the 5 stages of why and how your child decides to change and what to do at each stage, with Brenda Zane
Host: Brenda Zane, brenda@brendazane.com
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Show Resources
Stages of Change mobile-friendly cheat sheet download
CMC 20 Minute Guide chapter on ambivalence
Show Transcript:
Speaker: Brenda Zane
episode themes:
change, substance use, addiction, ambivalence, relapse, parenting
01:26
Hello, welcome back. So good to be here with you in this time, I'm so glad that you are making the time today to be really intentional about learning, finding support for yourself and doing the hard work that's required when your son or daughter is either experimenting with or misusing drugs and alcohol or if they're living in active addiction, it is such a tricky thing to navigate. And what I especially love about podcasts are that they give you a way to learn and tap into a community in a really low profile way. So you might not be ready yet to join a online support group or walk into an Al anon meeting, or even pick up the phone to call a therapist or a treatment program. But you can be here and listening. And hopefully it will kind of build your confidence and build some of that knowledge that you have. So that you can then reach out for additional help when you're ready for it.
And I know for some of you, this may be the first step that you're taking on the journey. Or it might also be your 100 and 50th step. But either way, it says that you are showing up, you're learning and you're aware. And being aware is so so important.
Today's episode is really important. And I've been wanting to do this for a while. It is something that I knew nothing about until a few years into my son's struggle. And knowing this information would have really helped me. And I think also him because I would have had a completely different perspective on how to interact with him. It's the stages of change model.
And it's so enlightening that I decided that I would do a whole episode on it and provide some ideas of things that you can do in each stage to help move somebody forward. Instead of having conversations blow up in your face, which I know happens a lot.
So for me, this is all hindsight, because I learned it late in the game. But if you're hearing this, it's just the right time that you are supposed to be hearing it. I truly believe that the fact that you're listening to this today, wherever you are, whatever you're dealing with, it's what you need right now. And it may be that this information will apply to someone else in your life, not even your child. Maybe it's you. But I am a big believer that things happen when they're supposed to happen. So the fact that you're hearing this today is not a coincidence.
For some context as to why I believe this is critically important information. I recall times when my son was doing crazy things, living a really dangerous lifestyle, hanging around with less than stellar people and doing various drugs. I would take advantage of any time that he was in our home, and I would swoop in with lectures and advice and I would pepper him with questions. And often it would sound like me trying to teach or convince him out of doing what he was doing. I just assumed that because I wanted him to stop All of the crazy that he would also want to stop, if I could just get the same information that was in my head into his head, right?
Like, it's so obvious that this isn't good for you, and it's damaging our relationship and our family. And I had spent so much time researching and learning. And I felt this really strong sense that if I could just get him to know what I knew that he would change.
Well, I'm guessing that you can imagine how those conversations turned out probably similar to some that may be happening in your house, or in your relationship. So we will jump into the stages of change model, and hopefully give you some real practical things that you can start working on today, with your son or daughter, or yourself or a spouse, whoever it is, again, I believe that this information is what you needed to hear today, the stages of change, or you'll also hear it called the transtheoretical model. And I'm not going to go into why that is. But there is a reason why it's called that. I'm a little bit of a research nerd.
It came about in the late 70s by researchers James Prochaska and Carlo di Clemente, and they were studying ways to help people quit smoking. And over the years, this model has really been found to be an effective way in understanding how people go through a change in their behavior.
An important thing to note about this model is that change happens slowly. And relapses are really an inevitable part of the process. I might need to say that again. relapse is a natural and usually inevitable part of the process. What we all see is that people are unwilling or resistant to change during the early stages, and then eventually develop a proactive approach to changing their behavior. And we also see that change is rarely easy. It requires a lot of small steps to get to a goal.
Just think about this in yourself in something that you would like to change about yourself or something in your life that you want to be different, there's probably been a point in time where you weren't concerned about it at all. And then you get to a point where you start to see there are some downsides to what you're doing. And then you start to think about changing, but it's usually not a linear process. And it usually happens over time. And this is no different with our kids, it just might seem more obvious, because we're observing it from the outside. And the danger level, and the consequences may be way more significant. So it's painful, and it's incredibly frustrating.
