Table 5

Stages of Change and Stage Appropriate Intervention

Stage of Change

Characteristic

Intervention Approach

Suggested Language

Pre-contemplation

Not thinking about change.

Discuss risks of drug abuse and benefits of quitting. Link specific negative consequences to drug use. Strongly advise quitting.

"What would it take for you to consider seeking help?"

Contemplation

Thinking about change in next 6 months but not within 30 days

Discuss immediate benefits of quitting to self and loved ones. Emphasize health, economic and interpersonal payoffs.

"What would it take for you to seek help now?"

Preparation

Ready to change in next 30 days

Discuss strategies and options. Pick a change date. Refer to specialist if necessary.

"Which option do you think will work best for you?"

Action

Has initiated and maintained new behavior for up to 6 months.

Support decision. Encourage change. Discuss pitfalls and common sources of failure.

"What do you think will be your biggest challenge? How might you deal with it?"

Maintenance

Quit for more than 6 months

Periodic follow-up and continued encouragement. Discuss triggers.

"What have you learned about people, places, events, and emotions that make you want to use?"

Tommasello Harm Reduction Journal 2004 1:3   doi:10.1186/1477-7517-1-3