Precontemplation

Abstract

In Chapter 2 the point was made that the most neglected stage of change is precontemplation. While the literature is replete with theorising and research on contemplation, treatment and relapse prevention, much less is known about how to bring resistant clients to a point where change will ever be seriously contemplated, let alone attempted. For example, a recent and influential book on the treatment of addictions (Miller and Heather, 1988) which was based entirely on Prochaska and DiClemente’s (1988) change model, contained not one chapter on working with precontemplators. In part this gap is explained by Prochaska and DiClemente’s own finding (1983) that precontemplators employ fewer of the ten change processes (see Chapter 2) than at any other stage in their relationship with drugs. Little if any time is spent in self-re-evaluation, there is less openness with significant others, precontemplators have fewer emotional reactions to the negative aspects of their habit and they do little to shift their attention or environment in the direction of change. Such resistance to change obviously provides the drug counsellor with very little to work with.