Amber Hollingsworth explains the "stages of change" model as it applies to addiction recovery, highlighting that recovery is typically a back-and-forth, trial-and-error process rather than a single "rock-bottom" moment. She defines and illustrates the stages — pre-contemplation (denial), contemplation (thinking about change), preparation (research and small steps), action (trial, bargaining, attempting change), and maintenance — and discusses relapse as a contested but possible outcome. The talk emphasizes realistic expectations for family members, recommends gentle responses to small steps, and frames bargaining/trial-and-error as a normal part of progress.
Chapters
Today's session is all about what to expect from the recovery process. You know, most people think that the way this whole thing works is someone who's alcoholic or an addict. They struggle with their addiction problem until they hit bottom. And then all of a sudden, in this sort of grand spiritual experience, the person comes to their senses and they just decide, you know what? I'm done with this. I don't want to do this anymore. I'm an addict, I'm an alcoholic, and I'm going to go to meetings and turn myself around. I'm here to tell you, don't wait for that. That's very, very, very unlikely to happen. The process is actually a little bit more what I might call start and go back and forth, trial and error than that. So I'm going to teach you a model that they actually teach counselors in counseling school to help you sort of understand how this thing really is going to play out and what you're looking at when you're looking at it, because that's going to help you to know how to help yourself or how to help your loved one. So there's this model in counseling school. It's called the stages of change. And basically it's to help you understand the process that someone goes through as they're on their journey to change something pretty major or significant in their life. And this really doesn't just apply to drugs and alcohol. This can apply to any major change that someone needs to make. But it's really important when you look at the recovery process this way. If you are the family member and you're walking alongside someone that has this problem, you have your head on straight about how this is going to work so that you will keep your sanity. Basically, if this is going to. Getting your expectations right is really going to help you make it through this whole thing alive and with your wits about you. So the first stage of change is known as pre contemplation. Now, that's really a fancy word for what you and I know of as denial. Basically, this is before the person realizes that they actually even have a problem. So this person is completely unaware that they need to make a change at all. Now, this stage will probably, if you're the family member, make you want to strangle them, because it can seem so glaringly obvious that you just can't even wrap your head around how they could possibly be missing it. The next stage of change is called contemplation. And that's what I like to call thinking about it. This is the. Well, yeah, I'm having some problems with my alcohol or with my whatever, but it's not alcoholism. It's not addiction. I just need to change something. You know, I need to change the way I'm doing this, or I'm just too stressed. But it's the first time that the person starts to entertain the idea that there's any problem. Generally, what you really need to understand about this stage, though, is that this doesn't mean that the person begins to think that they're an addict or an alcoholic. They just begin to think that something's going wrong. But it's not because they're an addict or an alcoholic for sure. But it's the first time the little wheels start to turn. This is called contemplation. The next stage is called preparation. And this means the person begins to think about, what do I need to do to get this problem under control. Now, we're not saying I'm an alcoholic or anything. I don't know that I need to go to, like, AA meetings or anything every day. But maybe I need to make a little bit of change. So the person may do things like researching online. That's where most of us start when we want to figure something out. Or they may talk to a friend, or they may know someone that's in recovery. And so they may ask them about their experience, or they may talk to their minister. These are, like, little preparatory steps that people are going to make in their almost, like, investigation of what can I do about this problem? Now, keep in mind, this doesn't necessarily mean that they have full acceptance of the magnitude of the problem. In fact, most people, when they come into the recovery process, the denial, I say, peels back like layers of an onion. It's not like I'm in denial, and then I'm not in denial, which is the way most of us expect for that to happen. But it's usually like, okay, like, I have a problem because my wife's on my butt all the time about my drinking. That's my problem. And then that might turn into, well, I probably am drinking a little bit too much, but it's really because I'm, like, stressed. And most of my stress comes from the fact that my wife's not on my butt all the time. Well, okay, like, the drinking is getting a little bit too far. I'm drinking most every day now, and so on