Understanding the Stages of Change in SUD Recovery
Recovery from Substance Use Disorder (SUD) is not a linear journey. Instead, it’s a process marked by different stages of change, as individuals progress toward a healthier, substance-free life. Understanding these stages can help individuals, families, and professionals provide the right support at the right time.
This model, known as the Transtheoretical Model of Change, identifies six key stages of recovery:
- Pre-contemplation
- Contemplation
- Preparation
- Action
- Maintenance
- and sometimes Relapse
Let’s explore each stage and what it means for SUD recovery.
1. Pre-contemplation: Ignoring the Problem
In the precontemplation stage, individuals are not yet ready to acknowledge their substance use as a problem.
They may:
- Deny the issue altogether.
- Lack awareness of the consequences of their behavior.
- Feel defensive if others express concern.
How to Support:
- Avoid judgment or confrontation.
- Share information about the risks of substance use.
- Encourage open, empathetic conversations to plant seeds of awareness.
Real-Life Example:
Consider John, a 34-year-old struggling with alcohol dependency. Despite repeated concerns from his family about his drinking habits, John dismisses them, insisting he has everything under control. His lack of awareness about the long-term consequences of his actions—like potential liver damage—keeps him in the precontemplation stage. Over time, gentle conversations from his sister and exposure to real-life stories about recovery start planting seeds of awareness that may eventually motivate change.
2. Contemplation: Considering Change
During contemplation, individuals begin to recognize the impact of their substance use.
They may:
- Feel ambivalent about making changes.
- Weigh the pros and cons of quitting or reducing substance use.
- Start thinking about the possibility of recovery.
How to Support:
- Offer encouragement and validation for their thoughts about change.
- Share stories of hope and recovery to inspire action.
- Help them explore their motivations and goals.
Common Challenges:
In the contemplation stage, fear of failure or the unknown often holds individuals back. For example, Sarah, a 28-year-old considering quitting opioids, frequently thinks about how much better her life could be without substances. However, she’s afraid of withdrawal symptoms and doubts whether she’ll succeed in long-term recovery.
How to Overcome Challenges:
- Encourage small, achievable steps to build confidence.
- Discuss potential treatment options that offer medically-assisted withdrawal to ease discomfort.
- Help them visualize the benefits of recovery, such as improved health and relationships.
Real-Life Example:
Sarah’s turning point came when a friend from a support group explained how they managed withdrawal through a detox program and shared how their life improved post-recovery. This conversation inspired Sarah to start researching her own options, realizing she was not alone in facing these fears.
3. Preparation: Planning for Action
In this stage, individuals are ready to take steps toward change.
They might:
- Research treatment options or recovery programs.
- Set specific, achievable goals for reducing or stopping substance use.
- Reach out to support networks or professionals.
How to Support:
- Assist with practical planning, such as finding a treatment center or support group.
- Help them outline clear and realistic goals.
- Reinforce their decision to move forward with positive reinforcement.
Practical Tips:
- Encourage making a list of goals and actionable steps. For instance, writing down milestones like “Find a local recovery group by Friday” or “Schedule a consultation with a therapist this week” can help maintain momentum.
- Suggest using tools like apps or journals to track their progress and keep them accountable.
Real-Life Example:
David, a 40-year-old father of two, had decided he wanted to recover from his cocaine addiction but didn’t know where to start. A family friend helped him research local rehab centers and even accompanied him on a tour of a nearby facility. Feeling supported, David created a step-by-step plan: attending an intake session, organizing childcare for his kids during his treatment, and setting up regular check-ins with his sponsor. These small but crucial steps helped him move confidently into the action stage.
4. Action: Taking Steps Toward Recovery
The action stage involves actively working toward recovery.
This could include:
- Attending therapy or rehab programs.
- Practicing new coping skills and strategies.
- Building a sober lifestyle and avoiding triggers.
How to Support:
- Celebrate milestones and progress.
- Provide ongoing encouragement and accountability.
- Address challenges or setbacks with compassion and problem-solving.
Real-Life Success Story:
After enrolling in a 30-day rehab program, David faced an initial adjustment period where he doubted his ability to stay committed. However, the structured environment and supportive counselors helped him build confidence. He discovered new coping mechanisms, such as journaling and mindfulness exercises, and connected with others who shared similar struggles. Each small win, such as completing a week of sobriety, gave him momentum to keep going. By the end of the program, David felt empowered to continue his recovery journey at home.
