Are you ready to change?

Are you ready to change?

We all have bad habits that get in the way of our enjoyment of life. These habits can be highly self-destructive; heroin addiction is an example. Or they can be small things that might hold us back such as watching too much TV. Whatever the case, you may be wondering how people go about changing; understanding change might make it easier to do.

Quite a number of years ago now, Prochaska and DiClemente (1983) came up with a model of change that explains how people modify a problem behavior or acquire a positive behavior. Initially it was applied to smoking cessation and is now used to explain changes in behavior in general. The primary organizing principle in this model is called the Stages of Change; it describes a person’s readiness to change in 5 stages. Let’s look at how this might apply for someone with an alcohol problem.


In this stage a person is not even thinking of stopping their use of alcohol. Either the consequences of use are not grave enough or the person is willing to deny the seriousness of the problem despite evidence to the contrary.


As problems multiply due to excessive alcohol use a person may begin to accept that they have a problem. As a result of their drinking they may have financial, relationship or work difficulties or they may develop a health or mental health issue. Essentially, at some point, negative consequences may allow a person to develop some insight into the nature of the problem.


Contrary to what many people think, most people do not stop drinking in a vacuum. An often overlooked issue is that people have more success when they PREPARE to stop using once they have acknowledged a problem. Preparation could include decreasing how often or how much they drink each day, changing their social circle, changing their everyday routine so they don’t walk by their favorite bar, or beginning a meditation practice. They may decide on a stop date. The manner in which a person decides to prepare to change their drinking habit is as individual as they are.


At a certain point enough supports are in place to enable the drinker to decide to stop or modify their use. This does not only include elimination of a problem behavior but also includes the addition of positive behaviors. In short, a bad habit is replaced by a good habit. For example, it is not unusual for people to become involved in some kind of sport or exercise regimen as a replacement for their alcohol use.


A person becomes more confident about the changes they have made when they have a period of sustained abstinence or non-problematic use of alcohol. They are actively using strategies that they developed in the action phase and are able to maintain and build upon positive changes, preventing relapse.

Relapse is not included in the original model but can be considered to be a sixth stage. It is important to remember that relapse is very common and that a great deal can be learned from what precipitated the relapse. It is advisable to examine what may have preceded a return to problematic drinking so that the person can develop strategies to cope with this in the future.

On the path?
I have described a way that people change that has been validated by the research and by many people’s experiences. If you want to change a behavior it helps to know what the terrain looks like as you move forward. Nothing changes unless you do the footwork….

Norcross JC1, Krebs PM, Prochaska JO. Stages of change. J Clin Psychol. 2011 Feb;67(2):143-54. PMID: 21157930.

Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.

This information is for educational purposes only and should not in any way be considered a substitute for professional help. If you are in need of immediate help please contact your local psychiatric emergency services.

Helping a friend with an alcohol or drug problem

the bridge back
the bridge back

A friend of mine sought my counsel today. She has a friend who is depressed and drinking heavily. She says he is, “going steadily downhill”. Other friends of his have attempted to help by putting pressure on him to get help. This has not been effective. My friend has remained on the sidelines not knowing how to approach the situation. She wanted to get some advice about how she might help. I gave her some suggestions.

Attitude adjustment
People who have alcohol and/or drug problems are usually very down on themselves already. The last thing that he needs is for people to be critical. If you want to begin to talk with him about his drinking approach him with acceptance and respect. A nonjudgemental attitude will go a long way in engaging him in a meaningful discussion of his alcohol use.

Offer support
Offering him your opinion that he may need help is a delicate matter. Only he can decide to get help. If you are understanding and supportive it is more likely that he will be receptive to your observations.

Provide resources
Be ready to provide resources if he acknowledges the problem and agrees that he may need to stop his use. There are programs that are outpatient, residential and self-help. 12-step programs are a good resource but there also are other alternatives now which engage the person with a substance use problem in an exploration of the problem and may give him tools to decrease his use, use more safely and/or move toward abstinence as he decides what is best for him. This approach is called harm reduction. You can find a list of resources here:

Set limits
Take care of yourself in this. Do what you can to assist him but be firm about the kind of behaviors that you will not tolerate. These behaviors could include drinking while you are in the car with him, insulting or violent behavior, stealing, etc.

Be prepared for setbacks
In the end he may or may not choose to effectively cope with his problem. He may try several times to get the help he needs and not be successful. But remember, research and experience have shown relapse is the rule rather than the exception and it often takes more than one try to be successful. Your role as his friend may be to be the voice of reassurance and optimism in the background. After all, it’s his show…..

This information is for educational purposes only and should not in any way be considered a substitute for professional help. If you feel that you need immediate assistance please call your local psychiatric emergency services.