Treatment Strategies: Stages of Change

Sometimes people ask me how drug addiction treatment works. There are many ways we intervene, but the most practical one is helping a client work through the stages of change. Everyone experiences different stages of change, sometimes beginning in treatment. Whilst others are still trying to change on their own. There is a method to the treatment process.

On admission many of our clients are in crisis, so are their families. Some are entering treatment for the first time, while others are back after a relapse and still others are going into treatment again for further help. This article might help you to understand the change process and you might be able to recognise yourself in your own process of change.

The change process is exactly that, a process and not an event. We’re looking at changing behaviour when we work with our clients, but we have to be aware of where our client is in the change process.

The first stage is Precontemplation

Everyone has experienced this phase of change, and one of the examples I use is the decision to lose weight. The stage is important because it is about not considering any change whilst being aware of a few negative consequences. In my weight loss example, it means that the person is aware of some health problems connected to their weight but are not planning to take any action soon. In addiction someone may be aware that their use of Marijuana might be affecting them negatively, but they don’t want to change and have little to no insight into their problem. They might be saying “I can stop any time I want”.

At Eden we know how to work with client’s in this stage. It might be surprising for you to know, but many clients in treatment centres are at this stage when they come into treatment. We have specific ways in which we work on people still in this phase. The person you care about may be saying things like, “This is not a problem for me. It’s everyone else’s fault”.

The second stage is Contemplation

There is more awareness of the problems or negative aspects of the situation. You might not be fitting into your favourite pair of jeans, but you feel ambivalent about going to gym. You are uncertain, and there is still no definite plan to change. In addiction our client’s know that their using is causing problems in their lives but they might be wondering how they will ever be able to stop using forever. They may still be trying to stop on their own.

At Eden we have special interventions for clients in this phase of change. We move people through the different stages, with the goal of planning, preparation, action and maintaining abstinence.

The third stage is Preparation

The progress at this point means that the client is beginning to make steps to change. You might be looking at different gym’s to find out which one offers the best value for your money, or you might be getting advice from family and friends about what they have done to lose weight.

By this stage, some clients are at the point when intervention is ideal, they are ready to start looking at different treatment options and are starting to make plans for what to say to the boss, or other family members about treatment.

Although this is the ideal stage that patients should enter treatment, it isn’t vital and we still work with all stages with different interventions in the treatment process.

The fourth stage is Action!

Now you’re going to gym – your goal is three times per week. Sometimes you’re getting three sessions in, but you feel bad when you don’t. People in early recovery may be engaging with treatment, and actively trying different forms of support. But this is still an early part of the change process and lots of support is necessary.

There may be a real possibility that the person you care about could relapse in this phase. The important thing is to intervene straight away to help them get back on track. Intervention can be in the form of extending treatment, trying outpatient treatment, going into therapy or committing to group therapy.

Use any “failure” as an opportunity. Relapse is real. But it isn’t the end.

The fifth stage is Maintenance

You can see progress – you’ve lost some weight and your tummy is a little firmer. You are feeling better and healthier.

For an addict or an alcoholic, this is still an uncertain time. They may have left treatment and are going to AA or NA meetings. They have changed some of their old behaviours. Support is still important for them. Relapse prevention plans have been created so that any challenges can be dealt with.


It is possible that the person you care about can reach 1 year clean and sober. If they’ve achieved this, they are well on their way. But be realistic, relapse is real. Sometimes when relapse occurs you will have to help them get back into the change process. At Eden we’ve worked through this change process with countless clients. If your loved one is still trying to do it alone and is not making it, they should be encouraged to have a session with one of our counsellors who can help them identify a plan of action.

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