Behavioral Stages Of Addiction: What Are The Stages Of Recovery?

S4 tages Of Addiction Treatment

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Addiction recovery stages are behavioral phases of change that addicts often have to overcome to achieve progress in letting go of an addiction. These stages of change in recovery are experienced by a higher percentage of addicts. Overcoming addiction and achieving sobriety is a circle of change that requires discipline at every level.
Making a full addiction recovery requires a model of action, letting go of certain hindrances and beliefs. What should a person expect at a recovery phase? The developmental model of recovery expresses how natural changes occur both physically and mentally in substance users. Most addicts are not too keen on breaking the cycle of addiction due to the obvious benefits.
Some may have imagined the stages of recovery from addiction and envisaged the levels of difficulty that may accompany this decision. The motivation to go through stages of change in addiction is lacking. This is the basis for the addiction model. The transtheoretical model stages of change are used to define the psychology behind addiction and behavioral changes.

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Table Of Contents:

What Is Transtheoretical Model Of Change?

Transtheoretical model stages are a behavioral change model conceived by renowned alcohol addiction researchers, Prochaska and DiClemente, in the 1970s. A higher percentage of addicts experiences these stages of change in recovery. Studies have sort of explaining the reasons why some individuals are able to go through stages of addiction on their own. Some others, unfortunately, are incapable of quitting substance abuse without extensive measures of staging an intervention.

young doctor consulting patient

Transtheoretical model stages emphasize decision-making abilities. The finding on the wheel of change crosses gender, age, social status, and other personal inclination. The addiction model operates on the belief that behavioral change is not spontaneous, but is often indecisive and comes in phases. Each phase is mutually exclusive and requires reinforcement of intentions in order to scale through.

Prochaska and Diclemente’s stages of change model proposed that there are 5 phases experienced in the cycle of addiction.

Stages Of Change Addiction

The 5 stages of change addiction continuously evolve to replicate the behavior of addicts in every phase of decision making. They are:

  • precontemplation
  • contemplation
  • preparation
  • action
  • maintenance

A sixth phase, “termination” or “relapse” was later added in the stages of recovery to refine the model further.
Stages of change infographic from addiction resource
The Initial model proposed 5 stages of addiction. Often times the model is referred to as 6 stages of change. This is with the recognition that there is a final step of recovery that must be attained as an ideal. The 5 stages of addiction recovery deal with the aspect of decision making and behavioral discrepancies, while the sixth and final phase emphasizes closure.
Here are the stages of behavioral changes, as postulated by Prochaska and Diclemente.

Precontemplation Stage

Essentially this is the most critical phase of counter-intuitive recovery phases. What does precontemplation mean? In the precontemplation stage, the individual who is dependent on substance is completely unwilling to seek any form of medical help. The person is either unaware of the deteriorating effect that the substance has on their personal life and the life of others, or is in denial of the severity of the problems.
The precontemplation stage is characterized by an emphasis on the negative effects of quitting their addiction. Lack of information on the harmful effects of an addictive substance can keep an addict on the precontemplation stage of change for longer than foreseen. In some cases, addicts may be even involuntarily committed to rehabs or mental hospitals to prevent further self harm or dangerous behavior.
Woman is Rejecting her addiction to alcohol
Multiple unsuccessful treatment attempts and relapses can greatly contribute to the extension of the precontemplation stage. The challenge with this one is that it can be by will as a way of rebellion or as poor decision making and reluctance due to the overwhelming effects that withdrawal may cause. This rationale resigns the addict to an indifference, which makes this phase one of the most dominant of the six stages of change. A research found that 40% of addicts find themselves categorized under this step.

Contemplation Stage

The contemplation stage of change is usually the next highest category, where behaviors are tilted towards an interest in change. In the contemplation stage, people come to the realization that their habits or addictions may be creating an air of difficulty for them and also their loved ones. The contemplative stage of change comes with considerations on the possibility of finding a solution to the addiction problem. Advantages and disadvantages are laid on the table to predict further what life would be like if that decision was made. The feeling is ambivalence. However, the addict is open to understanding and learning how to manage and control their addiction.

encouragement of the addict
The openness to new ideas and stages of treatment model does not necessarily translate to proactivity. This phase is merely a learning phase, with the possibility of commitment at some time in the future. Many people have spent years in the contemplation stage of change in substance addiction.  Contemplation is one of the 5 stages of recovery that requires a non-judgmental approach to motivating the user to seek necessary help.  A positive outcome ends with the user accepting to seek medical help as soon as possible.

Preparation stage

The preparation stages of change addiction confirm that the person in question has commenced plans to adopt strategies in curbing their addiction. This addiction cycle phase may consist of different levels of preparation according to which ones he or she feels is most efficient. The cycle of change may come in any order.

female doctor receiving emergency call
The preparation stages of change addictions may consist of strategies on what kind of changes specifically is to be made, how to go about this change, supporting institutions or bodies, how to obtain helpful resources that may assist in cutting down addictions and cravings such as nicotine patches, medications etc, finally, ensuring that addiction triggers are disposed of. Triggers may include wine bottles, drug alternatives, alcoholic household reagents, and other reminders.

