The longer an individual stays trapped in addiction the more their life will be destroyed. Escape from this destructive behavior is only possible when the addict is ready to change. This motivation must be strong enough to overcome denial and ignorance about the problem. Those who want to help the addict will face a real challenge until there is this readiness to change.
There is a lot of interest in the reasons why some people become ready to change while others do not. This has led to the development of some useful theories to explain why this happens. It is now understood that readiness to change involves a number of different factors and that the individual will pass through stages of change.
The Transtheoretical Model of Behavior Change provides a framework for understanding the stages of change. Like all theories it might not reflect reality exactly but it can help aid understanding of how change occurs. The stages identified as they apply to addiction are:
* Precontemplation can be considered the normal condition for an addict. At this stage there is no motivation to change. It is only by getting beyond precontemplation that an alcohol or drug abuser has any chance of escape. Some individuals never seem to get past this stage.
* Contemplation is the second stage of change. Here the addict will begin to notice the problems arising from their substance abuse. They now worry about the effect their behavior is having on their life and their relationships.
* The Preparation stage is where the addict decides that they want to escape the abuse. At this point they begin to prepare for change or even make some small positive changes to their life. It is now that they may seek out information about rehab or other treatment options.
* The Action stage is where the addictive behavior is actually dealt with. This can involve entering a treatment facility or just going it alone.
* Maintenance is the continued work that is needed to prevent relapse. This can include support groups or other types of aftercare. The motivation to stay on the path of recovery can decay over time if it is not reinforced.
* Termination is the stage where there is no risk of a return to the previously destructive habit. There is debate as to the arrival of such a point for addicts. 12 step programs are based on the idea that the individual in recovery is always at risk of relapse.
The addict may need to repeat the stages of change a number of times before they are able to achieve lasting recovery. Some will never make it past the contemplation stage because they do not believe that change is possible or worth the effort.
It can be helpful for those offering help to addicts to have a way to measure readiness to change. Different tools have been created to do this and one of them is the readiness ruler. This tool uses a scale from 0 to 10. If the client chooses 0 it means that they are not prepared to change while 10 means that they already changing. The therapist asks the client to rate their willingness to change a behavior. If they choose a number greater than 5 then they will be viewed as ready for change, given the right support and encouragement.
It can be difficult to promote readiness to change in those addicts who are still in the precontemplation stage. Any strategy for this will need to be focused on tackling denial and ignorance about the destructive behavior. This may be accomplished by encouraging self analysis and providing health education about the destructiveness of addiction. Those who have reached the contemplation stage of change can be helped by increasing self-efficacy. When the individual is convinced that they have the ability to change this will motivate them to make it happen.
The willingness to change behavior can be short lived. This readiness may occur after the addict has hit a rock bottom. Perhaps they have behaved particularly badly and now feel full of remorse. If this contemplation is not turned into action it will be easy for the individual to return to their previous denial of the problem.
Just because an addict is ready for change does not mean that they are necessarily ready for rehab. They may want to change their behavior without any outside help. This could involve an attempt at moderation or to abstain from substance abuse altogether. A lot of those people attempting to deal with addiction without help will fail. When this happens they may return to their previous behavior or become ready for rehab or other treatment option. Some individuals may succeed in their attempt at going it alone.
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