Stages of Change

Question 1

Precontemplation

Answer 1

Client is not yet considering, unwilling or unable to change.

Question 2

Contemplation

Answer 2

Client acknowledges concerns and is considering the possibility of change, but is ambivalent and uncertain.

Question 3

Preparation

Answer 3

Client is committed to and planning to make a change in the near future, but is still considering what to do.

Question 4

Action

Answer 4

Client is actively taking steps to change, but has not yet reached a stable state.

Question 5

Maintenance

Answer 5

Client has achieved initial goals such as abstinence and is now working to maintain gains.

Question 6

Recurrence

Answer 6

Client has experienced a recurrence of symptoms and must now cope with consequences and decide what to do next.

Question 7

Establish rapport, ask permission and build trust.

Answer 7

Precontemplation

Question 8

Express concern and keep the door open.

Answer 8

Precontemplation

Question 9

Raise doubts or concerns in the client about substance using patterns.

Answer 9

Precontemplation

Question 10

Exploring the meaning of events that brought the client to treatment or the results of previous treatments.

Answer 10

Precontemplation

Question 11

Eliciting the clients perceptions of the problem.

Answer 11

Precontemplation

Question 12

Offering factual information about the risks of substance use.

Answer 12

Precontemplation

Question 13

Providing personalized feedback about assessment findings.

Answer 13

Precontemplation

Question 14

Exploring the pros and cons of substance use.

Answer 14

Precontemplation

Question 15

Helping a significant other intervene.

Answer 15

Precontemplation

Question 16

Examining discrepancies between the clients and others perceptions of the problem behavior.

Answer 16

Precontemplation

Question 17

Normalizes ambivalence.

Answer 17

Contemplation

Question 18

Help the client “tip the decisional balance scales” toward change.

Answer 18

Contemplation

Question 19

Eliciting and weighing pros and cons of substance use and change.

Answer 19

Contemplation

Question 20

Changing extrinsic to intrinsic motivation.

Answer 20

Contemplation

Question 21

Examining the clients personal values in relation to change.

Answer 21

Contemplation

Question 22

Emphasizing the clients free choice, responsibility and self-efficacy for change.

Answer 22

Contemplation

Question 23

Elicit self-motivational statements of intent and commitment from the client.

Answer 23

Contemplation

Question 24

Elicit ideas regarding the clients perceived self-efficacy and expectations regarding treatment.

Answer 24

Contemplation

Question 25

Summarize self-motivational statements.

Answer 25

Contemplation

Question 26

Clarify the clients own goals and strategies for change.

Answer 26

Preparation

Question 27

Offer a menu of options for change or treatment.

Answer 27

Preparation

Question 28

With permission, offer expertise and advice.

Answer 28

Preparation

Question 29

Negotiate a change or treatment plan and behavior contract.

Answer 29

Preparation

Question 30

Consider and lower barriers to change.

Answer 30

Preparation

Question 31

Help the client enlist social support.

Answer 31

Preparation

Question 32

Explore treatment expectancies and the clients role.

Answer 32

Preparation

Question 33

Elicit from the client what has worked in the past either from him/her or others whom he knows.

Answer 33

Preparation

Question 34

Assist the client to negotiate finances, child care, work, transportation or other potential barriers.

Answer 34

Preparation

Question 35

Have the client publicly announce plans to change.

Answer 35

Preparation

Question 36

Engage the client in treatment and reinforce the importance of remaining in recovery.

Answer 36

Action

Question 37

Support a realistic view of change through small steps.

Answer 37

Action

Question 38

Acknowledge difficulties for the client in early stages of change.

Answer 38

Action

Question 39

Help the client identify high-risk situations through a functional analysis and develop appropriate coping strategies to overcome these.

Answer 39

Action

Question 40

Assist the client in finding new reinforcers of positive change.

Answer 40

Action

Question 41

Help the client assess whether he/she has strong family and social support.

Answer 41

Action

Question 42

Help the client identify and sample drug free sources of pleasure.

Answer 42

Maintenance

Question 43

Support lifestyle changes.

Answer 43

Maintenance

Question 44

Affirm the clients resolve and self-efficacy.

Answer 44

Maintenance

Question 45

Help the client practice and use new coping strategies to avoid a return to use.

Answer 45

Maintenance

Question 46

Maintain supportive contact.

Answer 46

Maintenance

Question 47

Develop a "fire escape" plan if the client resumes substance use.

Answer 47

Maintenance

Question 48

Review long-term goals with the client.

Answer 48

Maintenance

Question 49

Help the client reenter the change cycle and commend any willingness to reconsider positive change.

Answer 49

Recurrence

Question 50

Explore the meaning and reality of the recurrence as a learning opportunity.

Answer 50

Recurrence

Question 51

Assist the client in finding alternative coping strategies.

Answer 51

Recurrence

Question 52

Maintain supportive contact.

Answer 52

Recurrence