AddictтАЩs Cycle of Change
By Simon Mott and Henk Nagel
The topic at a glance
- What is the addictтАЩs cycle of change?
- What usually stands between you and change.
- How to set goals and reach them.
Like other chronic diseases, addiction often involves cycles of relapse and remission.
тАУ┬аASAM (American Society of Addiction Medicine)
The cycle of change is a model that was invented by тАЬProchaska and DiClementiтАЭ who were two psychologists looking to invent a road-map for people to help them overcome changing habits and addiction. It was initially created to help those who wanted to give up smoking, but since its invention, it has become a very useful tool in helping people in all addictions known as┬аthe Addicts Cycle of Change.

The 5 stages of the addictтАЩs Cycle of Change
The AddictтАЩs Cycle of Change is based on the idea that changing the behaviour of people in active addiction does not happen with one step only. It has been shown that people go through a process which involves different stages. The different stages are:
- Pre-contemplation or Step O
People in the pre-contemplation stage arenтАЩt yet thinking about addicts cycle of change. They are perhaps already seeing negative consequences of their using, however, are still in denial and feel that their addiction is not a big enough problem to initiate change. People at this stage tend to be defensive when challenged about their problem.
- Contemplation or Step 1
When people reach the contemplation stage, they are at the point where they can see the negative consequences of their addictive behaviour and are thinking about change, however, tend to be ambivalent about it. People in this stage are more open to suggestions and advice from others and may go back and forth weighing up the pros against the cons. This stage can last for a long time as they are not quite at the action stage yet. Sadly people can waste many years in active addiction by becoming stuck at this level.
- Preparation or Step 2
The preparation stage begins with a decision to change and steps taken to make this happen. For our clients, this is the stage in which they [cp_modal id=тАЭcp_id_2a3fbтАЭ]contact Hope[/cp_modal] and make plans to come and get help, away from the stresses of everyday life in a safe environment. Triggers are constant reminders of addiction or addictive behaviour which result in large cravings and make it difficult to fight going back. It is much harder to overcome these alone without the support of professionals and peers which is a big reason many choose to come to Hope.
- Action or Step 3
This is the stage when the action happens! For our clients, this is the time when they arrive at Hope and┬аstart the program. The early days of action are so important as although this can be a new and unfamiliar time, it is also a very exciting period in oneтАЩs recovery. The program we offer our clients is designed to help them through the action stage and set them up with a solid recovery for when they leave treatment and go back to their homes.
- Maintenance/ Recovery or Step 4
The maintenance stage helps people continue with the progress made already. It involves staying abstinent from drugs and alcohol and following the tools learnt while in treatment. Part of what we offer here at Hope is a chance to start working a 12 Step program. Our clients attend three AA/NA (Alcoholics Anonymous/ Narcotics Anonymous) meetings each week and by continuing this as well as the CBT work once leaving treatment brings an opportunity for a full and happy life in recovery. We also offer our clients the opportunity to go and spend some time in a nearby Sober House to help with the transition from primary treatment.
The tools that we provide our clients with at Hope means that there is a good chance of the addict leaving treatment and having a free, happy and healthy life in recovery. The alternative to this in the cycle of change is relapse, in turn starting the cycle again.
Change is the solution
Change тАУ most human beings are familiar with the concept of change, and resistance to change. Humans are prone to remain in their comfort zone, the familiar no matter how uncomfortable it appears.
Most people have a desire to change certain negative and/or self-defeating habits but find themselves having a lot of difficulties with the implementation of the desired change. People usually only change when survival is at stake.┬аThere is a lot to say about change, so I will focus on the aspects of our past that we want to change in this article, and explore some of the solutions such as goal setting.
What usually stands between you and the change
The definition of change is тАШto make or become differentтАЩ. In my explanation, I would say that change means replacing one habit for another or replacing one thought for another. In our treatment, we challenge behavioural aspects to replace a negative habit for a positive one, and we use Cognitive Behavioral Therapy to help clients replacing negative and unhelpful thinking patterns for a more positive, performance-enhancing thinking pattern.
