Addict's Cycle of Change and how to set goals and reach them

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Addict’s Cycle of Change

By Simon Mott and Henk Nagel

The topic at a glance

Like other chronic diseases, addiction often involves cycles of relapse and remission.

– ASAM (American Society of Addiction Medicine)

The cycle of change is a model that was invented by “Prochaska and DiClementi” 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 the Addicts Cycle of Change.

The 5 stages of the addict’s Cycle of Change

The Addict’s 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:

People in the pre-contemplation stage aren’t 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.

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.

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=”cp_id_2a3fb”]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.

This is the stage when the action happens! For our clients, this is the time when they arrive at Hope and start 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 one’s 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.

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 – 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. There 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 ‘to make or become different’. 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 person’s comfort zone, core beliefs about ourselves and the world around us, our past experiences, low or insufficient levels of desire and motivation, fears for the unknown etc.

Addicts in particular are likely to develop automatic negative responses

“We are a product of our past” 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 don’t 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 – but addicts in particular – 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 ‘the state of having mixed feelings or contradictory ideas about something or someone’. 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 won’t be fully committed to making the change you would like to make and are likely to ‘build a case’ 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 you’re setting are Specific, Measurable, Acceptable, Realistic and Time-bound (SMART).

Change is the solution – 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 Transtheoretical model or so called addict’s cycle of change stages (as described above). Termination stage describes the point at which no conscious effort is needed to maintain the change, it’s now become second nature. Unfortunately, this stage does not apply to the chronic disease of addiction as recovery maintenance is always necessary to stay safe.

How change can happen: Hands-on examples

Ultimate goal: Achieve abstinence and get my life on track

SMART goals or goal setting criteria is another model that can be used to achieve change

At Hope, the common goal usually includes the following for rehab admission (e.g. because I can’t stop by myself, I tried it already many times, so I need help).

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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