08:06
We'll talk through the stages. And there's five of them plus one that was not in the original model, but is kind of inherent with the chain the stages. So they are pre-contemplation, contemplation, preparation, action, maintenance, and then the sixth, again, which isn't part of the original, but it gets added in especially in the substance use realm. And that is, of course, relapse. And don't worry about writing all of this down. Because if you go to the shownotes, there's a PDF there a little cheat sheet that you can download with all of this, the stages. And a lot of this information that we're going to be talking about today. So show notes are always at BrendaZane.com/podcast, then just look for this episode. This is number 66. And you'll find the download.
So let's start with pre-contemplation. If you're here listening to this podcast, there's a really good chance that your son or daughter is in this stage. They're denying that there's any problem or they're ignorant that what they're doing actually is a problem. They're not considering change, and they might actually be unwilling or unable to change. It's that kind of ignorance is bliss stage. Someone in this stage might feel like they're just resigned to their current way of life. And they may believe that they don't have any control over their behavior.
This is especially true when you're talking about substance use. And there are chemicals at work that make your body dependent on them. Or if you don't use those substances, you're going to get really sick. So this can make a person believe that they are not in control and they don't have any choice but to keep using and I know so many of you hear that from your kids. I definitely heard that. And so that is a really good indication that this person is in the pre-contemplation Stage.
So what can you do as a parent, if your child is in this stage, the most important thing to realize if they're in this stage is that education and information that's forced on them is not going to be effective. So all the googling, and all the research that you've done is great. Keep that in your back pocket. But pulling it out and shoving it at them, is really going to push them away for making change, rather than pulling them toward it. This is where you really want to use open-ended questions to start to help them recognize what impact their behavior is having on them and on other people. So that could be What do you like about using XYZ? What don't you like about it? Or I know, using XYZ is really important to you, and you spend a lot of time and money on it. What is it doing for you? Are there any downsides.
11:01
And you can also ask for their permission to share information, all of this information that you have gathered, you can ask if they would be open to hearing something that you've learned. But be ready for them to say no sense. Remember, they are not seeing this as an issue right now. If they are willing to engage in conversation, and they are willing to take some of the information that you have, you could ask them a question like what would have to happen for you to see this as a problem. So that will just get them thinking a little bit into the future, they'll start to think about things that they care about. And it might just spark some ideas for them in their head. It's also important in the stage to clarify with them that the decision is theirs to make, you cannot force them to do or not do anything. So saying something like the decision to use XYZ or not to use it is yours. I just want to understand what it's giving you and be there as a resource for you if things start to change.
Now, I know these statements might sound really radically different from what you have been trying. And if what you've been trying is not working, you can always shift strategies and do something new. These questions also have to come from a genuine place, not a sarcastic place, not a passive aggressive place. Not a judgmental attitude, but actually curious, you really want to know why this is working for them. And if your child is in this stage, it can also be a good time to have a harm reduction conversation. You're not saying that they must stop what they're doing 100% overnight, but talk about whether there's a safer way that they could be doing it. So if you're interested in this episode, 65 is a really great one to go back to if you haven't listened to it. It's with Deedee stout, she's a harm reduction specialist. And it's all about how you can use craft skills and questions to introduce that and potentially use that as a solution in your family.
The second stage is contemplation. This is where the person has an initial awareness of the problem. And they might be sitting on the fence about doing anything about it. They may have had some pretty impactful negative consequences if you're allowing those to happen. And they are starting to see that there are in fact some downsides to what they're doing. So their awareness is growing.
