Change is rarely a straight line. The process of change is littered with ups and downs, jumps forward and backwards, and motivational waxing and waning. Psychologists James Prochaska and Carlo Di Clemente studied this process and have developed a theory for how people change that is widely accepted. This process states that change has 5 stages, from not even thinking about changing a behavior (which they call Precontemplation), to making maintaining the changes you’ve made (which they call Maintenance). In understanding these 5 stages, you can recognize where you (or a loved one) are in the process and change, and can slowly work to help move through the stages of change.
- Precontemplation: At this stage, you have no intention of changing your behaviors and you do not really feel that you have a problem. If you are here in treatment, it is often because there is some external pressure to be in treatment. This may make it difficult for you to define what you want to work on in treatment, which in turn often makes being in treatment in this stage a frustrating experience.
- Contemplation: This is a stage where you are starting to consider the impact your substance use has had on your life in a more serious way, while typically also feeling quite ambivalent. You are aware a problem exists but you are not sure you want to do anything to change the problem. You are beginning to add up the positive and negative consequences of use in your daily life, but may feel too overwhelmed to make real changes.
- Preparation: This is a stage where you are prepared to make changes based on your evaluation of the impact of substance use in your life, but you have not fully decided how to accomplish these changes, and what your goals are going to be. For example, you may have decided to change by going to support group meetings, but you haven’t decided which group is right for you, or for how long you’d like to stop using.
- Action: In this stage, you are modifying your behaviors and are working at changing your life. This often involves devoting a good deal of time and effort to making changes, as well as an accompanying sense that you are on a path you feel good about for yourself.
- Maintenance: This is the stage where people work to prevent a return to old behaviors and to maintain the gains made during the action phase. This stage still involves a good deal of effort and dedication of time and energy.
Over time, we all move through these five stages of change, sometimes moving forward and sometimes slipping back (or a relapsing into old behaviors). How can you use this information to best help you or a loved one move forward in the process of change? Here are a few tips to keep in mind.
For Individuals Trying to Change:
The changes each person makes are part of a personal journey defined by many factors. Most importantly, each person must go through these changes at his/her own pace. Some stop using and never go back. Others change slowly over time, and though they may want to stop completely, it might take several episodes of using before they are able to do so. Some begin the long and difficult process of lifestyle change; others stay focused on “just not using right now.”
It is important is to stay in tune with your own pace, and to establish a way of changing that you can sustain. Try not to compare your pace and style of changing to other people’s pace. That can be a setup to feel like you “should” be going faster than you want or that you’re already doing so well that you can “let down your guard” some (opening the door to a return to unwanted behaviors).
For Loved Ones Helping Someone Change:
As stated above, change is a very personal journey and there are a lot of factors that go into it. It’s important to remember this and to respect that people need to change at their own pace. That said, there are things you can be thinking about to help someone through the change process. Remembering the following two tips can help you be a more effective helper.
- Remember the term Succesive Approximation: Changing a complex behavior like substance us is just that . . . complex! If you can help break it down into smaller, simpler changes that help encourage movement towards the larger goal, which is much easier for people to do and be successful with. That process is call Successive Approximation. For example, maybe the big goal is to stop drinking, and a small goal can be going to the gym regularly. While this might feel miles away from what you want to see, achieving that goal might bring your loved one a step closer to having a healthier life, which would combat the idea of drinking each night (and moving them towards making a change there). Picking and rewarding a small step can help with the larger goals.
- Tolerate Relapse: The process of change has the idea of relapse (a return to old behaviors) built into it. Change isn’t a one-way street, and the more you can tolerate that, the more you can help someone continue to move forward even when they are struggling to themselves. For more information about how to tolerate that, check out the 20 Minute Guide (www.the20minuteguide.com).
Understanding how change works can be very helpful to your own process of change or helping a loved one change their behaviors. Changing substance use patterns is a marathon. Keeping this process of change in mind can help keep you from trying to make it into a sprint.