Nobody can force an addict or alcoholic into recovery. The family might serve up ultimatums, and a judge might require attendance at 12-step meetings. But nobody recovers unless they truly feel the desire to change.
This does not happen overnight. Change is a process. Just as a caterpillar does not turn into a butterfly in the course of an instant, those who choose to recover must undergo a process. Some find the recovery process quite grueling, while others embrace a life of sobriety from day one. No matter which category they fall under, however, they will often find that their change occurs in steps.
We do not mean the 12 Steps with which AA and NA members are so familiar. In this case, we refer to six specific stages of change. No addict or alcoholic will achieve sobriety without undergoing at least five of these stages. The sixth stage (total recovery) is questionable, in that many debate whether it truly exists in the case of those who suffer from substance use disorders.
All of these stages fall under what we know as the transtheoretical model, so named because it transcends most traditional theories of change. As such, it lends itself to a wide variety of applications, from addiction recovery to organizational change in business. For our purposes, however, we will describe each of the stages of change only as they pertain to recovery from alcoholism and drug addiction.
Please note that the transtheoretical model consists of multiple components. In addition to the stages of change, it also describes levels and processes of change. We may examine these components in future writings. At this time, we wish only to provide an overview of the general change process and how we incorporate it into our programs here at Amethyst Recovery.
Stage #1 – Pre-Contemplation
In the first stage, we find ourselves still unready to change. At this point, we harbor no intention of altering our behavior within the next six months. When we find ourselves in this stage, we can usually attribute it to one of two circumstances. The first may be that we have tried to change in the past and were unsuccessful. This weakens our morale and leaves us feeling incapable of any sort of meaningful transformation. The second circumstance is much simpler—we simply do not understand the consequences of continuing along our current path.
An alcoholic or addict in the pre-contemplation stage has yet to hit rock bottom. If those they love suggest seeking help, they may openly resist. They most certainly will not come up with the idea on their own. Even if it crosses their mind, they will feel no inclination to pursue the thought much further. They will continue drinking or engaging in drug abuse until they learn new information about the consequences. Unfortunately, we usually come by this information the hard way. Rather than learning from the experiences of others, we often must suffer our own hardships before we move on to the next stage.
Stage #2 – Contemplation
Arriving at the contemplation stage, we are still not quite ready to undergo a metamorphosis. However, unlike the pre-contemplation stage, we begin opening ourselves to the idea. We may even set a target date to begin changing within the next six months. In the case of addicts and alcoholics seeking treatment, the deadline will be much sooner.
Many things might bring us to the contemplation stage. Perhaps we suffer consequences in the form of legal troubles or health issues. Our friends and family members might hold an intervention that opens our eyes to the manner in which our behaviors have hurt those we love. Whatever the cause, we cease to look at sobriety as a pointless endeavor and begin performing a cost-benefit analysis.
At first, we will usually weigh both sides equally. We are not completely ready to give up our old way of living. But we also do not relish the idea of continuing along our current path, either. This dilemma can last for quite some time, which causes many to put off seeking treatment.
Family members of the addict or alcoholic in this stage may find themselves frustrated. It can be hard to deal with a person who seemingly understands the consequences of their actions yet refuses to change them. Fear not, however, for those who reach this stage are closer to beginning their transformation than they may initially appear.
Stage #3 – Preparation
Once the addict or alcoholic reaches the preparation stage, they are willing to make an immediate change. Experts on the transtheoretical model define “immediate” as within a month following the onset of this stage, although it will be sooner for most who seek to enter addiction treatment. Many will enter detox immediately, or will detoxify on their own and enter treatment within a week. Others may wait longer, but success in this stage often depends on quick action.
The catalyst for reaching this stage of change tends to be more of the same that led to the contemplation stage. In this case, the consequences might be worse, or the intervention might take place when the addict or alcoholic is more lucid. Sometimes, the addict’s reasons for finally moving forward may remain something of a mystery. In the end, the reason for reaching this stage matters for less than the simple fact that change is imminent. When we reach this stage, we find ourselves ready to collect information on treatment and begin making a plan.
Stage #4 – Action
Finally, we reach the stage that the addict’s friends and family have long awaited. In the case of those who suffer chemical dependency, the action stage will usually consist of many phases of treatment. Those who enter treatment soon after their last instance of using will generally start with detox or residential treatment. They then enter into day/night treatment for an average of thirty to forty-five days.
Not all addicts and alcoholics who recover will include treatment in their action stage, but it certainly helps. Since the action stage as it pertains to alcoholism and addiction generally relies on total abstinence, those who enter treatment stand a better chance of success at concluding this phase of change and progressing to the next one. They will receive therapy and addiction education, not to mention a strong support network of fellow clients. These resources help them to undergo the necessary processes to ensure long-term change.
Stage #5 – Maintenance
The maintenance stage is the point at which the addict or alcoholic has undergone most of the necessary change processes and now works to continue the path they have begun to tread. This stage of change will last different lengths of time for different people. Addicts and alcoholics in early recovery are generally suggested to attend ninety 12-step meetings within ninety days. But this suggestion actually coincides more with the action stage than the maintenance stage. By the time they are done with their 90-in-90, most recovering addicts and alcoholics should work on maintaining their recovery by finding a home group and working with a sponsor.
During this stage of change, it helps to stay rooted in a strong recovery community. For this reason, we generally suggest that clients seek a sober living house for at least six months after they leave treatment. Six months is generally accepted as the minimum duration for the maintenance stage. The maximum estimate is five years, although most addicts and alcoholics will have left sober housing by the time they reach this point.
Regardless of how long we choose to stay in sober housing, we must continue to maintain our recovery. The longer we remain clean and sober, the further we lower our chance of relapse. If we fail to maintain a solid program of recovery, we may find ourselves beginning the transformation process over again from the beginning.
Stage #6 – Termination
Applying the transtheoretical model to addicts and alcoholics, the termination stage would imply permanent recovery. Many claim that addicts and alcoholics never truly recover. On the other hand, AA’s Big Book clearly utilizes the word “recovered” on its very title page. Nonetheless, those who use past-tense words of this sort may find themselves the subjects of ridicule when in the company of those with particularly strong opinions on the matter.
We will not attempt to provide a definitive answer to this debate, as we possess neither the ability nor the desire. It is nobody’s place to tell you whether you can or cannot truly recover from chemical dependency. We would caution you, however, not to focus too much on this issue in the first place. Many use it as an excuse to let up on their program of recovery while they are still in the maintenance stage, and the consequences of such an action can be dire. We would rather see you continue your maintenance longer than arguably necessary if it means lowering your chance of relapse. Overconfidence buries far too many innocent people. We’d be happy never to see it happen again.
The “Bonus” Stage
Relapse does not take a formal place in the stages of change, yet it certainly merits discussion. Despite our warning above, not all who relapse are doomed. In fact, many come back from a relapse stronger than ever. Still, it generally behooves us to avoid backtracking through the phases if at all possible. As such, we suggest taking the above stages as seriously as you can. If we educate ourselves on addiction, take stock of the consequences, build a support network, and keep working through our program, we truly can recover on the first try. Perhaps it doesn’t happen as often as we might like, but it never fails to inspire those fortunate enough to witness it.
Through a solid treatment program, you can facilitate the stages of change with greater ease than those who attempt to go it alone. For more information on our program of recovery, contact Amethyst today. There’s no need to wait. Get started on making a positive change, and living a worthwhile life of sobriety.