The preparation stage is case sensitive and may work differently for everyone. The stages of change model can only be a success with proper preparations.

Action stage

In the stage of change model, during the action stage, what is the key component? One could easily say that the essential factor is identifying functional ways of dealing with the distress of withdrawal. The action stages of recovery from addiction can be better executed by enrolling in a treatment center that offers professional substance abuse treatment, detoxification, cognitive behavioral therapy, 12-step programs, alternative medicine, counseling, and other essential support services to enable the individual to better cope with stress and changes in habits and lifestyle.

Doctor measuring blood pressure
The success of the action phase is crucial to the maintenance phase. The action stage of change substance abuse should not be rushed, rather is tailored to the specific needs of the individual in question. Ideally, friends and family members show invested support and encouragement during the action process model of addiction.
Programs such as AA meetings are put in place to expedite the healing process, introducing the patient to a new drug or alcohol-free life. The action phases of recovery addiction may last for about three to six months, depending on the levels of progress made.

Maintenance stage

The aim of the maintenance stages of change substance abuse is to sustain the newfound life and to stick to lessons learned through the phases of treatment. This stage of change is largely a phase of adaptation. Individuals who have gone through phases of successful treatment have to familiarize themselves with life without their cravings. A drug and alcohol-free life becomes a reality by taking the necessary precautions.
According to the transtheoretical model, relapse is always a nearby possibility, especially because people with long term substance use disorder still feel the need to use once in a while, especially when the craving is triggered. Severe substance abuse is a chronic disease that requires long term residential treatment, and even on the maintenance stages of addiction recovery, the risks of relapse are still significant.

Meeting Of AA Support Group
From the first step to recovery till the maintenance stage, the individual in question is equipped with all the tools needed to maintain their resolve. Relapse prevention models are put in place to assist in sobriety, especially for individuals who have attended a recovery program in the past.

Termination stage

Ideally, the cycle of addiction should end at termination. However, many people do not make it to this phase. Following the stages of change model addictions, the termination stage is the final point where the person adjusts to abstinence and is able to control themselves even when there are addiction triggers present. These independent stages of recovery from substance abuse demonstrate a complete recovery where the substance no longer has control over the individual.

Recovered Men Hands High Five
This phases is difficult to attain, and most people often have to live with the possibility of relapse for the most part of their lives. This, of course, depends on the individual as addiction cases and time of healing differs from one individual to the other. It is possible to achieve the termination phase. Many people achieve it after one or more relapses.

However, with the right treatment regimen, under the counsel of professionals, one can attain complete freedom from alcohol, drugs, and any other forms of addiction.

Limitations Of The Transtheoretical Model

On careful observation of the stages of addiction recovery chart, one may notice a few gaps in the change model.  There are a number of limitations in the Transtheoretical model. They are as follows:

  • The theory fails to address the social regard in which the changes occur, such as status, income, SES, and others.
  • The model misconstrues the patterns of decision making. it assumes that people make planned decisions following an outline, which is often untrue.
  • The time difference between each phase is unclear. Many people spend longer periods in certain phases than others, making the model inconsistent.
  • There is no specific factor that determines what stage a person is on. There are a set of questions that have been designed to categorize individuals in them better. However, these questionnaires often require updates and are often invalid.

The model is a guide that seeks to provide strategies for health practitioners and interventions and to better understand the dynamics of the decision-making process.

Ask For Professional Help To Prepare For The Changes

In many first time cases, the changes in behavior, emotions, and cognitive responses may be highly indecisive and slow. The stages of recovery often require a stronger professional influence in order to transition smoothly from one phase to another. Professional treatment is imperative in all cases to impact on behavioral processes and to achieve a successful recovery. Here are some ways that professional treatment can prepare one for the cycle of change recovery:

  • Raising consciousness through facts
  • Enabling the management of emotions and addiction triggers
  • Recognizing environmental effects
  • Reevaluating self in order to recreate one’s image
  • Help in creating counter conditioning
  • Motivation and relationship-building support
  • Management of stimulus
  • Provisional support for social reintegration
Professional assistance is helpful, especially in stages of addiction denial. The successes achievable through professional treatment cannot be overemphasized.
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View Sources
  1. The Transtheoretical Model (Stages of Change), http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html#headingtaglink_1
  2. Moullec G, Ninot G, Varray A, Desplan J, Hayot M, Prefaut C., An innovative maintenance follow-up program after a first inpatient pulmonary rehabilitation, https://www.ncbi.nlm.nih.gov/pubmed/18164191
Ahmed Zayed, MD

Dr. Ahmed Zayed

Content Contributor

Dr. Ahmed Zayed is a Bachelor of Medicine and Surgery. He is graduated from the University of Alexandria, Egypt. Dr. Ahmed Zayed has a passion for writing medical and health care articles and focuses on providing engaging and trustworthy information to readers.

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