KEY POINTS-

  • Readiness is essential for successful recovery.
  • Recovery progresses through six stages of change.
  • Families can promote readiness and offer support and resources.
Nathan Cowley/Pexels
 
Nathan Cowley/Pexels

Many years ago, I urged my daughter to go back to college. She was living with a fellow with substance use disorder at the time, but she seemed to be doing OK on the rare occasions I saw her.

I convinced myself that she was “almost clean” and thought that being in school would motivate her to get serious about recovery.

 

I chose her courses, paid her tuition, and bought her books. I checked her assignments and helped with her homework. But I couldn’t force her to attend classes or study for tests. Predictably, she ended up dropping out before the semester ended.

I remember that as a particularly painful episode, but my daughter barely remembers it. She was much more heavily into drugs than I had realized. When I recently reminded her of how hard I had pushed her to enroll in school, she said, “That was a bad idea.”

She wasn’t ready to get serious about recovery, let alone think about school. She wasn’t ready to change anything at all.

Since then, I’ve thought a lot about “readiness.” What does it mean? How do we get there? For those of us who love a person with a substance use disorder, how can we help a loved one become ready to change?

 

Six Stages of Change

Psychologist James O. Prochaska, Ph.D., developed a highly regarded model of the process of change. In his view, behavioral change usually progresses through six identifiable stages: pre-contemplation, contemplation, preparation, action, maintenance, and termination.

In stage one (pre-contemplation), the person doesn’t recognize that a problem exists. In stage two (contemplation), the person becomes aware of the problem but is not ready to do anything about it. In stage three (preparation), the person plans to address the problem; in stage four (action), they put their plans into action.

Stage five (maintenance) is almost always the most difficult because it means making the change permanent. At this point, relapse to earlier stages is common—part of the change process in Prochaska’s view. Many people spiral through these five stages again and again before achieving stage six (termination), in which the temptation to relapse is no longer an issue.

 

Prochaska’s model provides a useful blueprint for understanding how people change. It reminds us that change is hard and that progress is rarely straightforward. It also underscores the importance of readiness.

Ready for Recovery

When someone we love has a substance use disorder, our instinct is to try to fix things right away. And experts agree that the earlier addiction is treated, the better. But our loved ones are more likely to accept help if they are ready to change.

 

As the psychiatrist James S. Gordon, M.D., wrote:

It’s not that some people have willpower and some don’t. Some people are ready to change, and others are not.

Fortunately, there are things we can do to help our loved one move toward readiness:

1. Choose a comfortable place and time to talk to your loved one when calm and sober.

2. Honestly express your concerns, offering specific examples of your loved one’s problematic drug-related behaviors.

3. Emphasize your care and concern for their well-being.

4. Avoid lecturing, threatening, bribing, or shaming.

5. Build connection by listening without arguing, even if you disagree with what they’re saying.

6. Provide information about resources to help them address their drug problem.

7. Don’t be discouraged if you’re met with resistance. Denial is common, and it may take many conversations before your loved one is ready to admit they have a problem.

The bottom line is that we cannot force readiness on others any more than we can force ourselves to be ready for change. And indeed, many factors beyond ourselves can affect our loved one’s motivation to change.

Still, planting seeds of awareness and offering care and support can help our loved ones prepare to embark on the life-changing recovery journey.