A STAGE OF CHANGE APPROACH TO ADDICTION IN THE MEDICAL SETTING

Despite recent advances in its understanding and treatment, addiction remains a difficult challenge for clinicians within medical settings s uch as the general hospital. The use of single, traditional paradigms (disciplinary, therapeutic, educational, or libertarian) for approachi ng addiction-related problems have often failed to embrace the complex ity of the patients' motivation to change. Prochaska and DiClemente's [7] stage of change model offers a realistic, practical, and broadly a pplicable means by which clinicians can facilitate behavioral change f rom the stage of denial (precontemplation) through that of sustained r ecovery (maintenance). Clinicians can help addicted individuals to mov e from precontemplation to contemplation by enhancing their ambivalenc e; from contemplation to preparation by considering their history of c hange; from preparation to action by flexibly intervening based on thi s understanding; and from action to maintenance by evaluating the outc omes of these interventions. A stage of change model is also useful in understanding the process of change in clinicians' own approaches to patients with substance use disorders. (C) 1998 Elsevier Science Inc.