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The 5 Stages OF Behavioral Change

By Debbie McGauran

Behavioral change is not as straightforward as many people might imagine. Breaking free of your bad habits is not a question of waking up one day, having a light bulb go off in your head and presto you’ve dropped all your bad habits.  Research has discovered that there are five distinct steps to changing your behavior in order to achieve positive, lasting changes in your life.

According to the transtheoretical model, these stages are: precontemplation, contemplation, preparation for action, action, and maintenance. People may oscillate back and forth between the various steps for many months or years before achieving long lasting change in their behavior. This model is frequently used by experts when counselling clients with alcohol or drug addiction problems. Let’s explore these stages in more detail…


1. Precontemplation

In this stage individuals are not aware they have a problem and are actively engaging in risky behaviors such as excessive smoking, drinking, use of drugs, gambling or engaging in unsafe sexual practices. It’s important to keep in mind that people are engaging in these risky behaviors for a reason.

Whether a person is drinking to numb the grief of a broken marriage or snorting cocaine to get high and be accepted by their friends, these behaviors all have one thing in common. They work. In the short term these behaviors provide immediate relief from stress, can make you feel good, accepted and as though your life is problem free. In the long term, they can have devastating consequences, ruin lives and can prove fatal.

2. Contemplation

In this stage the thought may occur to an individual that they actually have a problem. Friends, relatives,or other community members may be commenting on their substance use or behavior. They may be arrested for driving under the influence or end up in the emergency department with an accidental recreational drug overdose.

A physician may point out that their abnormal blood work results are indicative of liver damage due to excessive alcohol consumption. Their behaviors are now resulting in unexpected consequences such as others taking notice, health problems or run-ins with the law.

3. Preparation for Action

In this stage the individual acknowledges and accepts the fact that their behavior is problematic and are considering what to do. Family and friends can provide assistance by encouraging the individual to seek professional help. Now is the time when the individual can benefit from information on treatment options including the names, phone numbers and contact information for treatment centers, their local AA chapter or mental health and addictions counselors.

When people with addictions problems attend the emergency department due to adverse health effects related to their addiction they are provided with pamphlets or phone numbers of treatment agencies. In order for change to be effective however, they must be the one, not hospital staff to make the phone call to the treatment agencies.

4. Action

In this stage the individual takes action. Action can take various forms including calling the treatment agency, attending AA , making a doctor’s appointment, going for counselling, or quitting cold turkey.  Alcoholics or drug addicts who suddenly stop using can develop a dangerous condition known as delirium tremens. Left untreated this can prove fatal. An alcoholic or drug addict may need to attend an in-house detox and/or treatment center for an extended period of time.

Treatment may also be forced upon an individual by the courts due to criminal behaviors stemming from their additions. It can be helpful for people to change certain elements in their environment to foster success. This may include disposing of all their cigarettes, drugs, alcohol, or even moving to a new neighborhood and cutting ties with their substance abusing friends. This is because misery loves company and people who are using will try to pull their recovering friends back down. At this stage individuals may not be fully prepared to commit. They may still be waffling back and forth. For example they may call addictions services but fail to follow through with appointments. For those who do follow through on all the necessary actions they move on to the final stage of change, maintenance.

5. Maintenance

During this stage an individual has successfully changed their behavior and is reaping the rewards. They may be engaged in regular AA meetings, counselling, or simply have stopped their counterproductive behaviors. However, if confronted by serious life stressors such as death of a loved one, divorce, or illness, they may be vulnerable to ‘falling off the wagon’ and ending up right back where they started from; at the precontemplation stage.

Some recovering alcoholics and drug addicts will find themselves moving through these stages multiple times before achieving long term success.  It is therefore helpful to know which stage an individual is in so that appropriate interventions can be enacted.

Debbie McGauran


Debbie has been a registered nurse for over 25 years with experience in geriatrics, medicine, surgery and mental health. For the past four years, she has practiced as a crisis nurse in the ER. Debbie lives on a farm with her family, two dogs, a cat, and four horses.

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