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Stage of Change in Addiction Recovery

Posted on March 18, 2021

Stage of Change in Addiction Recovery

The stage of change in addiction recovery is well documented since they were first used by two alcohol researchers. The model is known as the trans-theoretical model and shows how recovery is ultimately achieved.

There are six main stages of change:

  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
  6. Termination

This is interesting, as through these stages we are able to see how change occurs, and how the addiction is treated and managed.

Stage 1: Pre-contemplation

This is probably the most difficult stage of change in addiction recovery, as the person entering treatment is still in denial, and does not really see that they have a problem.

The people in this stage are loosely grouped into four categories:

  1. Reluctant contemplator has little or no awareness of their problem and does not see the need to change
  2. Rebellious Pre-contemplator doesn’t want to get rid of the addictive behaviour, they don’t want to be told what to do
  3. Resigned Pre-contemplator Are overwhelmed by their addiction, and don’t feel it is possible for them to change
  4. Rationalising Pre-contemplator They don’t feel that substance abuse is an issue for them, and they think they have all the answers

Stage 2: Contemplation

The person realises that they have a problem, but don’t feel committed to change. They may want to change, but they are still contemplating, and this stage can continue for a while. While they are in this stage, they are receptive to finding out the consequences of their behaviour and options for treatment.

Stage 3: Preparation

The person sees where they are and will determine actions for a long-term treatment plan. Take pregnancy for example women who continue to drink alcohol during pregnancy, certain techniques like setting realistic goals towards cutting right down can be more helpful than just giving up.

A lot of ongoing education is needed in this area, as once the baby is born and breastfeeding commences, giving up alcohol is essential for the next six months, to prevent alcohol from affecting the baby, if this doesn’t happen they need to formula feed.

Stage 4: Action

This is the stage where changes in behaviour start. For many, it begins in a residential treatment centre, where medical professionals can help a person to begin their recovery. At this stage, the underlying causes of the addiction are looked at, and alternatives are explored.

During this stage holistic wellness bolsters recovery. The person will be given coping mechanisms during this stage to protect them against a relapse later on. People use substances for different reasons, and many are escaping from past pain, and underlying causes are looked at carefully.

Substance and alcohol abuse doesn’t just change if a person could stop their problematic alcohol and drug use they would, and underlying causes can take a few years of work to resolve. Once the person is motivated to make the change, they are on the way to changing.

Stage 5: Maintenance and Relapse

Sustaining change takes time and effort, and gradually the person will adapt to their new lifestyle, free of substances. As they get stronger falling into their old ways and habits becomes less of a threat.

However, substance use and abuse are considered chronic conditions, and relapse may occur at any time. The program allows for relapse to occur, be treated, and for the client to move forward without judgment, and sometimes it just means that further treatment of this phase is required.

Recovering from alcohol or drug dependence is a process, and will take time. When recovering from alcohol abuse the sufferer will sometimes develop another dependence, sometimes needing large amounts of sweets or chocolate instead of alcohol.

Causes of relapse:

  • Situations where alcohol may tempt the person
  • Triggers like personal setbacks may trigger a relapse
  • Mental Health issues
  • Poor physical health can lead to self-medicating
  • Guilt, when they lapse, can lead to a further lapse

Sometimes it can take as many as five or six attempts before the person successfully gives up the habit. This is not judged, by the team, but is considered an opportunity for the user to think about their trigger factors, and how to eliminate them.

This problem is considered by the team, and the following strategies have been proven to be successful and are:

  • Avoiding certain people and situations, some people are toxic and even though they know that you don’t drink, will encourage you to do so
  • Calling on support as needed. Calling on certain family and friends to help steer you away from trouble
  • Do positive things that you find yourself good at, volunteer in your community
  • Practice some self-care, take up an exercise routine, or swimming
  • Try to learn from your past mistakes
  • Try meditation and mindfulness
  • If you have mental health issues, ask to try a different medication
  • See a psychologist, go into long-term therapy, it will help you gain a better understanding of yourself
  • Develop a good diet and get enough sleep so that you are not stressed

Unfortunately, dependence has many aspects including social, physical, and psychological needing more than one strategy to address over time.

Every person’s experience of treatment and recovery is different, and some may only need two attempts to reach their goal while others will need a lot longer.

Stage 6: Termination

This is a stage where the person no longer feels threatened by their substance and has gained a lot of confidence in dealing with the situation they are in. Remember it is reached gradually and does not just happen overnight. It shows that permanent recovery is possible with the right support and treatment.


It is clear that a lot of progress has been made in the stage of change in addiction recovery, and many people progress to a situation where they live their day-to-day lives confident that they won’t relapse and have an alcoholic drink or take a drug. If a member of your family is suffering from addiction, it is time to take steps to learn as much about the problem as you can, to keep you and your family safe.


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