Ohio Valley Center for Brain Injury Prevention and Rehabilitation

Home

About Us

Substance Abuse

Agitation

Resource and
Service Coordination

Outcomes

Internet and TBI

Related Publications

Contacts

Site Map

Search

Substance Abuse and Brain Injuries

Stages and Process of Change

Precontemplation
Contemplation
Preparation
Action
Maintenance
PDF Version of Stages of Change

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. (See Motivational Interviewing)

The five Stages of Change are:

Precontemplation Ed Injury says Chill out, I can handle myself.
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).

Contemplation Ed Injury says I'm not sure I really need to do this.
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.

Preparation Ed Injury says I've been cutting back lately, but its not easy when all of my friends are using. After New Year's, I'll quit for good.
In this stage, people have the intention to change but have not 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.

Action Ed Injury says I'm not going to that party because I know people will be using there.
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.

Maintenance Ed Injury says Eight months ago when I was drining, I wouldn't have been able to work a full day.
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.