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Want to Understand Alcoholic or Addicted Thinking? Learn About the "Stages of Change" Theory

Updated on September 26, 2011

There are few things as frustrating as trying to understand the mind of an alcoholic or drug addict. Yet although the behaviors of addiction are confusing and sometimes even contradictory, any measure of true understanding into the mind-set of the using addict or alcoholic can help loved ones to make a difference in encouraging change.

Physicians and addiction professionals must also endeavor to understand the mind-set of addicts and alcoholics for effective treatment planning. One conceptual tool that these medical professionals use to better make sense of an alcoholic's motivations is a theory called the "Stages of Change".

You may find this framework of 6 stages of change helpful as well, as you struggle to better understand where your loved one who abuses drugs or alcohol may be coming from.

The Stages of Change

It's important to remember that the stages of change are dynamic (people MOVE through the stages) and they are also cyclical. People move along the continuum of change, and often after coming to the last stage, revert back to the first stage (Relapse).

1. Precontemplation

The addict or alcoholic is not thinking about reducing or stopping their substance abuse. They may not realize they have a problem, they may think that they are unable to change or they may not want to change their behaviors.

2. Contemplation

During this second stage, the addict or alcoholic becomes aware of the problem, and begins some preliminary thought about modifying their behaviors. People in this stage may linger here for years or even decades, caught between wanting to stop and wanting to keep using.

3. Preparation

A firm decision is made to stop or reduce substance use. People in the preparation stage may experiment with different ways to cut-down use on their own, and they may also investigate different more formal treatment options. People in the preparation stage are still using, but hope to stop shortly.

4. Action

During this fourth stage, the person begins a course of action to change their behaviors.

5. Maintenance

If the action stage results in a successful change in substance use behaviors, the next stage of change is maintenance. During this stage, the person must strive to stay sober, avoid triggers to use and will usually need to make significant lifestyle changes. The maintenance phase is a long term phase.

6. Relapse

Most people who cycle through the stages of change will relapse back to substance use at least once. This is quite normal. Most people will return to either the contemplation or even pre contemplation stages after a relapse. Relapse is seen as a normal part of the conceptual framework, and is viewed as a learning opportunity. People learn by failure what strategies did not work to help them stay sober.

Here is a link to a test called the Stages of Change Readiness and Treatment Eagerness Scale. This test can be used to evaluate where a person falls on the stages of change continuum.


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      C D  6 years ago

      tne question i asked was why the alcoholics seemed to be so depressed etc. the person is not and definitely not quitting their habit . the person even suggested for me to sneak booze into the hospital room if that person happens to be on their death bed!! i was asking as to why a person is so hooked on their habit ?!