The Stages of Change in Overcoming Addiction
03 December 2024
(FIRST DRAFT)
During one of our weekly November meetings we discussed the Stages of Change for Overcoming Addiction. The following post provides an overview of the comments group members presented and more. If you have additional ideas, please forward them and they’ll be added.
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We briefly reviewed the five stages and what each entails. However, the discussion focused on our potential roles and responsibilities as parents and caregivers of loved ones who may be looking for ways to address their substance use. How do we discuss this challenging journey while being supportive and respectful towards our loved one?
The Five Stages
Pre-Contemplation
Contemplation
Preparation
Action
Maintenance
Some versions of the model add a Relapse stage. We know from experience that it’s rare for someone to kick their habit on the first try.
While the stages are presented in sequence, the process may differ and shift.
A key point is that our loved one will never address their addiction until they are absolutely ready. Many of us have seen our loved ones suffer while they refuse to change. Their pain is obvious to us but they haven’t yet found the key to helping themselves out of the quandary.
As a result we need to be exercise understanding while appreciating that it is their journey and their decision to be in addiction or not.
1. Pre-Contemplation - In the first stage substance use may not seem problematic to the user even though it may be a consistent habit. As parents and caregivers we may not be aware of the substance use. Or we may have suspicions or evidence.
What we can do - We may want to reveal or ask about our observations and suspicions. We can address our concerns using “I” statements. ie. “I’m concerned about you smoking weed because I know it can affect your health”.
If they are open to a conversation you may want to ask them what benefit they find in using as well as the possible downside.
The pre-contemplation stage is also an opportunity for us to learn about substance use, addiction and the possible consequences for our loved one. This gives us some information and tools to work with for the next stage.
2. Contemplation - A loved one who recognizes that using is giving them trouble may be open to making changes. At the same time they may be ambiguous and fearful about the possibility of quitting drugs.
What we can do - We can offer help but stop short of laying down expectations. Why? They may be intimidated or simply turn away. It’s important to keep an open mind and to listen. One group member observed that when their loved one was having difficulties as a result of substance use they responded to them by saying clearly and consistently that “Nothing good is ever going to happen until you stop using drugs.”
You can underline that addiction is a disease and not a moral or personal shortcoming. We can point out that sometimes substances are a form of avoidance and escape from problems and unresolved issues. We can suggest that they may want to examine their motivation.
If the loved one has relapsed and they are contemplating a change we can ask what feels different about this opportunity?
3. Preparation - Your loved one needs to take various steps to get ready to make the changes that will help them let go of their addiction.
What we can do - ask them how they intend to proceed. Don’t provide an outline. If they aim to quit alcohol we could ask if they’d prefer to not have alcohol available in your house, or to not serve it in their presence. We may offer some supportive tips in regard to their preparation approach and other useful suggestions. We can tell them that we are always there if they have questions, or want to get our opinion.
It’s important that they chart their own course and have the satisfaction of taking charge.
4. Action - This is the most difficult step. Contemplating and planning are one thing. Actually changing the damaging behaviour can be frightening and hard to do. This is an especially sensitive time. Anyone who has quit a bad habit knows they can become irritable or irrational.
What we can do - If we see our loved one go off track or get frustrated, our best support is to ask open ended questions. Rather than “why” focus on “what”. For example, don't ask “Why did you have a drink when it was going so well for the last three weeks?”. Instead, ask, “What do you think you can do next time to avoid the situation that triggered you to have a drink?”
This is a good time to focus on the positive steps, compliment your loved one and acknowledge that they are strong enough to embrace change and improve their lives.
5. Maintenance - the long haul may not be as acutely challenging as shaking an addiction. But “forever” can feel like a daunting task. Quitting smoking, alcohol, organic or synthetic drugs can sometimes feel like a loss rather than a gain.
What we can do - we need to appreciate that this potentially stressful stage involves a significant change in your loved one’s life. The thrill of kicking the bad habit is replaced by potential boredom since the intensity of the effort has faded.
Our loved one may become a different person – more mindful or more communicative. Or they may withdraw at various stages. Ongoing support, understanding and assurance from our side is essential. We may be dealing with a changed person or we may find that the person we knew so well before they became addicted has returned to their former self.
Change can be difficult and it can also be exhilarating and liberating. Just as our loved ones have made missteps in their addiction journey we will too in our efforts to help them navigate this life change. Compassion and understanding are good companions to hold close in moving forward.
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Some of the ideas in this post come from the online publication Very Well Mind which focuses on mental health. You can read the full article here.