and so on. So you can see that it kind of happens in layers, that the person's able to see just what magnitude this problem really is or just the depth of the problem. And even then, even when you're dealing with a person that totally gets how bad the problem is, unless they've done this whole recovery thing before, you can pretty much guarantee they have no idea how difficult it's going to be to get under control and the amount of changes that they're going to actually have to make. And so I usually stress to family members and other clinicians, please do not take this person who might be in preparation or contemplation stage and hit them over the head with a baseball bat and say, you're going to have to change everything about your life and you're going to have to change all your friends, your playmates, your playgrounds and your play places, because that's going to send them running straight back into the pre contemplation stage. So these are little baby steps. And when you see them, do not hit them with a sledgehammer. These are little moments of opportunity. And in later sessions, we'll talk about what to do when you see these opportunities. But for now, I just want you to know, don't jump too hard when you see this. Now, the next stage of change is called the action stage. And in the action stage, this is when people actually start to try to get better. They start taking steps. Maybe they get to the first AA meeting, maybe they join, celebrate recovery at their church. Maybe they buy some books on recovery and start to read about this thing. They probably are going to start to set little goals for themselves, like, okay, I'm only going to drink on the weekends, or I'm only going to drink beer and not hard liquor anymore, or not any more than five drinks, or I'm going to do no more than $500 worth of cocaine every week. They're gonna set some sort of little limit for themselves. And I really refer to this process right here as bargaining. And it happens somewhere in that preparation action stage, kind of somewhere in the middle. And it's really a trial and error phase. And I don't want you to be too harsh on the person doing this. I mean, it might be frustrating to look at because you might be like, don't you get it? You can't drink at all. Like, it's not gonna be good. I know that's what you're thinking, but don't say it. You have to let people go through this. I have never seen anyone get better, get to recovery, get to sobriety without going through this trial and error process. Trust me when I tell you they are gonna try everything they can think of. First before deciding that they're going to give it up altogether. I mean, like, that's the last option. And if you will just hang tight and let this process kind of work through, hopefully in the best case scenario, you might have this person seeing a counselor or another professional that can help them through this process. They can sort of expediate it without sledgehammering it and shutting the whole thing down and making us head backwards. But expect some trial and error, some bargaining, some maybe let me try this or try that or make this little change or that little change and maybe I can get my use under control. Don't let this freak you out. This is actually a good sign. This is a person coming to terms with how significant the problem is and the major changes that they're really going to have to make. So you got to be careful how you react to this. Otherwise you can set them back 100 miles. Now, once the person gets there and they get stable and they get the problem under control and it's pretty stable, then they're going to move into a maintenance phase. It's just like with anything else in your life, any big change that you make, it's not like, okay, I found the solution, I conquered this problem, and it's done. Think about it like weight loss. You could go out, you could lose £100 today, and you feel awesome. But if you just go right back to your old patterns, you're going to lose all that progress you made. So there's a lot of action in the maintenance phase. The last thing I'll tell you is some people consider relapse the last stage of change. And that's one of those things. It's like, it's kind of something I hesitate on because it's a little bit of dangerous territory when you're talking to people that have substance use problems in their families, because some people take it as well. You're giving them permission to relapse or you're telling them, everybody relapses. And I don't want to do that. I don't want to set the stage, because the disease of addiction will absolutely use me saying, you know, relapse is part of the process. They'll take that as, oh, I have some buys out there. Like, I have some like, free get out of jail free cards that I can just use up at will because everyone does it. That's not what I'm saying at all. But understanding that this trial and error, this back and forth, what I'm going to call the bargaining process, is a natural part of getting better. So instead of letting that frustrate you, you need to understand that that's a good, clear sign that we're moving in the right direction. Well, I know that that's just the beginning of the story, but that's all we have time for today. And stay tuned in other sessions, and we'll learn more about what to do when you see these stages.
