6 Stages In Working With Alcohol
As part of my training, I was required to find and undertake two placements. My later placement was in various mental health settings with the NHS. My earlier placement was of my choice.
I am very grateful to the SWAN Project (Start Winning the War Against Alcohol Now) in Bristol, UK for the opportunity given to me from 2011 to 2014. I was extremely lucky to have Ronnie Aaronson, one of the founders, as my supervisor over this time. Whilst there, I worked with clients in various stages of struggling with alcohol and life issues, and I attended numerous training days.
I was taught a model based on the work of Prochaska & DiClemente, that identified 6 distinct stages that people go through in understanding their relationship with alcohol. You might find it useful or know of someone who might find it useful.
Stage 1: Pre-Contemplation
This is where people are often on automatic pilot. Strong emotions are often swallowed down with a pint of beer or a glass of wine or a bottle of spirits. People are generally unaware they have a problem and indeed drinking can be seen as the solution.
Stage 2: Contemplation
People begin to question if alcohol is really the answer to their pain. They begin to think about what they are doing, what impact it has on their life and their body. They might wonder what their life would be like if alcohol was less present. This stage is about thinking rather than doing.
Stage 3: Action
This is when people start to do something towards stopping drinking (or possibly slowing down). They set goals on what they want to do, by when and start to take steps to change. These steps might be about clearing alcohol out of their home or about strategies they might take when going out with their work colleagues socially.
Stage 4: Maintenance
Here people continue with their behaviours towards abstaining or drinking less. This is often a bittersweet step. They might begin to feel healthier, yet the plateau can be difficult to maintain.
Stage 5: Lapse
Often people lapse and end up having a drink when they don’t intend to. Something triggers them and overwhelms their resolve. If they can catch what they are doing and go back to the maintenance stage, then not all is lost. In fact, this can be a useful learning experience around their triggers to drink.
Stage 6: Relapse
This is where, for whatever reason, people lose their goals and go back to their former patterns of drinking. Again, not all is lost, if people can find their way back to earlier stages of contemplation or action.
I hope you find this model helpful. If you want to read more about addiction and self-soothing, I recommend the book by Gabor Maté “In the Realm of Hungry Ghosts. Close Encounters with Addiction”.
