"It is not necessary to change. Survival is not mandatory. "~ W. Edwards Deming

The stages of change have been described as  precontemplation, contemplation, readiness, action, and maintenance.*    (1) Precontemplation means that you do not believe you have a problem or you are not even ready to consider change. (2) Contemplation means that you believe you may have a problem and are willing to consider change but you are struggling with ambivalence and weighing the pros and cons and barriers to change. (3) Preparation involves getting ready to change. (4) Action means that you are making changes and living new behaviors. (5) Maintenance means that you are maintaining the behavior changes (and continuing to get rid of nagging character defects) that are a result of your treatment regimen.

            Your mission in recovery is to get to maintenance!!

            How do you get to maintenance?

            REPULSION: You move from precontemplation to contemplation by becoming repulsed by the consequences of addiction and/or mental illness. You see how your illness has been out of control and how it has interfered with your life and other lives.

            ABILITY: You move from contemplation to preparation by seeing that you should and can actually change. For example, you see that other people can do it so why can't you. You accept the fact that you can set certain treatment requirements into your schedule. You listen to people who refuse to enable you.

            IMPLEMENTATION: You move from preparation to action when you implement treatment techniques. At first, you may still be "bringing the body" without being mentally, emotionally or spiritually involved, but at least you are doing something. Gradually (or suddenly), your personality and behavior change such that you are turning into a sober and/or sane person. You implement by doing what people who refuse to enable you suggest. You “put your toe in the water” and feel how nice and warm the water is.

            CONSISTENCY: Maintenance is then the stage where you keep doing it. You realize that you are never cured so you consistently practice treatment regimens in order to maintain your change, sobriety, and sanity. Consistency is the result of repitition, belief and positive reinforcement. For example, you go to 90 meetings in 90 days, you continue to get rid of nagging character defects, you begin to feel “happy, joyous, and free.”


To-do:

Discuss with your sponsor or therapist (or someone knowledgeable who will not worry about enabling you) where you are in the stages of change. Try to get to the next level. Are you consistently doing recovery techniques bearing in mind that sobriety and sanity are daily reprieves? *Abram, K.M., Teplin, L.A., & McClelland, G.M. (2003). Comorbidity of severe psychiatric disorders and substance use disorders among women in jail. American Journal of Psychiatry, 160, 1007-1010. Steadman, H.J., Osher, F.C., Robbins, P.C., Case, B., & Samuels, S. (2009). Prevalence of mental illness among jail inmates. Psychiatric Services, 60, 761-765. Teplin, L.A. (1994). Psychiatric and substance use disorders among male urban jail detainees. American Journal of Public Health, 84, 290-293. National GAINS Center. (2006, rev. 2009)Developing a comprehensive plan for mental health and criminal justice collaboration: The Sequential Intercept Model. Delmar, NY: Policy Research Associates. Munetz, M.R., & Griffin, P.A. (2006). Use of the Sequential Intercept Model as an approach to decriminalization of people with serious mental illness. Psychiatric Services, 57, 544-549. Solomon, A.L., Osborne, J.W.L., LoBuglio, S.F., Mellow, J., & Mukamal, D.A. (2008). Life after lockup: Improving reentry from jail to the community. Washington, DC: Urban Institute, Justice Policy Center. Sacks, S., Sacks, J., McKendrick, K., Banks, S., & Stommel, J. (2004). Modified therapeutic community for MICA offenders: Crime outcomes. Behavioral Sciences and the Law, 22, 477-501. Petrila, J. (2007).Dispelling the myths about information sharing between the mental health and criminal justice systems. Delmar, NY: Policy Research Associates, CMHS National GAINS Center. Center for Substance Abuse Treatment. (2005).Substance abuse treatment for persons with co-occurring disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No. (SMA) 05-3922. Rockville, MD: Substance Abuse and Mental Health Services Administration. Peters, R.H., Bartoi, M.G., Sherman, P.B. (2008).Screening and assessment of co-occurring disorders in the justice system. Delmar, NY: Policy Research Associates, CMHS National GAINS Center.