There is a commonly used model for the process of change that incorporates several stages:

• Pre-Contemplation
• Contemplation
• Determination
• Action
• Maintenance
• Relapse

Below is a diagram that illustrates the transtheoretical model of change.

Do I Need to Change?

Many people come to counseling unsure of what needs changing, unsure of how to go about making changes, and often focused on the need for others to change.  Any of these beliefs can be good starting points for discussion because nobody comes to counseling because everything is going smoothly.

The Pre-Contemplation and Contemplation stages are fueled by the denial of the problem in one form or another.  Oftentimes blame is misplaced onto someone or something else.  Sometimes we convince ourselves that “It’s not that bad.”  It is human nature to justify and rationalize our behavior.  Getting past these forms of denial allows us to begin to accept responsibility for our behavior and move to the Determination stage.

What is Cognitive Restructuring?

What has begun to happen is sometimes called “cognitive restructuring.”  I prefer the term, “re-wiring the brain.”  In order to accept the fact that re-wiring is needed, we must understand that substance abuse has produced its own rewiring.  As substance use has progressed it has produced changes in our friends, our values, our priorities, our spiritual beliefs, and our ability to experience pleasure. 

The AA Big Book says that this movement from Determination to Action requires a leap of faith.  The Bible says that we must be transformed by the renewing of our mind.  It certainly will require us to prioritize our recovery over our job, our family, and our interests because to not do so is to eventually lose our job, our family, and every meaningful thing.

Next Steps to Change

The Action required begins with not drinking or using.  It also requires the development of social connectedness because addiction is a disease of isolation – 12-Step meetings are a good way to meet other people in recovery.  It requires the changing of cultural and habitual influences and also the development of new interests in order to have fun in sobriety.  As with all change or growth, sometimes it is 3 steps forward and 2 steps back.  It takes practice, practice, practice.  The good news is that it only needs to be done one day at a time.