The use of alcohol and drugs can get out of hand unnoticed. If you intervene more quickly in the process of addiction and seek help, you can prevent many serious problems. It is important to gain insight into your own process of change. In most cases you must have reached the ‘bottom’. That means you have to lose everything. It sounds harsh and ruthless, but it is the harsh reality. When you start to experience problems, seek help because alone you cannot change your life. Every addict can stop for a day. Sometimes even longer. But long-term behavioral change is not possible on its own.

When are people with an addiction ready to change?

People are willing to change their behavior if:

• They see that there are disadvantages that they do not want
• they worry
• they see the benefits of change
• they believe that they are actually capable of doing things differently
• they know how to do things differently
• they feel that the moment is right for change, that they are ready for it
• they face what is at stake

Personal process for addiction or problematic substance use

But someone also meets the above criteria, it remains a personal process. Addiction is destructive behavior that ‘numbs’ the deepest primal instinct of survival in a human being. The pros and cons of drinking, the degree of confidence, being able to change and being able to expect support from those around you are different for everyone. In addition, everyone makes their own decisions. What may be an important reason for one person to reduce use, may not be an important reason for another. Circumstances can also change and thus the assessment of what is important or feasible. Making the decision to use less is a complicated process and takes time.

Different phases during an addiction

It can help if you can imagine life without or with less. The people around you can help you in this process of awareness by indicating how they see your use and what it means to them. They can also indicate what kind of help they want and can offer when cutting back or stopping. People are afraid to change because they don’t know what to expect if they stop or moderate their use. A change process can be viewed in several ways. One of the methods that has been used in addiction care practice over the last fifteen years is based on the principle that change is a process with different phases:Preliminary stage You have no idea that anything is wrong, let alone that something needs to change . You are a carefree drinker. Not experiencing any problems.Consideration and awareness You experience that your use has a downside and you sometimes worry about it. You are considering doing it differently but are still unsure. You put your behavior into perspective and see in your environment that others are worse off than you. You stop for a few days, feel better and start using again.Decision and preparation You have looked at your choices and what you have changed about them. You are now ready to make a decision to change. Making a decision is easier if you make good preparation. Some try to do this on their own , but that is doomed to failure. With all change you need someone to guide you through the process, a good counselor or coach.Implementation You are now changing your usage. You notice that it is not easy to maintain the change and encounter all kinds of obstacles. It is important to address these obstacles and not avoid them. You also tackle these obstacles with your coach.Persistence (consolidation) Starting to change is often successful, but persevering is difficult. There are many difficult moments and relapse is lurking. In the change process, perseverance is the toughest ‘job’. Persistence is also called ‘consolidation’, which actually means: ‘making the change sustainable’. But the longer this abstinence process lasts, the more habitual it becomes. The difficult periods that initially occurred shortly after each other are becoming more and more frequent and longer.Relapse Falling back into the old habit and starting to use again. However, there is a difference between relapse and ‘slip’. A relapse is a phase in which you return to your old behavior and use. A slip is a phase in which you have made a mistake but then take your recovery seriously again. It is very important to also explain this distinction to clients.

Model by Prochaska and DiClemente

Prochaska and DiClemente were the first to write extensively about these phases of the change process in 1984. They saw that it often happened this way in people who were dependent on nicotine. Practice has shown over the years that change goes through the same process for all substance use. It also turned out that the change process continues: you can decide to change again and again, other considerations can play a role in the change and you can apply new skills. Prochaska and DiClemente preferred to see their model depicted as a circle.

Criticism of the behavior change model

However, there is also criticism of the model because, among other things, it gives the impression that the different stages are clearly defined and that every person goes through the stages in the same order. The model also assumes that people always change their behavior in a planned manner. While it is known that this is not always the case.

Power of simplicity

For the practitioner and client, the power of the model lies precisely in the simplification of the change process. The model visualizes the phases a person is in and it helps to look at the obstacles that clients will encounter.

Tips

By using the model, the practitioner can respond better to this and provide tips.Below are a few tips per stage:Preliminary stage You hardly worry about your use. You are a carefree user. You sometimes have vague complaints.Tip: Check whether there is a connection between the complaints and the days on which you use.Consideration and awareness You experience that your use has a downside and you sometimes worry about it. You are considering doing it differently but are still unsure.Tip: Consider what you would gain from changing your user pattern and also what you would miss. Compare this to the pros and cons of your use.Decision and preparation You have looked at your choices and what you have changed about them. You are now ready to make a decision to change.Tip: It is important to make a good action plan: what and how to change and when to start.Implementation You are now changing your usage. You notice that it is not easy to maintain the change and you encounter all kinds of obstacles.Tip: in this phase it can help to take small steps and overcome the obstacles one by one. Reward yourself when you succeed and don’t give up if things go wrong. Using it once again does not mean you are back to square one. Change is a process of trial and error. Stick to your decision and continue to change. Find out if there are people who want to help you and tell them what they can do for you.Persistence Starting to change is often successful, but persevering is difficult. There are many difficult moments and relapse is lurking.Tip: you can help yourself by identifying difficult situations and preparing for them as best as possible.Relapse Falling back into the old habit and starting to use again. Many people become disappointed in themselves when they fail to stick to their decision and are tempted to give up altogether. They fall back into their old habit and start using again.Tip: Changing your usage requires several attempts. It is not the case that everything is lost after a relapse. You can learn from it. The next time you are in the same situation you will recognize this and you will know what you can do to avoid slipping. Consider resuming your resolution.