By: Thea Soleil "Nine" Dona
Abstract
Prochska, DiClemente, and Norcross have identified change as a series of somewhat
universal stages: pre-contempla
tion, contemplation, preparation, action, maintenance, and relapse. Adolescence makes the previous
well-knit personality loosen under puberty, behavior back then is not enough to cope with present
changes, resulting in behavior that might frighten teachers and parents. (Teicher, 1956.) Therefore,
teenagers need to understand change since even if they might be comfortable with what harms them
and the pain probably feels safer than the comfort and safety they have yet to know, on account of
using adaptive and healthy response patterns to manage situations, relationships, and stress is
good because it allows them more control over the teenage life that’s overwhelming to most.
Pre-Contemplation
Pre-contemplation is the first stage, the unmotivation of a person unaware of a problem
and thus seeks no solution. In this stage, you are limited in your awareness of your behavior, and
can also be relative to the denial stage in the 5 stages of acceptance. They also present as
resistant, unready, and unwilling to change and are poured over with a negative view of change
in comparison to the benefits. A person in this stage is present in therapy most likely due to the
constant pressure of others pushing them to seek help. Until gaining the insight of commonly
analyzing one’s behavior, they remain in this pre-contemplation. Common comments are
exemplified by similar phrases, such as, “I don’t see a problem with what I’m doing, so there’s
no reason to change anything. (Rainan, Cogburn, 2023)
Contemplation
Marked by acknowledgment and awareness, this stage is an internal approach conflict
where the person doesn’t know whether it’s worth correcting their problem behavior. This
causes people to remain stuck in “contemplation”, also known as chronic
contemplation/behavioral procrastination for six months at the least. However, usually, people in
this stage are open to receiving information on their behaviors and solutions, unlike the
pre-contemplation stage. This is categorized by comments such as, “I know I have a problem,
and I think I should do something about it.” (Rainan, Cogburn, 2023)
Preparation
At this point, it is now easy to acknkowledge whether or not their behaivor is problematic
and can now commit to correcting it, as it is accepted the pros of change outweigh the cons. They
gather informaiton in various sources such as selfhelp books, counseling, chane-oriented
programs to develop their plan of aciton. Without the stage of preperation,. their plans are
insufficent if they fail to consider the impact the chane will have on their life, failing to
overcome challenges and relapse is often inevitable. But most of the time, planning is thorough
and intend to act in the next month and allows them to take behaivoral stpeeps towards the right
direction. They say things such as, “This is a really bad habit. I’ve been reading on how to equit,
and even though I havent, the behaivor has decreased.”
Action
Action is where change happens. Quitting is ecpected for a period less than half a year,
gaining onfidence as they believ in their will to continue changing. This is where they review the
ioportance of change and analyzing their self commitment. They are willing to recieve asistance,
support, and debvelop short-term positibve reinforcement and sustains motivation based on
rewards/ The visbible changes are not the only way they changed, and change is not soley based
on aciton and doing so makes it fdifficult. Their statements may include, “It’s easier said than
done, but I did something about it. I haven’t done this in 4 months.”
Maintenence
This marks abstinence from bad behaivor for more than 6 months/ The more a person
maintains this stage, the more confident they get in their ability to sustain their change and are
less tempted and afraid of relapsing. Even if they do htink about relapsing, they’re able to resist/
They know how to predict pontential triggers and have developed coping strategies specificallty
for these. They stay between 6 motnhs to five years.
The 1990 Surgeon General’s Report showed that after a year of quitting, 43% went back
to quitting and it wasn’t until 5 years it dropped to an impressive 7%. Just because you are in this
stage doesn’t mean you don’t still need support, and need to reevaluate why they changed,
acknowledge their achievements. triggers, and create back up plans.
Relapse
Defining Relapse
Over the past 20 years, the shift of relapse went from a complete abstinence to a broader
perspective on recovery. There is no standard definition of what makes a relapse. If we define it
as complete abstinence, that means we don’t acknowledge our non-abstinent improvements. It’s
something that can only be interpreted with context of the behavior change goal and must be
done by the person who’s trying to change.
A perspective of relapse is when someone gives up on changing no matter how much,
how frequently, and when. Contiuation of the Action and Maintence stages constitutes trying to
change. We mustn’t strictly define it, but conceptualize it since defining it with complete
abstinence creates feelings of failure, loss of hope and possibility of change and may revert the
individual back tot he Precontremplation phase. However, you cannot ignore mistakes and
difficulties completely, which is the purpose of the the Action stage.
Concepts
Substance Abuse and Mental Health Services Administraitobn (SAMHSA) defines
relapse as “A process of change through which individuals improve their health and wellness,
life a self directed I’ve, and strive to reach their full potential” (SAMHSA, 2012)
Alcholics Anonymoues uses the idea of total abstinence being a measure of successful
change and plays into the failure of an individual to work their 12 step program, sponsorships,
and support meetings. They and many researchers and clinicans also have begun to use the
chronic diasease concept to explain why relapse happens.
