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Table 1. Stages of Change Related to Substance Abuse
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Stage |
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Description |
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Precontemplation |
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Patients in this stage have no intention of making changes regarding substance use. They may be uninformed or underinformed. The risks of making change in their lives are often overestimated and seen as outweighing the benefits, which are often underestimated or unknown to the patient. There is little insight into the hazardous nature of their substance use. These persons are “resistant” or “unmotivated.” |
| Contemplation | |
Benefits of change are now better recognized and understood but are still outweighed by the apparent risks. Patients in this stage are stuck in a “love-hate” relationship with the substance but may state a desire to make change in next 6 months. |
Preparation/
determination |
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Patients in this stage state intent to take action within the next month or less. Concrete plan for change arises (eg, attending an Alcoholics Anonymous meeting, buying self-help book). |
| Action |
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Patients in this stage have made specific, concrete changes over the past 6 months, thus reducing their risk for disease (ie, changes have resulted in reduction or cessation of substance use). |
| Maintenance |
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Patients in this stage are engaging in lifestyle changes, which will actively prevent relapse. Relapse risk softens, cravings/temptation lessen, and confidence improves. This stage usually lasts 6 months to 5 years. |
| Termination |
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Patients in this stage have zero temptation and 100% self-efficacy. Most (> 80%) do not reach this stage. |
| Relapse |
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40%–60% of patients will relapse in the first year and may re-enter at any stage above. |
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| Adapted from Prochaska et al.1 |