13:45
A big part of the contemplation stage is ambivalence, wanting and not wanting to do something at the same time. And it's important to know that ambivalence is entirely normal. It is part of the process, and you should expect it. So when it happens, just recognize it as part of the second step and know that it is 100% Normal. In the shownotes, you will find a link to the section of the 20 minute Guide, which is the workbook that goes along with the book beyond addiction. There's a whole section in there about ambivalence. And so I will put a link in that into the show notes that you can read more about that particular aspect because it is so important.
Remember, your child is getting something from using substances. It's a solution. It's working for them at some level. So it kind of makes sense that they would go back and forth about changing that. It's really a cost benefit equation and until the cost is greater than the benefit. It is really really hard to change. Okay, so ambivalence is 100% normal in this stage of contemplation, and unfortunately, this is also where people can get stuck for a long time, they have hugely conflicting emotions, because they're weighing the pros and cons of changing their behavior. And yet, they may not really see a ton of benefit in making that change.
The cost of the change probably stands out more than the benefits like, Okay, I get it, this smoking weed every day is making me really tired and unmotivated at school. And I sometimes get paranoid, and I don't really like that. But if I stop using it, then I'm gonna be the weird one with all my friends. And when I start getting that anxious feeling that I have, I won't have any way to make it go away. So I won't have any friends, and I'm going to be really anxious. Now, that doesn't sound good. Even though I know my parents would really like me to stop.
See where that ambivalence comes in this this, these are the conversations or the thoughts that may be going through their head. If they're in the contemplate of stage, if they are in pre contemplation, these conversations are not going on in their head, the focus tends to be on what I am losing by making the change versus what I could gain. And usually the things you need to do to get the benefits are less popular with brands, and they take longer than it takes for a Xanax or some weed to kick in. And then we wonder why our kids resist change.
So what can you do if they are in this stage of contemplation? Again, using open ended questions that allow your child to explore the pros and cons of their choices, is a really good way to engage them in starting to think about it. It needs to come from inside them not getting pushed on them from you. There's a saying that is one of my favorites, which is people don't resist change, they resist being changed. People want to feel good, and be healthy and have good relationships with other people in their life. And they want to get there from their own awareness and their own choices.
There's another thing that I love. And I know that it's true from doing coaching with a lot of people is that people believe what they hear themselves, say, if you ask your son, are there any downsides to smoking weed every day? And he says, not really, it helps me chill out. But I also don't really want to do anything. That is the truth coming from his mouth. Whereas if you said you're smoking weed all day, and it makes you not want to do anything, guess what he's gonna say back. You're always nagging me, that's not true. I want to do stuff you just won't let me or whatever the scenario is. So the more you can ask those questions, the more they have to think through it. And then those words will come from their mouth, not yours.
Other questions for this stage are things like, why would you want to change? Notice the tone, there's not? Why would you want to change? Or why wouldn't you want to change? For you have to have the curiosity? Why would you want to change? Or what gets in the way when you think about changing? Or what could make a change easier or less scary?
And I know it's not going to happen overnight. So the first time you have this conversation is not going to be the one and only time. So you're going to need to approach it as a long term project. And you may not get the answer you want. But listen carefully, very carefully. And they will give you clues. During this stage, remember to they are finally aware that there are some negatives or disadvantages to what they're doing.
So instead of harping on those and saying like, Well, yeah, I told you that six months ago, you can focus on the benefits and the positives instead, like, Hey, if you're feeling more energy, when you smoke less weed, maybe you would want to pick up the guitar again. Or maybe we can take a trip somewhere, or whatever it is, it's appealing to them. So really focusing on the positive of making the change versus harping on them and reiterating the fact that you already know this information is going to be much more helpful. What you're trying to do is to work with them to help them see that the scale can tip the other way. And that the benefits could outweigh the negatives. Again, it's important to clarify that the decision is theirs. You're acting as a sounding board for them to work through some of this ambivalence.
And some of the best responses during these conversations are, huh, that sounds like a really tough decision. How are you going to decide what to do? Or, wow, that's hard. On the one hand, you want to do this. And on the other hand, you kind of want to keep doing what you're doing. I could see how that'd be really hard choice. Or it sounds like you have a lot to think about. Let me know if you want to talk through any of it together.
