Contributor: Billie-Jo Stuto, LCSW, LCADC, CCS, Program Director, GenPsych PC
Let’s start off by asking have you ever tried to change any behavior and what that experience looks like? Have you ever told yourself that I’m not going to eat chocolate for a week or that I’m not going to bite my nails anymore or that I’m not going to get back together with so and so?
What was that process like? Please take a moment to reflect on all of the times we said that we were going to do more or less of something. The plan is to walk more, drink less, cut down on carbs, and leave the office on time. How easy are these changes?
ICR Ruler
From a motivational therapy perspective (motivationalinterviewing.org), we want to look at how important is this change, what is our confidence that we can be successful, and what is our readiness for this change. This is often referred to as the ICR ruler.
The importance to us can be impacted by internal and external factors. It can be influenced by our values, by our family ties, and spiritual beliefs. Our confidence indicates if we feel skilled or equipped enough to make that change happen.
Do we have all of the tools necessary to be successful with this change? Are we able to avoid people, places, and things?
Our readiness for the change is often the area that receives the most attention in addiction treatment. How ready are we for ______? The stages of change model provide a framework for readiness (Prochaska & DiClemente stages of change). In the first stage, precontemplation is when there is denial that a behavior change is needed at all.
The person would contend that I don’t have a problem in the first place. The problem is my spouse, employer, probation officer, etc. If they would get off my back, everything would be okay. The second stage is contemplation where we start to question that maybe our life could improve in some way by looking at the behavior. This is all about ambivalence, maybe I have a problem, and maybe I don’t.
Willingness & Accecptance
It starts to open the door to willingness and acceptance. The third stage is preparation where I’ve decided that I need to make the change and now I need to build my confidence that I can do this. This is where concrete interventions start to come in and moves more into skills based therapy.
The fourth stage is action which is about doing something different and no longer engaging in the behavior. I’ve completely stopped using. The fifth stage is maintenance which is an ongoing effort to change the behavior long term and not relapse. The last stage is relapse which can happen at any point in the process.
It is normal for people to move back and forth within the various stages. One day I can be in action, have a relapse, feel guilt and shame and move back into precontemplation. On the reverse, someone can be in contemplation, get arrested for a DUI and then move directly into action as a result. Recovery is not a linear process. It is a lifelong process.
Step Six
In step six of the recovery process, “We were entirely ready to have God remove all these defects of character”, the focus is on acceptance and change (Narcotics Anonymous). The concept of acceptance and change seem like polar opposites and both are necessary to move forward.
Validation and support are instrumental in providing a safe environment to make change possible. Hope, willingness, and belief foster trust in our own personal development. I once heard that we are in the business of change and when we stop believing that change is possible we need not be in the helping profession.
Community Discussion – Share your thoughts here!
Many people are slow to change, have you found this to be true of yourself? What makes the process of changing easier for you?
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions and co-occurring disorders. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals. We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on September 18, 2015. Published on AddictionHope.com