While I know that there are few situations in life that are either on or off, that knowledge doesn’t prevent me from wishing there was a big magic switch with which we could change a person’s behavior by flipping it. If we want our son to clean his room regularly, we’d flip the switch and, presto: He cleans his room twice a week. If we want our daughter to do well in math, we’d flip the switch and, voila: She’s a mathematic genius. If we want our best friend to give up alcohol, we’d flip the switch and shazam: He’s clean of alcohol forever. If only there were such a switch, then things would be so much easier. Unfortunately, here in the real world, there’s no magic switch. Behavioral change takes time, patience, and acceptance; especially as behavioral change pertains to the substance abuse field.
Most of the time, I talk with people who think someone in their lives needs to change. I’m always melted with the hope and fear they carry. They want answers and they think that if the someone would just give up whatever adverse behavior, things can go back to normal. But, it’s not simple and there are no easy answers or methods. Change is quite possible; I even consider change probable most of the time. But, it’s a process.
One of the many standard models taught within the substance abuse treatment field is called, Stages of Change. This model encompasses several stages:
- Precontemplation: A person has no intention of altering his or her behaviors
- Contemplation: A person acknowledges a problem and is considering the possibility of making changes
- Preparation: A person is serious about changing and has begun taking small steps towards change
- Action: A person has made successful behavior changes
- Maintenance: A person preserves their changes and prevents a return to previous, unhealthy behaviors
It’s important to recognize that these stages are neither linear nor do they indicate that a person in one stage won’t recede back into a different stage. As a matter of fact, when it comes to substance abuse treatment, relapse is the norm, not the exception. That is, people in recovery will relapse. It takes several relapses before someone can achieve long term abstinence from drugs and alcohol.
When talking with someone about the need for change, it’s really important to assess where someone is within the stages of change. If, for example, someone is in the precontemplation stage, it’s going to be difficult to reach him or her. The reality is that the person in precontemplation doesn’t see a problem. If no problem exists, there’s nothing to change. When someone is the contemplation stage, it becomes critical to line up resources for this person such that the need to change is reinforced. Lining up resources can mean providing educational materials about substances of abuse. It can mean sharing stories about successful recovery. Really, the resources can be anything that can help foster an environment of safety without judgment. As a matter of fact, judging someone harshly at this stage will lead to regression: If someone thinks that he or she is “bad,” then bad is what bad does and forget change.
Most people in early (or no) recovery are in the first two stages. Once a person is on his or her way within the stages, change becomes a matter of reinforcement: He or she has to continue the healthy changes over and over again. I think that understanding that people require recognition and awareness of a need to change is a critical aspect of working with anyone who needs to change. It takes time, patience, and acceptance. In this life, there are no absolutes. But, as long as a person is willing to take up the fight, he or she can win.