The motivation to change is a major factor in addiction treatment. Some addicts have little to no motivation to change their behavior. Or their motivation may not be sustained. In 1994, James Prochaska, John Norcross, and Carlo DiClemente published their model of the stages of change, which describes six different stages that people go through when deciding to change addictive behaviors. This work has been widely integrated into addiction treatments.

The first stage is called pre-contemplation. At this point the individual does not believe he or she has a problem and is resistant to suggestions to change. There may be considerable denial about the extent of the problem.

The next stage is called contemplation. In this stage, the individual is aware there is a problem and is beginning to consider taking action to change. The third stage is known as preparation. The person is now taking steps in preparation of change. For example, he or she may start researching drug treatment options or talking to family and friends about the need to stop using the drug. Nonetheless, there is still ambivalence about giving up the substance.

The fourth stage is termed action. At this point, the person takes actual steps to stop the substance use. This may involve joining a twelve-step group, an outpatient treatment center, or even getting admitted for inpatient treatment. The person also recognizes the need to change a broad array of psychological and social patterns associated with the addiction.

In the fifth maintenance phase, the person has successfully stopped using the substance. Still, there is ongoing risk of relapse and the person needs to take care to prevent backsliding. There will be need for ongoing support and treatment, often in the form of a twelve-step group such as Alcoholics Anonymous (AA). There is also need for continuing attention to ways of handling emotions, relationships, and responsibilities.

In the final phase, termination, the person has successfully mastered the addiction. The temptation to use is no longer a significant danger. Nonetheless, people do not necessarily travel through these stages in a straightforward manner, and there is frequently movement back and forth between the stages.