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Stages of Change

Treatment Resistance: Stages of Change

Most people who agree to enter treatment at a residential substance abuse treatment facility only do so under coercion. They say that they accept the need for treatment, but what they really mean is they don’t want to go to jail. In some cases, going into treatment is the alternative to losing a job or ruining a marriage.

Going into treatment is a choice, after all. Any therapist can tell you that he has had potential clients stand before him and say that they don’t want to enter treatment and they would rather finish their time in lockup. So if you’ve agreed to at least begin treatment and follow the rules of the treatment program, you have already made one positive decision.

As you begin your sixty, ninety, or however many days in residential treatment, you will be identified as precontemplative. It’s a term used by substance abuse treatment counselors that refers to your refusal or inability to recognize that change is necessary. Necessary for whom, you might ask: The answer would be that change is necessary if you want to avoid jail, keep your job, save your marriage, preserve your health, or otherwise protect yourself from the bad things that happen to people who abuse substances.

Treatment counselors no longer preach at you about the reasons why you need to change. They utilize a new treatment approach known as motivational interviewing. Their interviews with you are engaged to help you explore the things that happen connected with substance abuse that have a negative impact on your life. Your counselor asks you open-ended questions, which mean you have to provide an answer beyond yes or no. For example, instead of asking “Don’t you wish things were different,” he might ask, “how would you like things to be different.”

There are additional techniques utilized by counselors throughout your sessions designed to help you communicate effectively and put you at the helm of your treatment plan. After all, you will have no motivation to make changes if you can’t recognize the need for them.

As you enter the next stage, called contemplation, you are probably recognizing the need but you still feel very ambivalent about making changes. The changes go beyond stopping your use of drugs or alcohol. They will be changes with the people and things in your life that affect you each and every day. All of these things are important in order to change your life and begin anew.

Preparation begins when you finally start to think about the things you can do to bring about change. You see that a change is needed, and you come up with ideas on the steps you should take. The action phase of your treatment takes place when you start to put your ideas to work. Maintenance means you have learned how to identify triggers and come up with a plan for resisting or avoiding them. You are now in the process of developing a healthy new lifestyle. Relapse, as scary as it sounds, is also a stage of treatment. You’ll find more information about recovery from relapse on this website.

Relapse is not the only scary stage of treatment acceptance—all of them are scary! The counselors who work in a residential substance abuse treatment facility understand what a struggle it is for the addict to admit the need for change. Many of them are in recovery or they have loved ones in recovery, and so they know what you’re going through.

So you embark now on a journey to determine whether change is crucial in your life. Will you accept the need for treatment? Will you resist it and go to jail, divorce court, the unemployment line, or even to an early grave? It’s all up to you. But people are there to help you, if you just make the first phone call. 

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