Prochaska and DiClemente’s Six Stages of Change in Addiction Recovery

Recovery from addiction is long and tedious. The individuals working through their substance abuse disorders experience a number of changes both during and after treatment. Most of the time, these changes reflect a pattern that has since become a model for the addiction recovery process. This is called the Transtheoretical Model, or the Six Stages of Change.


An Overview of the Transtheoretical Model
(A.K.A. The Six Stages of Change)

James O. Prochaska, Ph.D. and Carlo DiClemente, Ph.D. originally developed and published The Transtheoretical Model (the Six Stages of Change). This biopsychosocial model offers a unique insight into the process of purposeful behavior adjustments and reformation of poor habits, like substance abuse, for example. Rather than focusing only on specific aspects of change, the Six Stages focus more on the big picture. In fact, the Six Stages model of behavioral change:

  • Incorporates information gathered from over 35 years of scientific research and observational studies
  • Utilizes the results of research that had a budget of over $80 million in grants
  • Was constructed after the co-developers examined the results for over 150,000 research participants
  • Is used by behavioral science professionals all over the world

Aside from addiction recovery, the Six Stages also apply to a variety of other perceivably negative behaviors. The flexibility of this theory’s application is what gave it its name: transtheoretical. Still, most professionals use this model to examine cases of substance abuse and recovery. In William Morrow’s Changing for Good, Prochaska and DiClemente break down their model into the six titular stages. In order, these stages are pre-contemplation, contemplation, preparation, action, maintenance, and termination.

The six stages of change


Stage One: Pre-Contemplation

During the first stage, addicts will typically make excuses, or deny their addictions entirely. Those who get stuck in this stage may be fully aware that their addiction is a problem. Still, they may also try to justify their choices to continue reaping the “benefits” (i.e., the desired effect) of their drugs of choice. The transition into the next stage of change usually occurs when addicts begin to feel shame, embarrassment, or guilt.


Stage Two: Contemplation

The second stage of change begins when addicts recognize the problem. However, people at this stage don’t take action quite yet. Instead, they weigh their options about how to address their substance abuse, or whether or not they should. Most addicts don’t have the full commitment to change at this stage, but at the very least, they may start researching addiction treatment options for themselves.


Stage Three: Preparation

The third stage marks the actual initiation of change. This is the stage where addicts truly begin to show commitment to getting sober. Most people in this stage will make the decision to quit drugs, stop drinking, and get professional help. As the name of this stage suggests, people looking to conquer addiction take the time to prepare for treatment and plan their next move. Then they take action.


Stage Four: Action

The fourth of the Six Stages of Change marks the beginning of specific adjustments to a person’s lifestyle during ongoing addiction treatment. This stage encompasses the bulk of the addiction recovery process and lasts up to six months. During stage four, those affected by addiction will receive treatment, which may include but is not limited to:

Stage four is over when those in treatment achieve initial sobriety. Once that happens, the people in addiction recovery move on to stage five: maintenance.


Stage Five: Maintenance

The maintenance stage happens immediately after initial treatment has ended. Usually, people at this stage of addiction recovery will stay committed to their newly achieved sobriety by receiving encouragement and support from others at home and during meetings. Additionally, those in recovery may choose to continue their progress in outpatient treatment or additional counseling outside of group meetings.

Typically, the maintenance stage lasts anywhere from six months to five years, although support should continue beyond that. It all depends on the individual, the treatment plan, and the new routine. In any case, people that have reached this point of the Six Stages of Change in addiction recovery are motivated to stay sober, and they now have all the tools to make that possible. After about five years of continued abstinence, the chances of relapsing diminish to practically none.


Stage Six: Termination

The sixth and final stage of Prochaska’s and DiClemente’s model marks the ultimate goal for anyone in addiction recovery: termination. When people in recovery reach this stage, they no longer feel threatened by their substance use disorder. They still have to be mindful of triggers, of course, but all in all, the urge to use has vanished completely. Life at this point in recovery is happy and addiction-free. From this stage forward, people in recovery continue to practice maintenance of their sobriety and new, healthy habits with little to no chance of relapse.

Relapse chances decrease with time

Relapse During the Six Stages of Change

While the model seems straightforward in its layout of the addiction recovery process, it’s important to keep in mind that relapse is still possible at any point during the Six Stages of Change. Relapse is a common occurrence in addiction recovery, but this does not negate the progress of those who are sober or working to get sober.

The people who do relapse during addiction recovery can bounce back by returning to treatment, learning from the experience, and moving on. Remember, addiction is a chronic disease. And just like any other chronic disease, the risk of relapse will always be there. Still, the chances of relapse will continue to decrease with diligence and continued abstinence.


The Treatment Center by The Recovery Village Can Aid in the Six Stages of Change in Addiction Recovery

Everyone experiences the Six Stages of Change differently, which is why individualized care is necessary for the addiction recovery process. At The Treatment Center by The Recovery Village, all of our patients receive treatment plans and services that fit their individual needs. If you have an addiction and would like more information about the programs we offer, please call us at (855) 899-5065. All calls are confidential.

For more information on The Cycle of Addiction.