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Stages of Change

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For persons recovering from traumatic brain injury, the use of alcohol and other drugs can slow recovery and interfere with their ability to work and maintain family and social relationships. That means community professionals, like health care workers and those in human service agencies or vocational rehabilitation, may be called on to help persons change addictive behaviors in substance use or other life areas.

One theory of change successfully applied to addictions is the Stages of Change Theory by Prochaska, DiClemente and others. This theory, when combined with insights from Motivational Interviewing, can be used by community professionals to facilitate the change process for persons recovering from injury.

The Five Stages of Change


In this stage, people are essentially unaware that a problem exists and, as a result, have no intention of changing their behavior in the foreseeable future. However, persons close to them may be aware of the existence of a problem. If a precontemplative individual is in treatment, it is normally only as a result of coercion by someone in their environment (e.g. spousal insistence, employer requirement, or legal mandate).


People in this stage are becoming aware that a problem exists; they may be considering behavior change but have not made a commitment, such as setting a goal. These individuals often are weighing the pros and cons of the addictive behavior, and may be either over-estimating the pros or under-estimating the cons.


In this stage, people have the intention to change but have no established a specific goal. In the Preparation stage, people often reduce an addictive behavior, but not enough to have a qualitative effect on their life.


People in this stage make changes in their behavior and alter their environment in order to attain their goal of modification of an addictive behavior.


In this stage, people strive to consolidate the gains made during the Action stage in particular to prevent relapse in their addictive behavior. Prochaska and colleagues believe that a person must be beyond six months of having successfully attained a desired change in order to be considered in the Maintenance versus the Action stage.


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.