- Pre-contemplative (“not ready”): People are not intending to take action in the foreseeable future and can be unaware that their behavior is problematic.
- Contemplative (“getting ready”): People are beginning to recognize that their behavior is problematic and start to look at the pros and cons of their continued actions.
- Preparation (“ready”): People are intending to take action in the immediate future and may begin taking small steps toward behavior change.
- Action: People have made specific overt modifications in modifying their problem behavior or in acquiring new healthy behaviors.
- Maintenance: People have been able to sustain an action for at least six months and are working to prevent relapse.
Once a client’s stage of change is assessed,
Cliffside Malibu Outpatient Services uses stage-matched interventions.
Behavioral change is a process that unfolds over time through sequential stages. These stages can be stable or open to change, just as unhealthy behavior can be both rigid and mutable. We understand that clients may vacillate between stages depending on stressors, recent events, and mental health challenges, as well as other qualities that influence behavioral change.
Stage specific interventions can motivate change and movement through the stages.
At an outpatient level of care, we often work with clients for several months, so it is essential that we continually assess a client’s stage of change throughout the winding road of early sobriety to adapt the treatment goals.
Joe is in a pre-contemplative stage of change. He tends to deny or minimize the impact of his addiction. Even though he misses work due to hangovers, sleeps many hours a day, has lost interest in everything he used to like, and has slowly isolated himself from the world and his wife, he still makes statements such as “I don’t understand why anyone would worry about me.”
Most people use denial as a defense from time to time to protect themselves against an unpleasant reality or circumstance. However, with Joe, those unpleasant realities are leading towards devastating loss and painful loneliness. Our goal with Joe is to grow motivation for change. But in this stage, Joe lacks the information to see his problems clearly.
An important intervention for this stage is Consciousness-Raising. Becoming aware of a problem behavior, for a person who does not believe they HAVE a problem behavior, is delicate, but also the first step to change.
Since denial and rationalization are considered maladaptive defenses that protect against change, we assist client’s in identifying and making conscious when they use this defense to deny or minimize their addiction.
It is important to realize that we are not governed by our defenses, merely guided by them and, with practice and therapy, we can CHOOSE what guides our thought process and behavior.
Joe can learn to set aside painful thoughts, or feelings, so he can stick to the next task at hand. That could be engaging in sober support meetings, making a phone call to a friend, finding a doctor, or signing up for an art class. All activities that could assist in his remaining sober for one more day.
As you can see, it would not be helpful for Joe to have a treatment goal that requires Action. Expecting Joe to want to be sober or join a sober support network at this stage would set him up for self-sabotage and failure. We might recommend he do that as a healthy coping strategy once he has made some realization that he has a problem and has moved to a Contemplative Stage of Change.
So what stage of change are you? Call Cliffside Malibu Outpatient Services for a free assessment and find out how we can help you. Remember a thriving life, free of chemical dependency is within your grasp.
Cliffside Malibu Outpatient Services offers:
- Daytime and evening programs
- Ambulatory withdrawal management, or “medical detox”
- Partial Hospitalization Program
- Intensive Outpatient Program
- Outpatient Treatment
- Detox Services
- Personalized, focused programs to keep you sober