5. Maintenance: Sustaining Recovery
In the maintenance stage, individuals focus on sustaining their progress and avoiding relapse.
This stage may include:
- Continuing therapy or attending support groups.
- Developing healthy routines and habits.
- Strengthening their support system.
How to Support:
- Offer long-term encouragement and support.
- Help them identify and address new challenges.
- Recognize and celebrate their continued commitment to recovery.
Tips for Long-Term Success:
- Encourage participation in aftercare programs, such as alumni groups or mentorship opportunities.
- Help them develop a relapse prevention plan that includes identifying triggers and strategies for managing them.
- Promote the importance of self-care practices like exercise, meditation, and proper nutrition to maintain overall well-being.
Real-Life Example:
Lisa, a 45-year-old in recovery for prescription drug abuse, maintained her sobriety by attending weekly support groups and volunteering at a local community center. These activities gave her a sense of purpose and helped her stay connected to a sober lifestyle. When she faced challenges, like the stress of a new job, Lisa relied on techniques she had learned during therapy, such as deep breathing and prioritizing self-care. By staying proactive, Lisa successfully avoided relapse and continued building a fulfilling life.
6. Relapse: Learning from Setbacks
Relapse is a common part of the recovery journey. It doesn’t mean failure; instead, it provides an opportunity to learn and grow.
During this stage, individuals may:
- Revisit old behaviors or coping mechanisms.
- Experience feelings of shame or frustration.
- Reflect on the triggers that led to the relapse.
How to Support:
- Avoid judgment or blame.
- Encourage them to seek help and refocus on their recovery goals.
- Help them analyze triggers and develop strategies to prevent future relapses.
Common Triggers:
Relapses are often triggered by factors like stress, isolation, or exposure to high-risk situations. For example, a major life change like starting a new job can create overwhelming stress, while returning to social circles that encourage substance use can increase temptation. Recognizing these triggers early is essential for avoiding setbacks.
Real-Life Example:
When Maria relapsed after six months of sobriety, she initially felt defeated. However, with support from her counselor, she identified that social pressures during holiday gatherings were a significant trigger. By understanding this, Maria created a new plan to navigate future events with confidence and resilience. For example, she decided to bring a sober friend to family gatherings and leave early if she felt overwhelmed. This proactive approach turned her relapse into a learning experience that strengthened her commitment to recovery.
Strategies for Moving Forward:
- Rebuild confidence by revisiting earlier successes in recovery.
- Adjust the relapse prevention plan to address new challenges.
- Lean on a support system, such as a sponsor or therapist, to regain momentum.
FAQs: Common Questions About the Stages of Change
Why Understanding the Stages of Recovery Matters
Each stage of change requires a unique approach.
By recognizing where someone is in their recovery journey, families, friends, and professionals can:
- Provide appropriate support.
- Avoid pushing for changes before the individual is ready.
- Celebrate progress, no matter how small.
Key Statistics
- Studies show that individuals who tailor recovery plans to their stage of change are more likely to succeed in long-term sobriety.
- Approximately 40-60% of individuals relapse during the first year of recovery, highlighting the importance of understanding and supporting all stages.
Key Takeaways
- Recovery is a process, not an event.
- Each stage of change builds on the last, leading to meaningful, lasting recovery.
- Compassion, patience, and tailored support are essential at every stage.
Recovery is a journey of courage, persistence, and self-discovery. Understanding the stages of change not only helps individuals navigate their own path but also empowers loved ones to offer meaningful support. Together, we can build a stronger, healthier future—one step at a time.
Stay strong,
Jim
Sources:
- Governors State University. (n.d.). The stages of change model. Retrieved from https://govst.edu/uploadedfiles/academics/colleges_and_programs/CHHS/Departments/Addictions_Studies_and_Behavioral_Health/2ndsession%20stages.pdf
- SMART Recovery. (n.d.). The stages of change. Retrieved from https://smartrecovery.org/the-stages-of-change
- Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38–48. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC2583262/
- Clifford, J. S., Davis, S. L., & Goldman, C. R. (2022). Stages of change in addiction recovery: A comprehensive review. Journal of Substance Abuse Treatment, 129, Article 108463. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9014843/
