People who are intending to enter some form of treatment are usually in the preparation stage of change. If you have made that decision yourself then you are most likely at this stage. In this stage you will be actively getting ready for treatment by reading about addiction, and searching the internet for answers to your questions. This is healthy and signals your strong intention to change.
If family, employers, or other third parties are the main drivers of your treatment then you may still be experiencing a large amount of ambivalence. This is not surprising. It is because you’re are still in the contemplation or even pre-contemplation stage. This doesn’t necessarily mean that you won’t be able to change. It just means that there is a time-lag between where you’re at, and where everyone else around you is at.
According to The National Institute on Drug Abuse2 treatment doesn’t have to be voluntary to be effective. But nevertheless, decisions that are made for you (by others) can feel uncomfortable – because you are not ready!
This is an important point for families (or other concerned parties) to understand. Whilst it is sometimes necessary for us to take decisions on behalf of someone who is heavily addicted and unable to make rational decisions, it is also important to understand that their motivation may be several steps behind yours on the stages of change continuum. Therefore, patience and a non-confrontational approach is required until the individual is able to move from pre-contemplation to contemplation, and then eventually into preparation.
In order to facilitate this, counselors, family members, and other members of the support network should concentrate on raising the addicted person’s awareness first. Awareness raising (providing clear information) is the best technique in helping people to move through denial and ambivalence and into the preparation and action stages of change.
Principles of Change
When treating addicted people, we should note that certain principles of change work best at each stage. For example, an individual who is in the early stages of change will be put off by being forced to confront the ‘action’ stage of change immediately, before he or she has really realized that they have a problem. First they must go through the process of ‘decisional balance’, where they weigh up the costs and benefits of their addiction.
This is where the Stages of Change Model is essential in the process of recovery from addiction, because no other therapy model has a core component that deals with time. In other words, they all assume that change is an event. But recovery from addiction is not an event. It is a process. Therefore we need to acknowledge that it takes time and that there are certain principles at work in that timeframe.
Only a minority of addicted people (usually 20-25%) are ready to take action at any given time. And for this reason action-oriented therapeutic approaches don’t serve those individuals who are in the early stages of change. For those who are still in the early stages, awareness raising exercises like learning from books and videos, or quick written exercises like a cost/benefit analysis are more beneficial. In this way people in early stages of change can acquire more consciousness and ownership of their problem and the treatment can then move forward a lot more effectively.