Understanding the Stages of Change Model
and Resulting Clinical Applications
that Aim to Intrinsically Motivate Change
in the Substance User
Embracing the Process: Understanding the Stages of Change Model and Resulting Clinical Applications that Aim to Intrinsically Motivate Change in the Substance User
With a career in the drug and alcohol recovery profession, it is a realistic probability that a counselor will have a particularly diversified clientele population, consisting of individual clients, whom each have their own unique set of needs. Nevertheless, it is a reasonable expectation, as well as an ethical obligation, that recovery counselors have the capacity to handle this diverse caseload. It is common for a counselor to be working with several clients, all of whom may be at various stages of the change process, and doing so concurrently. A recovery counselor should always strive to implement the most advantageous interventions necessary to meet the unique treatment needs of each client. Therefore, it is not only helpful to be familiar with the stages of change and how they are applicable to substance abuse treatment, it is imperative for every recovery counselor to have a comprehensive understanding of the Stages of Change model and its relevant clinical applications and interventions.
Generally speaking, it is not uncommon for helping professionals in the addiction recovery field to become frustrated with their work, feel overburdened, and even “burn out”. This is partly due to a lack of understanding of the stages of change model and its implications. As a recovery counselor, our major role is to assist clients in understanding their substance abuse and to help them make the changes necessary for recovery. It is important to recognize that there is no “cure” for addiction, recovery is a process, and that even when it seems as if intervention with a client was in vain, the process of change is occurring. Connors, Donovan, & DiClemente (2001) took notice of a common practice in the helping profession; counselors would invest time and energy in promoting change, only to label clients who failed as "noncompliant" or "unmotivated." Nonetheless, their research has shown that labeling an individual in this way places responsibility for failure on the individual’s character and completely ignores the complexity of the behavior change process. When attributing the cause of relapse to negative character qualities in the individual, we negate the understanding of addiction as a disease, and actually promote the irrational belief system that addiction is a moral problem, though this theory has been empirically discredited. Research continues to support the hypothesis that behavior change is rarely a discrete, single event, but is better understood as a process of identifiable stages through which individuals pass (Connors et al., 2001). Prochaska, DiClemente, & Norcross (1992) originally began their research of the change process by using various methods to empirically study the ways people quit smoking. The Stages of Change Model was a direct result of this research and its theoretical constructs have been validated by numerous subsequent studies. Consequently, the Stages of Change Model has demonstrated applicability to a variety of behaviors, including substance abuse treatment, smoking cessation, exercise behavior, dietary behavior, and contraceptive use. Motivational Enhancement Therapy (MET) recognizes the perspective and concepts that the Stages of Change model presents as a critical component in understanding change. MET is a systematic intervention approach, originally implemented for evoking change in individuals whose drinking was considered problematic, and is designed to produce rapid internally motivated change (Miller, Zweben, DiClemente & Rychtarak, 1994). Motivational Enhancement Therapy was first studied with clients during the National...