Pre-contemplation
What it looks like: unaware of the problem with substance use, haven’t thought about change
Your goal: raise interest in change- increase the person’s consideration of risks of substance use
What skills to use: express empathy, avoid giving advice, use open-ended questions, reflect emotions
Contemplation
What it looks like: thinking about changing substance use, you will hear lots of ambivalence (reasons for and against changing)
Your goal: strengthen the person’s self-efficacy for change, guide them toward voicing their reasons for stopping, cutting down or getting help
What skills to use: listen to their ambivalence and reflect change talk, support self-efficacy
Preparation
What it looks like: Making a plan to change, setting goals
Your goal: help the person to determine what will work for them to meet their goal of cutting back or quitting substance use
What skills to use: support self-efficacy, reflect change talk, support problem-solving to reach a good plan for that individual
Action
What it looks like: making changes to their lifestyle, taking steps toward change
Your goal: help the person to implement their plan
What skills to use: point out successes and support problem-solving efforts when the plan is not working
Maintenance
What it looks like: continuing new behaviors, sustaining efforts to stay substance-free or continuing harm reduction
Your goal: help the person to identify and use strategies to prevent relapse
What skills to use: point out successes; affirm the individual, support problem-solving
Relapse
What it looks like: reverting to old habits (more than one “slip”)
Your goal: help the person to move through the stages again without becoming stuck or demoralized
What skills to use: express empathy, acknowledge ambivalence, support self-efficacy, avoid advice-giving, support efforts to problem-solve and find a plan that works