20:11
I'm not saying that these are easy responses by any means, because they go against our parent wiring, our internal wiring to fix, to solve, to provide solutions to give the answers. But trust me, if you try one of these, when your son or daughters opened up, and they're in the contemplation stage, you might be really surprised at their response.
The third stage is preparation. This is where you'll see them start experimenting with some small changes, they may say, I'm going to stop drinking for a month, or they'll try and go a week without taking any pills. It's a small step where they're testing the water. If they're drinking all day, right now, maybe they don't have a drink until noon, that is a change. Maybe they do an online search for an a meeting. Or they might ask you, if you could send them for the 20th time a picture of their insurance card, because they might call a therapist.
So there's a little bit of action taking place the wheels are turning and you That is how you know that they're now in this preparation phase. They aren't stable. Right? They're not they're not doing it all the time. But they are making some little movements. So just know that this is the third stage is a positive shift from out of contemplation. And their ambivalence has at least temporarily shifted in favor of making some change, because they're seeing some benefit from it.
21:47
If you're working to help them in this stage, it's really important to be supportive, and not acknowledge how hard change is initially. You can offer to be supportive in whatever way it's best for them. And know that it might mean you have to but out of the process, it might not be the way that you want to be supportive. So just be sure to ask the question genuinely, how can I be supportive of you right now? And then listen, and be respectful of the answer, even if it's not the answer you want. If they are open to your support, you can encourage them to take small steps.
Often As parents, we want to see big change, we want them to accept treatment, we want them to be 100% abstinent, or move into a sober living house. Like we want the big thing to happen right now. But in the preparation phase, they are taking positive steps, but they're probably not ready to make that big move. So acknowledging even small steps like not drinking until noon, or even asking for the insurance card. Those are big things when you're trying to make a significant shift in life.
The preparation phase is also a great time to talk about potential pitfalls, help them think about when they get the urge to use, it may be when they know they're going to be around friends, and they think they need to smoke some weed before so that they're not so uncomfortable. Or if they know that work is going to be really stressful and that they are going to want to drink the minute that they get home. Talk about those pitfalls so they don't turn into bigger landmines.
And you can ask them, What if this doesn't work? What other ideas do you have? How will you deal with this, if it isn't successful right out of the gate. just ignoring the fact that this might not take hold on their first try, can really set you all up for disappointment and more frustration. You might even agree that for a period of time, they are not going to change much other than just gather information.
Now, I will put a caveat here that this might not be a good strategy if they are using any street drugs that will potentially have fentanyl in them. If that's the case, definitely see if you can move to more of a Harm Reduction Strategy. But you might say what would happen if for the next three days, you only did XYZ maybe that's we're getting marijuana from a dispensary versus you're taking street Xanax which Street, which is annex and fentanyl. So what if you only did this for the next three days, but you really focus on researching the options for getting some help.
Again, your son or daughter might literally fall out of their chair if you take that approach because it's probably pretty radical from the approach that you've been taking. But I'm guessing that it would either be at least a welcome change to talk about and it may also just open up a broader discussion if they see that you're really working with them.
The fourth stage is action. It's when they are actively doing the new thing. They're in the process of the new behavior. So that might mean that they're in a treatment setting by their own choice, or they're just doing the thing that they need to do on their own. Just don't think that the only evidence of action is them being in treatment. That's not the only way that you can do that.
So when they're in the action stage, you can obviously keep being supportive and help them focus on new skills that they're learning and trying out. You can also help them by reiterating the long term benefits of why they're doing this. Because as we all know, just because you are actively doing something new, doesn't mean that it's always easy or fun. And it can be really easy to lose sight of why you made the change in the first place. This means though, that you need to truly understand their motivation for the change, and not be focused on your motivation for them changing, this is a shift that is hard to make. So your and theirs may be very different.
