Content reviewed by Karen Rubenstein, LMFT, Chief Clinical Officer at Cliffside Malibu

The first stage of change in the transtheoretical model is precontemplation. During this stage, individuals struggling with a substance use disorder may not view substance use as a problem or may not be ready for a change. People can remain in this stage for years due to the chronic nature of addiction. Treatment can help to foster change. Therapeutic approaches, such as motivational interviewing, can help individuals to increase their awareness and be more conscious of the consequences of substance use. It is essential to remember patience and to provide encouragement to anyone struggling with addiction and to help them move beyond the precontemplation stage.

Pre-Contemplation Stage of Change: What It Looks Like in Addiction Recovery

Change is an inevitable part of growth. Still, committing to change, even when it’s for the better, can be challenging. This is especially evident for those who struggle with repeated patterns of substance use.

Many things can motivate an individual to make changes in their life. However, people who struggle with addiction may experience significant internal battles when they consider changing their behavior. These internal battles are no fault of moral weakness; rather, they are a result of chronic substance use.

It may help to understand that change of any kind rarely happens overnight. Change is a gradual process that involves several stages. To better understand how change occurs in steps, researchers created the transtheoretical model (TTM), also known as the stages of change.

What are the five steps of the stages of change?

The five steps in these stages are:

  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance

It is important to understand each of these stages and how they correlate with addiction recovery. Here, we will break down the first stage, pre-contemplation. Then, we will discuss how individuals can shift from this stage into the next.

What is pre-contemplation in the stages of change?

Whereas contemplation is defined as deep reflective thought, pre-contemplation occurs before any conscious thought is placed on problematic behavior. In Chapter 4 of the book Enhancing Motivation for Change in Substance Use Disorder Treatment by the Substance Abuse and Mental Health Services Administration (SAMHSA), pre-contemplation is introduced with the following quote:

“The task for individuals in Precontemplation is to become conscious of and concerned about the current pattern of behavior and/or interested in a new behavior. From a change perspective, it is more important to recognize an individual’s current views on change and address her or his reasons for not wanting to change than it is to understand how the status quo came to be.”

During the pre-contemplation, those with substance use disorder (SUD) either don’t view their substance use as a problem or are aware but are not yet ready to change their behavior. It is normal for individuals to remain in the pre-contemplation stage for years. Some rarely ever consider moving to the next stage of change.

Why do people often remain “stuck” in the pre-contemplation stage of addiction recovery?

Many people who do not struggle with substance use wonder why those who do struggle to find the motivation to change. This can be especially frustrating for family members and friends who have felt the consequences of their loved one’s addiction. Addiction is a chronic disease that interferes with the way an individual behaves as well as how they think and feel.

Although an individual’s initial decision to use alcohol or drugs may be voluntary, substance use can quickly override brain structure and functioning. Important neurotransmitters, such as dopamine and serotonin, become hijacked. This causes the brain to believe that substance use will produce the utmost feelings of pleasure. In other words, their brain adapts to the drug’s effects and eventually becomes dependent on them to function normally. Consequently, all individuals who use substances, even in moderation, are at risk of developing an addiction.

People rarely make a conscious choice to stay in the pre-contemplation stage. Rather, their brains just get caught up in the seemingly pleasurable effects that result from substance use. Fortunately, there are ways that individuals can help themselves or loved ones move beyond this stage. This is done by increasing their motivation to change.

How do you move from pre-contemplation to contemplation in addiction recovery?

For an individual to move from pre-contemplation to contemplation, they must be willing to engage in self-reflection. They must address the consequences of their substance use without making excuses for it. Additionally, they must shift their perspective on their behavior to understand that they are causing themselves more pain by continuing to use substances.

For those with a loved one stuck in the pre-contemplation stage, there are ways to help them. First, be patient. As mentioned earlier, change rarely happens overnight. Loved ones must show encouragement to the individual struggling and help them evaluate the consequences of their behavior. More than anything, help the individual understand they are ultimately responsible for changing their behavior when they believe they are called to do so. No one else can do it for them.

Can addiction treatment foster the motivation to change?

Oftentimes, treatment can play a key role in fostering one’s motivation to change. There are a range of different therapeutic treatment approaches that facilities may use to help patients if and when they are ready to accept support.

For example, approaches like motivational interviewing (MI) can help individuals increase their awareness of the consequences and health risks of continuing their substance use patterns. The goal of MI is to help patients to overcome their tendency to be defensive about their behavior. Instead, they can center the conversation on resolving concerns.

Many additional approaches and treatment opportunities are available to help those with SUD move out of the pre-contemplation stage. Treatment is not meant to be a chore but an opportunity to change one’s life for the better.

Cliffside Malibu is an addiction treatment facility that understands how challenging it can be for individuals to find the motivation to change their substance-using behaviors. Addiction is a chronic and relapsing disease that requires professional treatment. To learn more, give us a call today at (855) 403-5641.