplation stage of change. They may not yet understand the health repercussions that substance abuse may be contributing to. Many people in this stage may be considered “high functioning” but still engage in chronic substance use. Likewise, it is only a matter of time before the consequences of their abuse begin to surface.

Stage 2: Contemplation

In this stage, an individual may start to weigh out the pros and cons of their substance abuse. The consequences of their substance abuse are hard to ignore, yet they are still ambivalent toward change.

Individuals who experience health, career, relational, or legal troubles due to substance abuse may find themselves in the contemplation stage of change. They may be aware of the consequences of their behaviors and, as a result, only slightly modify their substance use. For example, someone who receives a DUI may be aware that their drinking is a problem, but rather than stopping their behavior, they plan to no longer drive after they drink.

Stage 3: Preparation

In this sage, an individual makes a plan to commit to behavior change. They recognize that the cons of their substance abuse significantly outweigh the pros.

Individuals who make a plan to slow or cease substance abuse may be in the preparation stage of change. They may plan to attend support groups such as Alcoholics Anonymous (AA) or seek out self-help resources and programs. Education is vital in this stage, as individuals must thoughtfully consider the impact that behavior change will make in their lives to effectively embrace such change.

Stage 4: Action

In this stage, an individual is actively participating in an addiction treatment program or utilizing other recovery resources. They are learning new behaviors and working to incorporate them into their life. While this stage is the first active step toward lasting behavior change, individuals in this step are not yet stable.

Individuals in treatment working to establish or maintain abstinence are in the action stage of change. They experience a high risk of relapse, potentially ruminating about their past substance abuse and considering future use. Many people in this stage experience relapse as a celebration of meeting short-term goals, such as remaining abstinent for a month.

Stage 5: Maintenance

In this stage, “individuals have maintained total abstinence from the adverse behavior for more than six months,” according to the article above. Individuals become more confident in their ability to remain sober with continued participation in aftercare and sober social support networks. Over time, a person will be able to better anticipate and respond to potential triggers without considering or fearing relapse. Relapse prevention strategies are highly prioritized and utilized in this stage.

Moving Through the Stages of Change

Moving through the stages of change can be challenging. Utilizing professional guidance and support is most effective when attempting to move through these stages. Addiction treatment professionals have the tools, knowledge, and therapeutic approaches that individuals need to overcome ambivalence and commit to lasting behavior change.

It is necessary to understand that everyone moves through these stages at their own pace. Acknowledging the stage that an individual may find themself at can help them better empathize with their own needs and willingness to establish sobriety.

The stages of change provide a valuable framework that can help individuals better identify where they stand in their commitment to behavior change. For addiction recovery, the stages of change are valuable as they can motivate individuals to understand what steps they need to take to establish and maintain lasting sobriety. At Pathways Recovery Center, we utilize the stages of change model to empower our clients in addressing and overcoming their ambivalence surrounding change. We are dedicated to providing individualized support for all of our clients. We offer a wide range of treatment services and programs to treat substance abuse and prevent future relapse. To learn more, call us today at (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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