If you don't know their internal motivation, ask, if you say, Wow, I'm sleeping so much better at night, now that you're in treatment, it's not going to reinforce their motivation, it may even make them a little resentful because they may not be sleeping any better. So just be careful not to project your experience onto them. In this action phase, this is all about them. This is all about them achieving what they want to achieve in your needs, and your relief in your dreams and outcomes should not be projected onto them. What you can do is talk to them about their coping strategies and acknowledge how hard it is to turn to new things. When it could be easier to turn to the old ways of coping.
We have to remember that substances are a brilliant strategy for coping, because they work so incredibly well. And incredibly fast. Take a Xanax, within five to 10 minutes, you are going to feel way less anxiety and pretty numb for a while, go on a walk, do some deep breathing, call a friend punch a bag, those things might take longer to get the effect that they're looking for. And they won't come naturally at first. So even though it looks like a small change, if they're doing these things and finding new coping skills, that is huge. And you can play a big part in reinforcing the benefits of change by recognizing those. I
t's tempting in this stage to offer praise, like you're doing great, I'm so amazed at you, I'm so proud of you. But remember that this isn't about them making you proud, it is about them getting the benefits of the change for their life. So statements like that might be less impactful than if you can ask them questions, and let them hear from themselves how they're doing. So that might sound like how is all of this working for you? Or what's the best part of what you're doing? Or what are you learning about yourself through all of this? Or what's hard about this? And how are you dealing with that. So this keeps it all about them and the work that they're doing for themselves and not about you.
28:25
The fifth stage is maintenance. This is where they are continuing in the new behavior. And a characteristic of this stage is the avoidance of old behaviors, the new behaviors now the new daily routine, kind of the new normal. This means that they're using their new coping skills. They're leaning into whatever resources they found back in the planning phase, and they're doing it. As parents, we love this stage. We post pictures on social media. And we hold up signs that announce how long our son or daughter has been in recovery. And it's all great. And it's amazing. And often we feel like we've been successful to get them to this stage.
I just want to encourage you to remember that they've worked their way through a lot to get to this fifth stage. And it's not a guaranteed stage. Each and every stage in this process has two doors, one going in and one going out. In my mind, I kind of think of them as those revolving doors that you see in Chicago. We don't have those in Seattle really. But those round revolving doors in all the big buildings and they turn and they turn in the turn. And you can go around in those doors forever unless you choose to go into the building or out of the building. So when your child gets into the maintenance stage, there is still work to do to help them not enter the revolving door and then use it as an exit.
So many parents I work with Tell me at this The age that they are just waiting for the other shoe to drop, and that they still can't get any peace in their life. And that's why I think it's so important to understand each of these stages so that you can identify the mindset that corresponds to each one. And to know that it's normal for them to enter the revolving door at least once or twice and spin around. And each time they do they learn more about themselves, and you learn more about them as well.
So in the maintenance phase, there's a lot of encouragement, obviously, you can talk about their new coping skills, you can talk about which ones are working best, which ones are their go to skills? Why do they think those are working the best, keep talking about those long term goals, and know that once they uncover their intrinsic goal and desire, whatever it is that they are looking for what they want to have in their life, when they realize that the only way to get those is by making this a permanent way of life, things will change, and you won't be feeling that dread of the other shoe about to drop, you'll see it in them, that they have something on the horizon, or maybe they've already achieved it, and they don't want to risk it.
And yet, saying that there is a sixth stage. And of course, that is relapse, relapse is common, it shouldn't be thought of as a failure. And in the treatment world, we often hear about how relapse is quote, unquote, information that gives us clues about what's not working, or where their speed bombs are for that person. And if you take that mindset, you can help your child in this stage by not telling them that they failed, that they just wasted a bunch of money, or that they can't or won't learn or that they're just stubborn or hopeless. What you can do with them, if they're willing, is to look at what are those triggers for them? What what triggered them to end up with the relapse situation, go back to that intrinsic motivation for making this change. Maybe it's different now maybe that has shifted for them, and relook at what the barriers are for them to achieve that goal. And then you can make some stronger contingency plans.
