Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
Change rarely happens all at once. Most people do not wake up one day and decide to quit drinking or using for good. Instead, they move through a series of stages, sometimes quickly, sometimes slowly and often more than once. Understanding those stages can make the process feel less confusing and a lot less personal.
The stages of change model, formally called the transtheoretical model, is widely used in addiction treatment to describe how people prepare for and sustain change. Below, we walk through each stage, what it can feel like and what tends to help, whether you are thinking about your own use or supporting someone you love.
Precontemplation: Not Yet Seeing a Problem
In precontemplation, a person does not see their substance use as a problem, or at least not one they plan to address soon. They may feel defensive when others raise concerns, point to friends who drink or use more or believe the benefits outweigh the costs.
What helps: Pressure and lectures tend to backfire here. Calm, honest observations, information without judgment and a relationship that stays open can plant seeds. A question such as “How do you feel about your drinking lately?” invites reflection without demanding a confession.
Contemplation: Seeing Both Sides
In contemplation, people acknowledge there may be a problem but feel torn. They might think, “I know I should cut back, but it’s how I relax.” This ambivalence is normal, and people can stay in this stage for a long time.
What helps: Exploring the pros and cons of change, connecting substance use to personal values and goals and hearing from others in recovery can tip the balance. Try writing down what you would gain from change and what you fear losing. Seeing both lists side by side often clarifies what matters most to you.
Preparation: Getting Ready to Act
In preparation, a person has decided to change and begins planning. They may research treatment options, talk with a doctor, choose a start date or tell someone close to them.
What helps: Concrete planning. That includes learning which level of care fits, checking insurance and thinking about safety. If you drink heavily or use benzodiazepines, plan for medical supervision, since withdrawal from alcohol and benzodiazepines can be life-threatening. Reviewing the addiction treatment services available to you can turn an intention into a real plan.
Action: Making the Change
The action stage is when people actively change their behavior, such as entering detox, starting residential treatment, attending therapy or stopping use with support. This stage takes a great deal of energy and brings real emotional and physical challenges.
What helps: Structure, professional treatment, peer support and new coping skills. Therapies such as CBT and DBT help people handle cravings, stress and difficult emotions. Encouragement from family matters, too. Our guide to beginning your recovery journey in DFW describes what the early steps often look like.
Maintenance: Protecting Progress
In maintenance, new behaviors become more established, and the focus shifts to preventing relapse and building a fulfilling life in recovery. Cravings may fade but can return during stress, celebrations or unexpected reminders of the past.
What helps: Ongoing support through aftercare, outpatient therapy, support groups, healthy routines and relationships. Planning for high-risk situations and recognizing early warning signs keep recovery strong over the long haul.
What About Relapse?
Many descriptions of the model include relapse, sometimes called recycling, as part of the process. People may move back to an earlier stage and then forward again, sometimes more than once, before change takes hold. That does not erase progress. Each attempt can teach something about triggers, needs and which kinds of support work.
One safety note matters here. After a period of not using, tolerance drops, and returning to previous amounts, especially of opioids, can cause an overdose. If someone is unresponsive or breathing very slowly, call 911 and give naloxone if it is available.
How Families Can Use the Stages of Change
For loved ones, the model offers a useful reminder. You cannot push someone into a stage they are not ready for, but you can influence the movement. Match your approach to where the person is:
- Precontemplation: focus on connection and honest concern
- Contemplation: listen, reflect and avoid arguing
- Preparation: help with practical steps, like researching options
- Action and maintenance: offer steady encouragement and respect boundaries
Our page on supporting a loved one has more ideas for families at every stage.
Where Treatment Fits
People can seek treatment at any stage, not only once they feel completely ready. Ambivalence is normal when entering care, and motivation can grow as people begin to feel better physically and emotionally. At Promises Dallas-Fort Worth, treatment includes medical detox, residential care for addiction and mental health, partial hospitalization and a virtual IOP, followed by aftercare planning for every client. If you are in crisis or having thoughts of suicide, call or text 988.
Frequently Asked Questions
Can someone skip a stage?
People can move quickly through some stages, but most pass through each one to some degree. Some move back and forth several times before change sticks.
Do I need to be in the action stage to start treatment?
No. Treatment can help people who are still unsure. A conversation with an admissions team can be part of contemplation or preparation.
What if my loved one seems stuck in precontemplation?
Stay connected, share concerns calmly and take care of yourself. Al-Anon and family therapy can help you cope while you wait for readiness to grow.
Wherever You Are, You Can Start Here
You do not need to have everything figured out to call. Our admissions team is available 24/7 to answer questions, explain options and verify your insurance for free and in confidence. Same-day admission is often possible when a bed is available.
Look into your insurance options, send us a message or call (469) 546-9303.