There are many causes that make change difficult. Some of the main ones are: the personтАЩs┬аcomfort zone,┬аcore beliefs┬аabout ourselves and the world around us, our┬аpast experiences, low or┬аinsufficient levels of desire┬аand┬аmotivation,┬аfears for the unknown┬аetc.
Addicts in particular are likely to develop automatic negative responses
тАЬWe are a product of our pastтАЭ or so is a saying you might be familiar with. Humans develop automatic responses to everything that happens around us, and we do that because it helps us to deal with the complexity of the world. Some studies say that 80% of what humans do is unconscious and automatic. If you drop a pencil, you just pick it up. You donтАЩt think about what just happened, what the consequences are, what to do now etc. You probably just pick it up without giving it any thought.
This is because you have learned in your life that when a pencil falls out of your hand, you just pick it up and further nothing happens. This is an easy example, but the concept of automatic responses is a big part of how we live our lives. People in general тАУ but addicts in particular тАУ are likely to develop automatic negative responses to the world around us. Examples are anger, self-pity, feeling like a victim, blaming others, and many more. In some cases, anger can be a healthy response, but when it becomes a habit and surfaces regularly, it will become a negative way of responding.
How to set goals and reach them
Ambivalence means тАШthe state of having mixed feelings or contradictory ideas about something or someoneтАЩ. An example can be that you want to quit drinking alcohol because it causes a lot of problems in your life, but you enjoy getting drunk and are afraid of living life without drinking. Ambivalence makes change extremely difficult because you wonтАЩt be fully committed to making the change you would like to make and are likely to тАШbuild a caseтАЩ to justify falling back into old behaviour. If you are unsure about making the change, it means you are still contemplating and not ready for action yet.
Before you start making a big change, it is very helpful to set a clear goal to give yourself direction and something to work towards. After having the main goal set you can now start identifying all the little steps you need to make to achieve the main goal. You formulate all the little steps into little goals. Make sure all the goals youтАЩre setting are┬аSpecific,┬аMeasurable,┬аAcceptable,┬аRealistic┬аand┬аTime-bound┬а(SMART).
Change is the solution тАУ using the Transtheoretical Model
Goal setting is a very helpful tool that helps people with their changes because humans function in general much better if they have a clear direction about where to go and what to work for. Accomplishing goals is very satisfying as you will probably now.
Change is the solution: Using the┬аTranstheoretical model┬аor so called addictтАЩs cycle of change stages (as described above).┬аTermination stage describes the point at which no conscious effort is needed to maintain the change, itтАЩs now become second nature. Unfortunately, this stage does not apply to the chronic disease of addiction as┬аrecovery maintenance is always necessary to stay safe.
How change can happen: Hands-on examples
Ultimate goal: Achieve abstinence and get my life on track
- Goal one┬атАУ Precontemplation тАУ get feedback on what to change
- Goal two┬атАУ Contemplation тАУ select the priorities to change
- Goal three┬атАУ Preparation тАУ plan how best to change
- Goal four┬атАУ Action тАУ start the process of change
- Goal five┬атАУ Maintenance тАУ work out how to keep up the gains
- Goal six┬атАУ Termination тАУ decide whether to start new changes
SMART goals┬аor goal setting criteria is another model that can be used to achieve change
- Specific┬атАУ target something you want to change.
- Measurable┬атАУ accountability or document the change.
- Assignable┬атАУ how and when.
- Realistic┬атАУ for your life.
- Time-related┬атАУ set a time limit so you have a target.
At Hope, the common goal usually includes the following for rehab admission (e.g. because I canтАЩt stop by myself, I tried it already many times, so I need help).
- I will comply with a treatment program.
- I will be honest, open-minded and willing to follow the program.
- I will do whatever it takes to learn how to live clean and sober.
- After rehab I will do everything I have learned in rehab when I leave.
- I will use the support groups.
- I will do my ABCтАЩs every time I feel upset.
- I will get a sponsor.
- I will do my step work.
- I will do my meditation.
- I will do my physical exercise.
Using this change technique, goal setting and sticking to them, anyone can address addiction issues. I have changed many own self-defeating behaviours using goal setting, and I have helped many people do the same and change their lives.
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