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Harm reduction: Stages of change

Precontemplative

  • Person has no intention of changing
  • Person may not see behaviors as a problem
  • Often labeled as "resistant" or "in denial"

"I don't have a problem with how much I drink. It is everyone else with the problem."

"I inject only once a week. It's not like I am doing it everyday or anything."

Contemplative

  • Person is aware a problem exists
  • Seriously considers change
  • Has not yet made a commitment to action

    "I know I shouldn't drink as much, but it makes me feel better."

    "I don't use when I have the kids. That's good, isn't it?"

Preparation

  • Person is intent upon taking action
  • Some steps toward change may occur
  • Transitory-more commitment to change

"I have a plan about how I am going to stay clean."

"I feel pretty clear that using crystal while I am depressed is going to stop."

Action

  • Person modifies behavior, experiences and environment in order to overcome problem
  • Commitment is clear
  • Great deal of energy/effort to change

    "I know that I need to make these changes, so I�0;0;2019;m giving it my best shot."

    "I stopped going to the bar on my way to the grocery store. It is hard, but I'm doing it."

Relapse/Return to old behaviors

  • Person returns to using/behaving
  • Pattern of use may be similar or different than before

Maintenance

  • Person has been free of "former" behavior for at least 6 months.
  • Person engages in behaviors that are incompatible with drug/alcohol use.

    "I've been clean for ten months now."

    "I react to things differently. I don't get as angry, so I don't feel the strong urge to use."