A treatment model discussed in previous blog articles is the Stages of Change model, which assesses the strength of your desire to change versus the strength of your addiction.
Stages of Change is a clear description of the various stages that one goes through when making a significant life change.
In addition to this, there is also an assessment scale called the Stages of Change Readiness and Treatment Eagerness Scale SOCRARTES. It’s a self-report assessment containing 19 questions using three scales: Recognition, Ambivalence, and Taking Steps.
The assessment was developed in 1996 by William R. Miller and J. Scott Tonigan. It is meant to measure a substance abusers current state of readiness for change. The questionnaire takes approximately three minutes to complete and there is no training required to administer it.
One of the benefits of using the Stages of Change model as well as the SOCRATES assessment is that it can point to whether a person is ready to engage in treatment. Frequently, family and friends pressure an individual to begin treatment.
However, if he or she isn’t ready to make that change, then relapse can occur. Of course, the SOCRATES assessment as well as the Stages of Change model can also help an individual determine whether he or she is ready. Sobriety is a large commitment and one needs to be ready to make a step in that direction.
The Stages of Change model was developed about 13 years before the SOCRATES assessment. In 1983, clinician James Prochaska mapped out the stages of change. It can be used as a map if you or someone you care for is attempting to make the transformation from addiction to sobriety. Below are brief descriptions of each stage:
Pre-contemplation
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.
Contemplation
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.
Determination
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.
Action
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.
Maintenance
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.
The SOCRATES Assessment Measures These Three Scales
Recognition – At this state, a person is aware of the changes that he or she needs to make but has not taken any action toward this change.
Ambivalence – This stage is marked by a high degree of ambivalence. There is a strong desire to change but as a person gets closer to action, the benefits of using drugs or drinking also become evident.
Taking Steps – At this stage, a person has moved past the ambivalence and is taking action toward change.
Having tools such as the SOCRATES assessment as well as the Stages of Change model can facilitate clinicians, families, and individuals in making decisions about entering treatment.
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