Motivational Interviewing: Stages of Change
Motivational interviewing (MI) is a therapeutic technique developed specifically to reduce or eliminate patients’ ambivalence toward change. Since the initial conception of the technique, several refinements have been made to the approach.
This page will explore the theoretical model of change outlined in the modern concept of motivational interviewing.
The Transtheoretical Model of Change
Many times, individuals who enter treatment for substance use issues do not readily accept that their behavior needs to change. These individuals are often forced into treatment by family, their occupation, the legal system, etc. The need to help patients shed their apathy toward making a necessary change in their lives is the core aim of motivational interviewing.
Patients who demonstrated behavioral issues sufficient to qualify for a diagnosis of a substance use disorder, but who did not see the need for substance use treatment, must be approached differently than individuals who understand the need to quit using drugs or alcohol.
Thus, the initial task of the therapist is to identify where the client stands on their willingness to accept their need for change and their understanding of their issues. Once the person’s starting point is identified, it becomes a matter of adjusting treatment to fit the needs and understanding of the client.
According to the transtheoretical model of change outlined in MI, patients may begin and progress through 6 stages of change.
The 6 Stages of Change
According to the model, the stages of change are:
- Stage 1: The earliest stage an individual might fall into is the Precontemplation Stage. In this stage, the person may be experiencing some negative issues associated with their substance use; however, they do not perceive these issues as potentially serious enough to motivate them to consider changing their behavior. In this stage, the client has little or no motivation to change their behavior as they do not view themselves as having a problem.
- Stage 2: This stage is termed the Contemplation Stage. In the second stage, the individual may realize that their behavior is problematic, but they are ambivalent about making any changes. The person may want to change and may even have considered changing their behavior (e.g., quitting drinking, cutting down on their drinking, etc.) but has not invested any effort into changing their behavior.
- Stage 3: In the Preparation Stage, the individual has committed to changing their behavior and accepted responsibility for doing so. Most individuals in this stage weigh the positive versus negative ramifications of their behavior and have concluded that the negative aspects outweigh any benefits they perceive it brings them. Some individuals may have attempted to develop a plan for change, but in this stage, they have not taken any formal action.
- Stage 4: In the Action Stage, the person is actively involved in changing their behavior. Any active effort to change behavior would be enough to categorize them as being in this stage. Most individuals in this stage understand that they are responsible for changing their behavior, and they often require some form of outside assistance to help them reach their goals.
- Stage 5: This stage is referred to as the Maintenance Stage. In this stage, the individual has developed some aspect of efficiency that has allowed them to change their behavior. They may still be working on change, but they have become proficient enough to change their behavior. As a general rule, individuals must have made changes that have been in place for a minimum of six months to qualify for this stage.
- Stage 6: In the Termination Stage, the person has made all of the changes that are necessary for them to face new issues and continue productively. Even though the title of this stage implies the process is over, many individuals do not terminate their participation in their program of change; many people in treatment for substance use disorders continue to participate in social support groups such as 12-Step groups for many years after they have been sober or abstinent. In this stage, the person has been able to make positive changes, overcome their issues, maintain new habits, and continue to improve.
Individuals may enter treatment at any of the stages listed above; some progress in a linear fashion, while others may regress to previous stages due to setbacks such as a relapse.
Setbacks do not mean treatment cannot be successful, just that it may need to be restarted or adjusted. Recovery from substance use disorder is rarely linear, and many people experience relapses before achieving long-term sobriety.
Addiction Treatment in South Florida
If you or a loved one is struggling with addiction, motivational interviewing and other forms of treatment (e.g., cognitive behavioral therapy, dialectical behavior therapy, family therapy, medications for substance use disorder, peer support) can help.
Recovery First, American Addiction Centers’ Florida rehab facility near Ft. Lauderdale provides various levels of addiction treatment, including:
- Medical detox.
- Residential treatment.
- Partial hospitalization program (PHP).
- Intensive outpatient program (IOP).
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