Anyone who has worked with rehabilitating people with substance misuse problems or with offenders in general will have heard of the “Cycle of change” (Prochaska and DiClimente) It is one of my favourite models as it clearly illustrates why people find it so difficult to change behaviour and how people go round and round the stages, so why is it so difficult for me to practice what I preach?

I sat the other night staring at another glass of wine I’d promised myself I was going to “cut down on” and wondered what stage of the cycle I was in. The number of units I consume per week has been firmly in my consciousness since training to deliver the Drink Impaired Drivers Programme for Probation years ago. I learned exactly how many units are lurking in a glass of wine so I was deluded if I thought I was in pre-contemplation and unaware of any need to change. I couldn’t claim to be “maintaining” my change of behaviour either as the empty bottles in my recycling bin at home will testify!

Let’s look at the stages then and see where I can place myself.

Cycle of change – (1982 Prochaska and DiClimnte)

Pre-contemplation

At this stage you have not even thought about changing and may be happy where you are, or simply not considered that a change is possible.

Contemplation

You are thinking about change and part of you wants to change and part of you wants to stay as you are. You are ambivalent.

Decision (preparation)

You have decided to change and are going to do something about it. You may still have some ambivalence but you are going to make an effort to change.

Action

You undertake work to bring about the change you want. This might be a programme of action, getting information, making choices, or doing things differently.

Maintenance

At this stage you are maintaining your new behaviour, often at first through a conscious effort, later it becomes your unconscious, habitual behaviour.

Lapse

This can happen at many times during the cycle where a temporary lapse into the old behaviour happens. This does not necessarily mean a permanent return to the old behaviour. How a lapse is understood and managed can be critical to the overall success of the change as it can be an important way of understanding triggers and reasons for the behaviour.

Relapse

Everyone can have lapses from time to time and this often reminds them of what they wanted to change and can act as motivation to make a permanent change. However, sometimes a lapse can lead to a relapse which is a more permanent return to the old behaviour.

I would like to think I’ve moved from “Pre-contemplation” and “contemplation” and am sitting quite happily in “Action” I’ve definitely thought about wanting to reduce my unit consumption and have listened carefully to Government advice about what is “safe” and some weeks my wine consumption is definitely reduced (definitely!) The trouble is, being an experienced trainer of this model, I find those little lapses almost too good to resist! Understanding this model so well gives me permission to expect lapses and even look forward to them. “It’s ok, I must be due a lapse soon, oh good” I say to myself, rubbing my hands together with glee while I visualise a glass of Chateauneuf! Kidding myself that I will miraculously move into “maintenance” without any maintenance to my attitude! Can I learn from these lapses and see what triggers them? Yes, usually boredom and lack of motivation!

No wonder offenders and people with serious substance misuse problems find it so difficult to move on…..