Again, this might be something that they are not willing to have you involved in. But if they are, those are some of the things to be talking about. And there's a tendency to think that if someone relapses, they have failed at stage five, the maintenance stage, they got all the way to stage five, and then they bombed out. But a relapse could be because they didn't go through stages one through four well enough or deep enough or spent enough time there thinking and making plans. Maybe they didn't get there, because they were they were not motivated to go through those stages. That's why it's really important to know what they each of these look like and the role that they play in long term maintenance.
Of course, all this sounds great. And I experienced relapse with my son so many times. And I can honestly say it doesn't always feel like information, it can feel like failure. And it most definitely can feel like fear. I looked up some research
33:23
from the National Institutes of Health on this because relapse is so painful. And it can be so traumatizing to parents, who often go into the process and not realizing that this is a very, very real possibility. What I found in the study was that was done. And I will link to the study in the show notes. What they found is that approximately 15% of people who relapse regress to the pre-contemplation stage, and they often try to suppress the memory of that unsuccessful attempt. And any thoughts of the negative behavior. You may have seen this happen, where it's like they have amnesia about all the bad things that happened when they were back in that phase. And it can be really, really shocking to a parent to see that happen.
So that is a full rewind all the way back to stage one. And when that happens, you might be thinking that your child is completely crazy because they had come so far, they may have had months or even year or more in recovery, only to go back to where they are denying that there's not even a problem. Then the study also found that 85% of people returned to the contemplation or preparations stage. So again, it's important to know these stages so that you have context for what's going on versus just thinking that your person's crazy when they revert back. Remember the revolving door.
I think As parents, we see our kids misusing drugs or alcohol or both. living a lifestyle that isn't healthy and we We want them to go from there stage one, immediately to stage five, right? We want the fast track elevator, we don't want to trudge through all of the frustration and the hard work of stages two, three, and four. Because it's really hard, and it's painful to see. And there's often very real danger at each of these stages. So it makes sense that we want to shorten the path. But what has been shown in research is that if somebody skips the steps along this process, they're less likely to make permanent and lasting change. It's not that they can't you, you will always have the outlier, who gets forced into treatment, and then it sticks. But research has shown that it is less likely that that will happen.
So watch for those signs of each of the stages, and do what you can to encourage open conversation, asking the open-ended questions and being really genuinely curious about what is going on with your child. Also, know that if your goal is to shorten the time between stage one of pre-contemplation to stage four of action, harsh confrontation, yelling, lecturing, shaming, blaming, are not going to speed that process up, they may actually keep your son or daughter in that revolving door longer than they need to be.
So for quick review, and again, you can download the cheat sheet so you don't have to worry about writing this down. The five core stages are pre-contemplation. There's no problem here. contemplation, well maybe there's some downsides to this, I might think about change, I'm kind of tired of being stuck. And remember that this is where ambivalence is huge. Preparation is stage three, they're making some plans, they're taking some action, but there is still some ambivalence and nothing is permanent than an action they are actively modifying their behavior. And this may be when they're in treatment. And the change is more visible to other people when they're in the stage. And then the fifth stage of maintenance, there is commitment they're actively working on not retreating back to their old habits. And this is now the new normal.
Again, tap over to the show notes. There's a link in the description for this episode in your podcast player or you can just go to Brenda Zane comm forward slash podcast, and you can look for this episode, it's number 66. You can download the cheat sheet you can check out the research if you're a research nerd like me. I always like to provide those so that you know I have done the research I have gotten in depth looking at these topics.
Also, if you want to get on my email list, I do send a short email each Wednesday to anyone on my list just with some thoughts with some hope with some inspiration. And you can get on that list if you go to BrendaZane.com/email. And finally, if you want to get a free ebook that I wrote, it's called hindsight. Three things I wish I knew when my son was addicted to drugs. You can go to BrendaZane.com/hindsight and get it there.
Thank you so much for being here. Thanks for doing the hard work. I will meet you right back here next week.