The AA helps with many with this concept, specificaallySUDs, countering the
underlying dangers that overconfidence may lead to that can be taken in moderation when their
goals seem too far.
However, researchers and clinicians use a more scientific approach in
advancement of neuroscience and addiction. Their perspective advocates the use of medication
to decrease the risk of releases to ease substance-induced neuroadaptation and supporting
increased self-regulation and stress management.
Models
Marlatt and Gordon’s seminal work on relapse o prevention helped them to create a
biop[uyschologial model that used cognitive behavioral principles that focus on relapse,
conceptualizing it as failure to cope with cognitive distortions and cues that creates a
vulnerability via undermining confidence or pressure to stay ambience/
A large National Institutes of Health however believes relapse is too complex to be
categorized as simple cues, but resources and general coping strategies to explain relapse.
Current views explain relapse of a multidimensial unfolding process between someone and their
interactions with their environment.
Learning models also use biopyschiosocial approaches based on multideminsial
processes where relapse is an event that starts you back at square one. People need repetition of
multiple change tests to fully complete goals associated with the stages of change (interest and
concern, decision making, commitment and planning, successful implementation) to keep
change, seeing relapse as less failure and more opportunity.
Discussion
COVID-19: Recent Adolescenct Resilence to Change
An example of adolescence dealing with change recently is the pandemic of COVID-19.
The showcase of how adolescents dealt with change showcases how truly important it is on how
to identify and deal with it.
Youths in adolescence were most prominent in mental issues initiated by the pandemic.
The financial situation caused globally by the pandemic created the overall decrease in quality of
living for adolescents, even straining parent-child relationships. As a result, teenager’s resilience
defined how they processed and handled the change. COVID-19 survivors not only have direct
brain damage, including mental health, as well as even those unaffected psychically faced with
their mental health, even causing mental disorders for some.
Adolescents are the most negatively affected by the pandemic, accelerating the youth’s
depressive, anxiety, symptoms and other negative emotions before to during pandemic. However,
psychological resilience is an essential role playing into effective coping and adaptation in the face of
loss, difficulty, or adversity. The resilience skills we cultivate in our youth are important.There are
significant negative correlations between resilience, a persons sense of danger, and distress
symptoms. Developing our youth;s resilience efficiently promotes mental health recovery during
pandemics is becoming a consensus. It is absolutely critical we develop these skills as
adolescence is a leap period of physical and mental development, crucial for the maturation of
the neurophysiological developmental process that is the foundation of higher cognitive function
and emotional behavior. (Xing, et al. 2023)
Low Resilience
Less resilient teenagers are significantly more likely to have poor mental health outcomes
with more severe symptoms of depression, anxiety, and suicidal ideation.
High resilience
High resilience protects us against various mental health conditions, and by predicitng,
the severity of anxiety and depression associated with the pandemic significantly decreases
psychological distress and increased psotive experiences. More resilient Adolescents display a
more pro-social attitude and fewer mental health problems.
Conclusion
The easier it is for adolescents to understand change makes it easier for adolescents to create
change within themselves. It’s not something that can happen overnight, but Prochska,
DiClemente, and Norcrosses stages do help identify where adolescents currently stand and how
to move on to reache their goals. Often, relapse is seen as an end to that change but it isn’t
something as simple to restrict it’s definition to that. With recent events, it is now more
prominent more than ever that adolescents are aware on how to take on change and build up their
knowledge, resilience, and acknowledgement of change.
References
DiClemente, C. C., & Crisafulli, M. A. (2022). Relapse on the Road to Recovery:
Learning the Lessons of Failure on the Way to Successful Behavior Change. Journal
of health service psychology, 48(2), 59–68.
Fox, D. J. 2019. The Borderline Personality Disorder Workbook: an intergrative program to
understand and manage your BPD. New Harbinger Publications, Inc.
Prochaska, J. O., Norcross, J. C., & DiClemente, C.C. (2013). Applying the Stages of Change.
Psychotherapy in Australia (Vol. 19, No.2) 5-10.
Prochaska, J. O., Norcross, J. C., & DiClemente, C.C. (1992). In Search of How People Change:
Applications to Addictive Behaivors. American Pyschologist. (Vol. 47, No.9) 1102-114.
Raihan, N., & Cogburn, M. (2023). Stages of change theory. PubMed; StatPearls
Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556005/
Substance Abuse and Mental Health Services Administration. (2012). *Recovery
definition: A guide for people in recovery, families, and providers. U.S. Department of
Health and Human Services.
Teicher J. D. (1956). Normal psychological changes in adolescence. California medicine,
85(3), 171–176.
Xing, J., Xu, X., Li, X., & Luo, Q. (2023). Psychological Resilience Interventions for
Adolescents during the COVID-19 Pandemic. Behavioral sciences (Basel, Switzerland),
13(7), 543.
Comments