ADDICTION: Stages of Change

By Steven T. Padgitt, Ph.D.

Recent evidence suggests that there are definite stages people go through when dealing with the cessation of an addiction. This seems to be the case with both people who eliminate addictions on their own and those who seek the assistance from professionals. It has long been known that addictions, by their very nature, are hard to break and many attempts at cessation result in failure. Those who are successful go through five stages: precontemplation, contemplation, preparation, action and maintenance.

In the first stage, precontemplation, there is no intention to change addictive behavior. People in this stage are either unaware or underaware of their problem. Their families, friends, neighbors and employers may be quite aware of the problem while the "patient" is completely unaware of the problem. Precontemplators rarely present themselves for treatment unless pressured by others. In this phase the individual is unlikely to make any permanent change.

In the contemplation phase, the individual is aware that there is a problem, but has not as yet made any commitment to take action to eliminate the addiction. In addition to the awareness, the contemplator is seriously thinking about overcoming the problem. One of the features of this stage is that the individual may remain in this phase for an extended period of time. This is also a time when the individual assesses the difficulty of cessation versus the positive aspects of the addiction.

The preparation stage combines intent and behavioral criteria. They are intending to take action within the next month and have unsuccessfully taken action in the last year. In addition, they have often initiated some small change already. For example, someone in this phase may have slightly decreased the number of cigarettes s/he has smoked on a daily basis over the last month.

In the action stage the individual modifies his/her behavior, experiences or environment in order to break the addiction. This requires considerable commitment of time and energy.

The last stage, maintenance, is the phase in which the individual works to prevent relapse. This stage is seen as lasting from six months to an indeterminate period past the initial action. Many people, for example those subscribing to the twelve step program promoted by Alcoholics Anonymous, consider this stage to last a lifetime.

One of the major problems with the concept of addiction, beyond the physical component, is that of judgment and moral connotation. This emotional issue is paramount in people having difficulty in talking about it. The whole idea of being addicted to a substance is emotionally unacceptable to many people, and makes it nearly impossible to talk about; the thing they need most to do. Appropriate conversation can take the sting, out of acknowledging one's addiction and help solve the problems in ridding the dependency. If you find yourself plagued by an addiction, whether it is smoking cigarettes, drinking alcohol, using other elicit or even prescribed drugs or even engaged in an addictive relationship, the first step is to talk about it.

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