Five Stages of Change – How They Relate to Addiction Treatment & Recovery by William Morrison

Although addiction has psychological and physical elements (and perhaps spiritual as well), treatment goals are ultimately based on changing behavior. Even if you can’t ever get rid of the cravings or repair the damage, at least abstinence will prevent further damage. The question then becomes how best to encourage and support the change needed. Because it’s a behavioral issue, the field of cognitive-behavioral psychology steps in with various theories about how people come to make serious and fundamental changes in behavior.

Five Stages of Change Model

The five stages of change model is one such theory. It consists of three stages before action is taken, then an action step, and then a maintenance step.

The Get Readys The three preparation steps guide people through a process of realizing change is needed and coming up with a realistic plan. Moving between them comes with the realization that transformation is possible and then gaining the confidence and motivation to actually do something.

The Action Step At this stage, someone is actively pursuing their plan. It’s the “jump off the cliff” step. With the proper preparation, success is more likely; however, many addicts reach this step and fall back into previous stages. Quitting isn’t something to take lightly, after all. This is also the step most commonly taken out of order – some crisis or court demands an attempt at treatment and abstinence. Without the steps leading up to it though, failure is probable. The stages of change emphasizes that patients shouldn’t be pushed into taking action before they are ready. Growth has to come through all of the stages sequentially. Some treatment specialists mark this part as a defect in the theory and point out that patients sometimes do compress the first four stages into a sudden realization or epiphany.

Maintenance As the name implies, this step reinforces the new behavior and keeps it going until it becomes the normal, habitual way of living. Classically, maintenance is life-long. Practically, professional treatment only lasts weeks to months. Support systems have to be in place to encourage maintenance beyond formal treatment. Groups like AA and NA are a staple here. The real importance of the five stages of change is its framework. It allows treatment specialists to evaluate and customize therapy based on where a client is in the process.