Most people who enter treatment for chemical misuse issues do so because of other factors in their lives. These reasons may include difficulties in relationships, work , school, health, spirituality, etc. It is likely that someone close to the individual (boss, boyfriend, girlfriend, wife, husband) is concerned about the use and places pressure on them to seek treatment. They may acquiesce, even though they do not think that their use is “problematic” in order to relieve some of the external pressure. This scenario is common and is considered to be part of the precontemplation stage, one of five stages on the road to recovery. The other four stages include: 1)contemplation, 2)preparation, 3)action, and 4)maintenance.
After an initial assessment, feedback is provided which may shift the individual out of precontemplation and into contemplation. During this stage, people are more willing to acknowledge that they may have a problem and express ambivalence about change. This is to be expected since most substances provide sought after positive effects which include stress and tension relief, management of strong negative emotions, comfort in social situations, and others. Effective treatment acknowledges these factors and encourages the individual to express them in the privacy and confidentiality of working with their therapist.
Exploration of negative consequences of misuse may strengthen the part of the individual that wants to make positive changes in his/her life. This exploration may lead to preparation for positive behavioral change. At this point in treatment, the individual acknowledges that the negatives of use outway the positives and is ready to develop a plan to make positive changes and minimize harm. This may include decreasing use and exploring alternative approaches to manage the situation(s) that trigger use.
In the action stage, time is spent on executing the plan, and, in maintenance, necessary steps are taken to ensure that positive change is sustained over time.
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