The “stages of change” or “transtheoretical” model is a way of describing the process by which people overcome addiction. The stages of change can be applied to a range of other behaviors that people want to change, but have difficulty doing so, but it is most well-recognized for it’s success in treating people with addictions. It was developed from research looking at how change occurs in “natural recovery” from addictions, and has been embraced by the move away from confrontational and pathological approaches to understanding and treating addictions, towards motivational and person-centered approaches, such as “motivational interviewing.”
There are four main stages: precontemplation, contemplation, preparation and action. Additional stages of maintenance and relapse are also sometimes included.
These stages can be represented as a cycle, and it is suggested that people go through these stages in sequence. In reality, people can jump about between stages, go backward and forward, and even be in more than one stage at a time. But the sequential model provides a useful way of understanding the process of change, and gives a structure to how it change in addictive behaviors can be encouraged and managed.
Sources:
Hartney, E., Orford, J., Dalton, S., Ferrins-Brown, M., Kerr, C. & Maslin, J. "Untreated Heavy Drinkers: a Qualitative and Quantitative Study of Dependence and Readiness to Change." Addiction Research & Theory, 11:317-337. 2003.
Prochaska, J., Velicer, W., Redding, C., Rossi, J., Goldstein, M., DePue, J., Greene, G., Rossi, S., Sun, X., Fava, J., Laforge, R., Rakowski, W. & Plummer, B. "Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms." Preventive Medicine, 41:406-416. 2005.
Segana, C., Borlanda, R. & Greenwood, K. "Can transtheoretical model measures predict relapse from the action stage of change among ex-smokers who quit after calling a quitline?" Addict Behav. 31:414-428. 2006.
Velicer, W. F., Hughes, S. L., Fava, J. L., Prochaska, J. O. & DiClemente, C. C. "An empirical typology of subjects within stage of change." Addict Behav. 20:299-320. 1995.
