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Dr Shelagh Wright - Systemic and Family Psychotherapist and Family Mediator

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MOTIVATIONAL THERAPY FOR ADDICTIVE BEHAVIOURS

Stages Of Change

The MET approach is further grounded in research on processes of natural recovery. Prochaska and DiClemente (1982, 1984, 1985, 1986) have described a transtheoretical model of how people change addictive behaviors, with or without formal treatment. In a transtheoretical perspective, individuals move through a series of stages of change as they progress in modifying problem behaviors. This concept of stages is important in understanding change. Each stage requires certain tasks to be accomplished and certain processes to be used in order to achieve change. Six separate stages have been identified in this model (Prochaska & DiClemente, 1984, 1986). Individuals who are not considering change in their problem behavior are described as being in PRECONTEMPLATION. The CONTEMPLATION stage entails the person's beginning to consider both the existence of a problem and the feasibility and costs of changing the problem behavior. As this individual progresses, he or she moves on to the DETERMINATION stage where the decision is made to take action and change. Once the individual begins to modify the problem behavior, he or she enters the ACTION stage, which normally continues for 3-6 months. After successfully negotiating the action stage, the individual moves to MAINTENANCE or sustained change. If these efforts fail, a RELAPSE occurs, and the individual begins another cycle.

The ideal path is progress directly from one stage to the next until maintenance is achieved. For most people with serious problems related to drug use, however, the process involves several slips or relapses which represent failed action or maintenance. The good news is that most who relapse go through the cycle again and move back into contemplation and the change process. Several revolutions through this cycle of change are common before the individual maintains change successfully.

From a stages-of-change perspective, the MET approach addresses where the client is currently in the cycle of change, and assists the person to move through the stages toward successful sustained change. For the ME therapist, the contemplation and determination stages are most critical. The objective is to help clients consider seriously two basic issues. The first is how much of a problem their drug use poses for them, and how it is affecting them (both positively and negatively). Tipping the balance of these pros and cons of drug use toward change is essential for movement from contemplation to determination. Secondly, the client in contemplation assesses the possibility and the costs/benefits of changing the drug use. Clients consider whether they will be able to make a change, and how that change will impact their lives. In the determination stage, clients develop a firm resolve to take action. That resolve is influenced by past experiences with change attempts. Individuals who have made unsuccessful attempts to change their drug use in the past need encouragement to decide to go through the cycle again.

Understanding the cycle of change can help the ME therapist to empathize with the client, and can give direction to intervention strategies. Though individuals move through the cycle of change in their own ways, it is the same cycle. The speed and efficiency of movement through the cycle, however, will vary. The task is to assist the individual in moving from one stage to the next as swiftly and effectively as possible.

The following questions go some way towards helping a person consider the pros and cons of continuing with the additive behaviour:

Benefits Of Using

Benefits Of quitting