Stages of Change. Stages of Change

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1 1 Motivation to get sober changes throughout the recovery process; one day choosing sobriety may seem easy and other days sobriety may be the farthest things from your mind. Today we will be discussing the changes in motivation you may experience throughout recovery, as well as some information that will be helpful as you make decisions throughout your recovery. Knowing the stages of change people go through can help you realize you are not alone in this process! Everyone wanting to make changes in their life has gone through these stages. Stages of change will also help you be more aware of when you ve slipped back in terms of your commitment or when you ve moved ahead. There are 5 stages of change that represent different levels of motivation for making a change. People do not necessarily have to go through each stage. Some people can enter at Stage 3 and bypass Stages 1 and 2. Other people will never move past Stage 1. Still others will fall back a few stages and then move ahead. It looks different for everyone. These descriptions will help you identify where you are at today with regard to quitting alcohol and drugs: Stages of Change 1

2 2 1. The first stage of change is referred to as the Precontemplation Stage. While in this stage of change, there is no recognition there is a problem and thus no consideration of change. In fact, when someone accuses you of needing change, you might become angry and defensive. What are other behaviors/characteristics that might be included under the Precontemplation Stage? 2. The next stage of change is called the Contemplation Stage. In this stage, people are more willing to consider that a problem exists. They may start to recognize consequences of their behavior and spends time thinking about the need to change. They might begin weighing the pros/cons of changing, but are still feeling ambivalent or unsure if they are willing to commit to making the change. What are other behaviors/characteristics that might be included under the Contemplation Stage? 3. The third stage of change is called the Preparation Stage. In this stage, a person has made a decision to change his/her behavior. They are able to create a plan to help make changes. The plan may include gathering information, researching services, or talking with family/friends. What are other behaviors/characteristics that might be included under the Preparation Stage? 2

3 3 4. The fourth stage of change is referred to as the Action Stage. People in this stage of change recognize a problem, believe they have the ability to change, and begin to change the behavior. This might mean they have stopped using or cut down a lot. They are generally open to receiving help and will likely seek support from others. What are other behaviors/characteristics that might be included under the Action Stage? 5. The final stage is called the Maintenance Stage. A person in this stage has made significant changes to life and has successfully integrated new, healthy behaviors into daily living. They continue to practice and acquire new skills, actively anticipate situations that could lead him/her to return to old behaviors, and proactively prepare coping strategies to manage potentially high risk situations. People in this stage have maintained the changes they have made for at least 6 months. What are other behaviors/characteristics that might be included under the Maintenance Stage? There is one stage that people may or may not enter. This stage is referred to as the Lapse/Relapse stage. In this stage, people return to old behaviors either briefly or for an extended period of time. The goal in this stage is to re-enter the wheel in the action stage and learn from your experience. Now that you are able familiar with the characteristics of each stage of change, can you identify which stage of change you are in? How do you know which stage you are in? Does motivation always steadily increase or can motivation and stage of change vary over time? 3

4 4 Can you remember a time when your motivation changed and you moved backwards? What happened that caused your motivation to change? Can you remember a time when your motivation changed and you moved forward? What happened that caused your motivation to change? Do the stages of change apply to other changes you would want to make in your life? From completing the above questions, you probably noticed that your motivation changes over time. Think of cartoons you watched when you were little; oftentimes a small angel would appear on one shoulder and a small devil on the other. As silly as it seems, you also have a devil and an angel influencing your motivation. They might be reminding you of the fun you had while using, the consequences that you have had, or the values that you hold dear. What does your inner devil tell you? What does your inner angel tell you? Your motivation might also change as a result of learning about new, helpful ways of thinking. Imagine the difference between thinking, I ve screwed up my life with drugs and I don t deserve anything better and, I ve made some mistakes but I m ready to make positive changes to get my life back on track. You might also start feeling more motivated to achieve sobriety after you begin experiencing the benefits of being clean. This is called behavior activation. 4

5 5 When was a time when your motivation changed based on a change in thinking or behavioral activation? Now that you ve familiarized yourself with the stages of change, let s practice identifying which stages of change people are in from the following vignettes: 1. Sheryl has been a long time marijuana user. She gets angry at her mother and her probation officer when they suggest she needs to quit smoking. They blame her marijuana use on her lack of motivation and difficulty breathing. Sheryl often yells at them and states that she needs marijuana to be able to get through the day. What stage of change is Sheryl in? How do you know? 2. Jake has noticed that his pants have been fitting tighter, and he has had to go up a notch when he puts on his belt. He thought about the last few months and realized that he had been eating more junk food than usual. Jake goes back and forth with himself about whether or not he wants to go on a diet and start working out. He knows that gaining weight is unhealthy, but does not want to sacrifice his mornings or afternoons to work out. Jake decides he will make an appointment with his doctor to determine if he is at an unhealthy weight; he would like to get more information about how healthy he is before making a decision. What stage of change is Jake in? How do you know? 3. Will has been sober from alcohol for about two years. Even though he has a great deal of sobriety, Will believes it is important to remain active in the sober community in order to stay sober. Will does this by chairing weekly AA meetings. He also has several sponsees that he helps through the recovery process. In addition to AA, Will volunteers to speak at residential rehab facilities in hopes of giving hope to other addicts. 5

6 6 What stage of change is Will in? How do you know? 4. Carrie used to be a runner in high school and has always wanted to start back up. She made the decision to begin waking up early every day to get a morning run in. On her first morning, Carrie noticed she was having difficulty breathing. Carrie was concerned that something was really wrong because she had never had this problem before. Suddenly, Carrie realized that the problem might be that she began smoking cigarettes about a year ago. Because it was important for her to begin running again, Carrie decided that she was going to quit smoking cigarettes. After Carrie got home from running, she made an appointment with her doctor to talk about her options for help with quitting. What stage of change is Carrie in? How do you know? 5. Joey has a long history with cocaine use. After a close friend passed away from an overdose 3 weeks ago, Joey decided it was time to make a change. Joey hasn t used cocaine since his friend s death and has enrolled in outpatient services for his addiction. He has started building new friendships in the recovery community and has distanced himself from some of his old using friends. It has been difficult and a lot of hard work, but Joey is proud of the progress he has made so far. What stage of change is Joey in? How do you know? 6