Stable Lifestyle

This means that the person has reached the stage in which they can manage cravings and stress without returning to drug use as a way of coping. Effectively their new behaviour has become an automatic habit.

Pre-contemplation

• Not necessarily thinking about changing.
• Focused on the positive aspects of their substance use.
• Unlikely to have any concerns about their substance use.
• May show resistance to talking about their substance use.
• Unlikely to know or accept that their substance use is risky or problematic.
• Unlikely to respond to direct advice to change their behaviour but may be receptive to information about the risks associated with their level and pattern of substance use.
• Sometimes described as ‘happily using’.

Contemplation

• Thinking about cutting down or stopping substance use.
• Ambivalent about their substance use. They may be able to see both
the good things and the not so good things about their substance use.
• Likely to have some awareness of the problems associated with substance use and may be weighing up the advantages and disadvantages of their current substance use pattern.
• Likely to respond to information about their substance related risks, advice to cut down or engage in discussion about their substance use.

Preparation

• Intending to take action.
• May vocalise their intentions to others.
• Making small changes in their substance use behaviour.
• Re-evaluating their current behaviour and considering what different behaviour could offer them.
• Becoming more confident and ready to change their behaviour.
• Considering the options available to them.
• Setting dates and determining strategies to assist change.
• Gathering of information from a variety of sources: friends, relatives, internet and health professionals.

Action

• Have made the decision that their use of substances needs to change.
• Have commenced cutting down or stopping.
• Are actively doing something about changing their behaviour.
• Have cut down or stopped completely.
• Are likely to continue to feel somewhat ambivalent about their substance use and to need encouragement and support to maintain their decision.

Maintenance

• Attempting to maintain the behaviour changes that have been made.
• Working to prevent relapse (the risk of relapse decreases with time).
• Focusing attention on high risk situations and the strategies for managing these.
• Best equipped when they develop strategies for avoiding situations where they are at risk of relapse.
• Are more likely to remain abstinent if they receive reward, support and affirmation.

Relapse

Lapses (single occasions of use) should be expected and can occur at any time. Relapses occur when the person returns to the behaviour they were trying to change. Lapses and relapse should be viewed as a learning process and not a failure. Few people change on the first attempt and relapse is a good time to help clients review their action plan.