Category Archives: Recovery

Cognitive Behavioral Therapy and the Stages of Change

CBT and Stages of Change Model of Addiction

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is an empirically tested treatment for mental health disorders. Cognitive behavioral therapists work with clients to identify his/her maladaptive thoughts and restructure these thoughts that they no longer produce negative emotions and behaviors. A cognitive behavioral therapist will often be phased with a scenario in which a person was prompted to go to therapy by a friend, spouse or family member. It is often the case in which a client does not have insight or awareness into the problems with his psychological and behavioral functioning. At these times a primary goal in psychotherapy is to help the client gain insight into the benefits of psychotherapy. Cognitive behavioral therapists determine which stage of change their clients are in at any given time.

Stages of Change

Prochaska and Declemente’s Stages of Change Model addresses different levels a person may be on when considering change, especially addiction. Cognitive behavioral therapist may review this model with clients to help them identify which stage of change they are in at any given point. The first stage of this model is called the precontemplation phase. During the precontemplation phase clients deny that they have any problems and lack awareness into their psychological functioning. It is often seen in cases in which anger management is a goal that clients are in the precontemplation phase. Cognitive behavioral therapists often see clients for anger management were preferred by a family member or spouse. If a client is in the precontemplation phase change, the cognitive behavioral therapists will work with the client to help him see on his own the benefits of engaging in psychotherapy and the negative consequences of his anger expression. The second stage of change is called the contemplation stage. In this stage a client is considering making a change, although has not taken steps to do so. Cognitive behavioral therapists work with clients in the contemplation stage to help them move to the next phase called the action stage. In the action stage clients are willing to make a change, recognize their own shortcomings and problems and take active steps to remediate them. In the action phase a client is a willing participant and is fully engaged in treatment. The final stage of Prochaska and Declemente’s stages of change model is called in the maintenance phase. During the maintenance phase the client has already achieved his goals in the action phase and works toward maintaining these gains.

Substance Abuse and Stages of Change

The stages of change model is often used by cognitive behavioral therapies in the treatment of substance abuse. As noted above, it is often the case where substance abusers are encouraged to attend treatment while in the precontemplation phase. That is, they deny the existence of a problem, though their substance abuse has likely negatively impacted friends, family members and various domains of the client’s life. Cognitive behavioral therapists treating substance abuse disorders youth motivational enhancement techniques to help the client see the negative consequences of his substance abuse and come to a realization on his own and he would benefit from psychotherapy to help remediate the problem. It is also the case in substance abuse treatment that clients continue to necessitate therapy during the maintenance phase. Especially in the beginning of the maintenance phase, clients benefit from support of their cognitive behavioral therapists to help resist relapse. Cognitive behavioral therapists will decrease the frequency of sessions as clinically indicated, based on the client’s progress. With regard to substance abuse, the longer the client has remained abstinent the better the prognosis.

Cognitive Behavioral Therapists

Cognitive behavioral therapist may address the stages of change model in both the individual psychotherapy and group psychotherapy formats. In group psychotherapy group members may relate to one another and offer narratives about how they each progressed through the various stages of change.