Facing Addictions – The Stages of Change
My favourite approach when dealing with addictions is the Stages of Change or Transtheoretical model identified by DiClemente and Prochaksa. In EFT and counselling it signposts for us where a person is at. When we want to change something in ourselves, we might be able to identify where we are in the cycle with it just now. Rather than just being for addictions this model is used for life changes such as getting more exercise or a pattern of unhealthy relationships.
- When someone is in the precontemplation stage, it’s a bit like ‘ignorance is bliss’ as they just don’t see a problem within themselves. The problem is out there somewhere. Approaches used by therapists in counselling or EFT would be to teach ways of managing stress, encourage gentle reflection on behaviours, to identify risks if this applies and to form a rapport.
- Contemplation Stage is where a person isn’t making any plans to change but realises there is something not right in their behaviour that is causing them pain. They experience a lot of ambivalence in this stage and it can be quite confusing. Almost like at times they rally around for evidence that the behaviour is fine, and then the next minute the opposite. I created an EFT video which might help with this type of ambivalence.
- Preparation Stage is a planning phase. The person wants to change and is actively making plans to change within the next month. Support focuses on looking at what will help the person, such as social supports and alternative hobbies and things to do instead of the behaviour. Foreseeing potential obstacles and exploring ways to respond to these if they should crop up. In EFT we teach how to work with cravings and the many emotions that can come up in making behaviour change such as feeling left out, stressed, frustrated, getting into old unhelpful ways of thinking. The persons skills are reinforced.
- Action stage is the doing part. Either taking up the exercise or giving up the substance, whatever it is. We work in EFT to re-emphasize the benefits, work with any issues of loss or obstacles that come up, reiterate support systems and personal development techniques especially tapping rounds that support and positive visualisation.
- Maintenance is the keeping it up stage, and can last from 6 months to several years. Therapy input is to look at how to manage frustrations and stress, reinforce personal success. Still this far on the person can experience ambivalence. People who have given up alcohol ask themselves ‘maybe after all these changes I could handle drinking just fine now.’ Sometimes looking at relapse is helpful, what it might look like, how to see it creeping up. Things such as ‘stinking thinking,’ where you blame everyone else and go into a place of victimhood, rather like in the pre-contemplation stage can be a warning sign that relapse is on the horizon.
- Termination stage is where the person graduates from the problem, after some years, they no longer are at risk of relapsing. Some schools of thought, such as AA say that this never happens and people should never take for granted that they are at risk of slipping.
- Relapse is not inevitable but certainly happens to many, also referred to as recycling, and it should be emphasised even though the person starts again at pre-contemplation that all is not lost and the learnings along the way are not gone, they just need to be revived again when the person is ready.