Psychiatry · Substance Use Disorders (Alcohol, Opioids, Other Substances)

The Prochaska and DiClemente Transtheoretical Model (Stages of Change) is used in deaddiction counselling. A patient with alcohol use disorder says: 'Yes, I know my drinking is a problem and I'm planning to do something about it within the next month.' Which stage is he in?

  • A Precontemplation
  • B Contemplation
  • C Preparation (determination)
  • D Action
Correct answer: C. Preparation (determination)

Explanation

The Transtheoretical Model stages are: (1) Precontemplation—not aware of or denying the problem; (2) Contemplation—acknowledges the problem and is ambivalent, considering change in the next 6 months; (3) Preparation—intends to take action within the next 30 days, may have taken small preparatory steps; (4) Action—actively making changes; (5) Maintenance—sustaining change >6 months; (6) Relapse—return to prior behavior. This patient acknowledges the problem AND plans action 'within the next month'—this specific timeframe (30 days) distinguishes Preparation from Contemplation (6 months).

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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