Drug and Alcohol Treatment: Slowly Getting Sober with Stages of Change

Drug and Alcohol Treatment | LakehouseRecoveryCenter.comAlthough the process of ending an addiction, or making any type of major change, can feel chaotic, there is a roadmap for transformation. In 1983, clinician James

Prochaska and others developed a model that outlined six stages of change. It is known in the mental health field as the Trans-Theoretical Model (TTM) and casually as the Stages of Change.

The model incorporated a variety of clinical theories (thus, the name Trans-theoretical) as well as the observations of individuals attempting to create sustainable behavior change.

In fact, the States of Change model is so popular among drug counselors that you might learn about it in your drug and alcohol treatment.  The TTM Model, the Stages of Change, is often used to facilitate freeing  adults from addiction or other unhealthy addictions, such as gambling, shopping or pornography/sex addiction.

The stages and their definitions are listed below. They can be used as a map if you or someone you care for is attempting to make such a transformation, or if these stages are not presented in drug and alcohol treatment.



At this stage, an addict may not recognize there is a problem. There are no thoughts about making any change at all. If anyone points out a concern, anyone in this stage would feel that that he or she is exaggerating. The impact of the problem has not become conscious and there is no consideration to make any adjustment to one’s life.



Adults in this stage are willing to consider that there might be a concern. However, their ambivalence is high. They haven’t made a firm decision to change; rather, they know that the drinking or drug use is problematic and are willing to look at pros and cons to sobriety. At this stage, a counselor or therapist might accompany an individual through a risk-reward analysis. Together, they might examine previous attempts to change in the past, causes for failure, and benefits and barriers to change.



The hallmark of this stage is that a decision to change has been made. Although there continues to be some ambivalence, the determination to change is strong enough to outweigh any obstacles. There is a serious attempt to change with a realistic look at anticipatory problems, concrete solutions, and a sensible plan for recovery.



As the energy of determination continues to build, an individual takes action and chooses to implement his or her recovery plan. A person might make their commitment to change public by telling friends in order receive external validation for their efforts. This stage might also include attending support groups, AA meetings, or individual therapy. As a recovery plan succeeds, emotional rewards might also become evident such as self-confidence, happiness, and optimism.



Although a recovery plan is in place and a recovering addict has taken action towards that plan, maintaining sobriety can be challenging. This stage might even include relapse, but the foundation for a sober life is becoming firm. The person in recovery is becoming more aware of old habits and is growing the ability to make healthier choices. The test of this stage is maintaining the new behavior in order to create a life-long change.



Some clinicians do not include this stage in the TTM model, particularly when applied to substance abuse. Some clinicians believe that once there is an addiction, there will always be one and that the stage of maintenance is ongoing.

However, other clinicians see this stage a time when the individual is no longer tempted or threatened by any substances. He or she has complete confidence in his or her sobriety.


It should be noted that these stages of change could be applied to anything. However, they have successfully been used for over 30 years with substance abuse users and healing from addictions. Whether you or someone you care for is searching for sobriety or freedom from other unhealthy behaviors, the stages above present a roadmap for change.



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