Stages of Change and the Process of Positive Change

People who seek treatment for alcohol and chemical use issues and other problematic behaviors enter therapy at different stages of readiness to change. In their research on behavior change, psychologists Prochaska and DiClemente identified five stages of change: pre-contemplation, contemplation, preparation, action and maintenance. The therapeutic process differs depending on the stage you find yourself in when you seek treatment.

Individuals in the precontemplation stage usually do not consider their behaviors as problematic and often pursue treatment due to external pressure from family and friends, as a result of relationship conflicts, problems with work, or legal issues.  If they feel they are being forced into treatment,  their emotional experience will likely color the therapeutic interaction. The feelings and thoughts associated with this experience will likely have to be processed in order to develop conditions of safety and trust and build a foundation of collaboration. In contemplation mode, a person is willing to consider that (s)he may have a problem but usually  feels ambivalent about change. Ambivalence is natural;  especially if the behaviors are associated with positive experiences. During this stage, we will work together to assist you to process the pros and cons of change and compare them to the pros and cons of continuing the behaviors that brought you into treatment. Furthermore we will look at the various meanings associated with the behaviors. According to Tatarsky, a leader in the field of harm reduction psychotherapy, behaviors contain multiple meanings that need to be understood and worked through as you embark on positive change.

During preparation, an individual acknowledges that the behaviors are problematic and  change is fundamental to improving health, well-being, quality of relationships, self-esteem and overall satisfaction in life and love. With this understanding, I will provide the support you need so you can begin to strategize and develop a change plan that may include reducing or ceasing problematic behaviors. Within the action stage, energy and effort will be invested in application of the plan. During this period, various challenges may emerge in accomplishing the identified objectives and goals. These challenges are accepted and invited for processing into the therapy where we can  explore them and  develop strategies to resolve them.

The fifth stage of change is maintenance, wherein you recognize that quality of life has improved through the changes that you made.  Here, I will work with you to ensure that the gains you have made are sustained and that you continue to grow.

I look forward to our collaboration on your journey to improve the quality of your life.



Considering a different treatment approach?

Are you interested in exploring a different approach to managing substance use issues but don't know where to look? Perhaps you are feeling discouraged due to ineffective experiences in the past? Have you experienced interventions which contributed to feelings of anger, guilt or shame?

Rest assured that you are not alone in having been exposed to unintended consequences at abstinence-only facilities and prescriptive therapies. In my experience, abstinence based approaches to substance use issues may not work for many factors.

While concerned about the negative consequences of substance use, many individuals are not ready to give up their relationship to their substance(s) of choice because they experience positive effects from this relationship. Individuals report accessing feelings of relaxation, self soothing, happiness, increased focus, ability to be socially engaged and engaging while others report a sense of wholeness, potency and confidence. Furthermore, the use may symbolize underlying conflicts that need to be understood and worked through. The complexity of these issues may require an approach that is tailored to your specifications and is open-ended, unlike time-limited interventions, in order to achieve maximum benefit. 

If this approach is indeed something that you are interested in learning more about, you may be ready for a substance use issues treatment (S.U.I.T.) tailored to your specifications.  S.U.I.T. begins with a sophisticated initial evaluation in the context of alliance building between us. At the end of the initial assessment, I will offer feedback and suggest treatment options tailored to your needs. Treatment recommendations will vary depending on your challenges, strengths, preferences and motivation to make positive changes in various domains of living. I am open to your suggestions and will work with you to develop a course of treatment that is a good fit for you and your lifestyle. As our work shifts or deepens, we will make alterations and consider enhancing care with other options to maximize your satisfaction in life and work.

I look forward to our collaboration. You may contact me at (917) 715-6357 or