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Stages of Change

Researchers have suggested that persons who use or abuse alcohol and other drugs (with or without brain injury) may be in one of five stages of change with respect to use.

  1. First is the Precontemplation stage, when the individual has no awareness of the problem.
  2. The second stage, Contemplation, is characterized by some awareness of a problem but ambivalence about the need to change.
  3. At the Preparation stage, the individual begins to make plans and gather support for a change, but stops short of setting a specific goal.
  4. Goals are set and changes made in the Action stage, incorporating the changed behavior into their lifestyle.
  5. After six months of successful action, a person enters the Maintenance stage, when changed behavior has become a part of the regular routine and the focus is on future goals rather than the change itself.

At any point in the process, relapse may occur, bringing a person back to an earlier stage of change.

The person recovering from brain injury must consider lifestyle changes that exclude substance use. This is not easy; with or without a brain injury, changing substance use behaviors can present a challenge.


This website has been funded with financial assistance from Grant #H133A120086 awarded by the U.S. Department of Education, National Institute on Disability Rehabilitation Research (NIDRR) to the Ohio Valley Center for Brain Injury Prevention and Rehabilitation for the current funding period of 10/01/2012 - 09/30/2017.