Fundamental Treatment Strategies in Providing Integrated Dual Disorders Stages of Treatment

Early efforts at substance abuse treatment for persons with a dual disorder often consisted of demanding abstinence and teaching consumers about the many dangers of drug and alcohol abuse. While some people responded to this approach, for many it was a failure. This service approach was ineffective for those who did not want to stop using substances or lacked the awareness of the consequences of their substance use. Clearly, another approach was needed.

Working in the area of addictions treatment, Prochaska, Norcross, and DiClemente (1994) developed the transtheoretical model of behavior change. They identified five stages through which one progresses in making life changes:

1. Precontemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance.

Prochaska and his colleagues found that although the amount of time spent in each stage may vary for different people, the process, sequence, and the tasks of each stage do not.

According to Prochaska et al. (1994), in each of the five stages the individual is concerned with different tasks. To be effective, services designed to assist people to make changes (e.g., to reduce or eliminate substance use) must be relevant to the stage the person is in. We now take a look at descriptions of these five stages.

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