Preparation

In the preparation stage, individuals make a commitment as well as initial plans to change the behavior. They need to create an effective and acceptable plan and have the dedication to implement it. Velasquez, Mary M. Group Treatment for Substance Abuse, Second Edition (Page 56). The Guilford Press. Kindle Edition.

DiClemente, Carlo C.. Addiction and Change, Second Edition:

Stage Task:

• Creating and strengthening commitment needed to support action
• and developing an accessible, acceptable, and effective plan for change.

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Change processes at work:

• Reinforcement: Small steps toward change are successful and reinforce the commitment; alternative reinforcements begin to be viewed as valuable.
• Counterconditioning: People and places that trigger the behavior are identified, as well as alternative coping strategies to cope with the urges.
• Stimulus control: Self-observations and monitoring uncover and begin to avoid the presence of triggers in the person’s life.
• Self-liberation: The person chooses what elements and strategies to include in the plan and commits to implementing the plan.
• Helping relationships: The person seeks out others who can encourage and support changing the addictive behavior.

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The Preparation stage of change entails developing a plan of action and creating the commitment needed to implement that plan. Decisions do not translate automatically into action. To change a behavior, one needs to focus attention and energy on breaking the old pattern and creating a new one. Planning is the activity that organizes the environment and develops the strategies for making change. Commitment is essentially a matter of finding the time and energy to implement the plan. One of the most frequent reasons why individuals do not change is that they lacked the time and energy to do it. But it would be difficult to implement and sustain any change plan without a firm choice and sustained commitment. Being prepared to act requires a plan of action and the dedication or commitment to follow through on that plan. It can be simple or more complex, but there needs to be an implementation strategy to make the behavior change happen. For the Preparation stage, individuals must summon the courage, commitment, and competencies to accomplish the change. DiClemente, Carlo C.. Addiction and Change, Second Edition: How Addictions Develop and Addicted People Recover (Guilford Substance Abuse) (p. 23). Guilford Publications. Kindle Edition.

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The advertising slogan “Just Do It “may contain an important message for routine procrastinators, but it is a dangerous message for anyone attempting to change an addictive behavior.

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• Preparation also is characterized by initial use of other behavioral processes like counterconditioning and stimulus control. Planning is often accompanied by self-observation and monitoring that allow the individual to begin avoiding places and people associated with the addictive behavior and foster attempts to employ alternative coping strategies to deal with urges to take drugs, drink, or gamble.
• In Preparation, there are often small steps that are being taken or have been taken to modify the behavior, like a call for help, restructuring the environment, an attempt at self-regulation of the addictive behavior, or a recent attempt to quit.
• In addition, alternate reinforcing activities, such as getting involved with family, work, or school activities, can be increased so they will be available as viable substitutes for the addiction.

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[Dealing with other issues in life:] The suggested strategy of AA to put aside all other problems and focus only on the alcohol or drug addiction until 1 year of sobriety is achieved is one way to develop a plan (Alcoholics Anonymous, 1952). However, it is not the only way, and multiple problems may need to be addressed to create an effective and acceptable plan.

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Another important element in getting prepared is an assessment of the status of self-control strength and self-regulation capabilities. As discussed in earlier chapters, loss of control is one key indicator of a serious substance use disorder, and self-regulation is impaired to some degree in all individuals who have this diagnosis. This maybe compounded by significant current loss of self-control strength (Vos & Baumeister, 2016; Muraven & Baumeister, 2000) or impairment in affect regulation and executive cognitive functioning that preexists the use disorder, as these issues will disrupt planning and commitment. In fact, for individuals with compromised regulation systems, planning must address how to manage impaired self-regulation. I have begun to use the term “scaffolding” as a metaphor to understand management of impaired self-regulation (Reid, 1998; Stone, 1998). The greater the self-regulation impairment, the greater is the need for personal and environmental scaffolding.

Self-regulation is needed for most of the action activities and tasks (monitor cues, cope with cravings, delay, distract, shift attention, accept, become mindful). Scaffolding to support these activities is needed to support the structure during construction, whether this consists of supportive environments, personal aids, medications, interpersonal guidance, housing, or other types of support. Just being told to go and do it when self-control is seriously impaired ignores the critical role of self-regulation in acting to break an addiction.

See also

• Commitment
• Change Plan