Substance use: Interventions and stage of change
Table 6.1 Matching interventions to the stage of change
stage of change
indicator of the stage
appropriate intervention for the stage
May be defensive or uninterested in change
May feel hopeless about change
Develop trusting relationship
Increase percep- tion of risk
"How do you feel about your use of …?"
"What does using
… do for you?"
Aware of pros and cons but has not acted
Acknowledge am- bivalence and try to tip the balance
Evoke reasons for change
Strengthen self- efficacy
"What are some
of the good things about using …?"
"What are some
of the not-so-good things about
Committed to change
Starting to make plans
Help plan: identify strengths, barri- ers, vulnerabilities
Provide informa- tion and treat- ment choices
"What was difficult last time you tried quitting?"
"What are other changes you've successfully made?"
Implementing plans and making genuine efforts to change
Help patient take steps toward change
Focus on the positive
Help plan for high-risk situations
"How do you feel about the changes you've made so far?"
"What would you do in a triggering situation?"
|Maintenance||Has had a period of time not using and is trying not to relapse||Help patient iden- tify strategies to prevent relapse|| |
"What are changes you've made in your life to help
you continue not using?"
|Relapse||Stopped for a pe- riod of time, but is now using the substance again|| |
Help minimize degree and dura- tion of relapse
Assist patient in identifying rea- sons for relapse
|"What was hap- pening in your life when you started using again?"|