January 14, 2018
Which came first, the chicken or the egg? Which came first, the trauma or the substance use? Many clinical programs […]Read more ...
Stages of Change: On your marks, get set, go!
As a counselor with experience and training in the field of addiction, the basic ideas within the stages of change model make total sense. The problem is, knowing about the stages doesn’t necessarily get anyone off the couch or out of their local bar in time to avoid disaster.
People are often dug in deep with their love of beer, cocaine, or wine. Meanwhile, their spouse is at home wondering how much longer this will go on before calling an attorney to draw up divorce papers. In short, addiction has taken control, and it is the dream of everyone who loves and cares for an addict to have them change their behavior.
Stages of Change (based on the research of Carlo C. DiClemente and J. O. Prochaska):
1. Precontemplation: Divorce, jail, having children removed from the home, hospital visits, and DUI’s are a good practical way to describe the first stage of change. Another way to word this stage would be not yet thinking about change. The other idea that comes to mind is denial. Although the behavior and the consequences of the behavior seem to call for hopelessness, the precontemplation stage is important. It might even be the most important stage of change. This is the stage where desperation and personal hell can begin to put some holes in the armor of addiction. It leads to thinking about behavior and allows for a willingness to consider another set of behaviors. You guessed it, Contemplation comes after Precontemplation.
2. Contemplation: Not much needs to be said about this. In fact, the less time one remains in this stage, the better. I have spoken with many an addict who does some thinking after getting put in jail and their best idea is to go home and have a beer. Moving on to Preparation at this point is vital. The addict has decided to do something different.
3. Preparation: Preparation for change could be best described as making some calls.
• Making an appointment with a counselor
• Finding out where AA meetings take place
• Setting up a lunch date with that long lost aunt or uncle who you heard got sober a while back …
Find someone to talk to who might know more about how to change the behavior you no longer want in your life.
4. Action: This is really nothing more than showing up for that counseling appointment, lunch with Uncle Frank, or walking into that AA meeting and letting people get to know you. In the action phase, people begin to believe they are worth the effort. The kinds of actions taken to bring about change for the addict are simple.
• Don’t drink alcohol or use drugs.
• Begin to replace that behavior with new behavior that can bring emotional peace and relief.
Unfortunately, simple does not mean easy. During this phase, people quickly learn that they were used to a method of relief that was instant. As people learn new actions, the feeling that often comes during this phase is one of restlessness due to our body’s physical adjustment of not having the booze or pills to numb out. This is why new actions must include spending time with others who have learned how to deal with negative emotions in different ways.
5. Maintenance: As we build our actions and coping strategies, we build confidence. We gain what many have called a tool box to deal with life. Confidence grows with a new pattern of actions. This is fairly self-explanatory. We maintain our place on the wagon cruising through life without worrying about police in the rear-view mirror. We are off the sauce reengaged in a relationship with loved ones. We are showing up on time for work. We consider going back to school to pursue the dream that forever eluded us from the barstool. Some of the key behaviors that have traditionally helped people maintain abstinence from alcohol and drugs are:
• relapse prevention counseling
• AA meeting attendance
• regular exercise
• meditation practice
• community service activities.
6. Often included in the stages of change model is Relapse. I’m not sure I’m the first to state this, but I personally don’t want it there. People make changes and never look back all the time. Sure, change does go backwards sometimes. “Relapse is part of recovery” is a common phrase. Obviously, we want to learn from it and get back into action. However, there are plenty of addicts who will only use this as an excuse and continue to relapse. In my experience, what is part of recovery is taking the actions to maintain a better life. Relapse is part of the disease of addiction. Relapse is part of not being willing to practice the behaviors that work.
Pre-contemplation: Bleeding, car totaled, spouse and kids don’t seem to like me.
Contemplation: I wonder if there is a connection between getting high and my life being a wreck?
Preparation: Pack my bags, I’m heading to the White Knuckle Retreat House in Phoenix!
Action: Wow, I’m learning a lot about how to deal with these cravings. I didn’t know I could still take a two mile run!
Maintenance: I remember how much my sponsor in AA helped me. Now I’ve had the opportunity to help someone else stay sober.
Relapse: You don’t have to. Get some help and get back to your Action/Maintenance plan.