Similar to the “Stages of Grief,” the “Trans-Theoretical Model” (or as it’s more well-known, the “Stages of Change”) is a model that explores and expresses the most common steps taken towards change.
The original “Trans Theoretical Model” is important because it noted the ways in which many people approached changing a behaviour. However, early editions of the model didn’t work, until an important phenomenon was acknowledged: relapse.
Relapse, as a word, is one of many words that has been co-opted and twisted, lost its meaning, and, over time, I’ve heard it used as slang and it carries a lot of negativity and shame. I think it’s important to look at the what the word means because it is importantly not unique to addiction.
Similar to the word consequences, relapse is a very objective word that simply refers to a return to previous behaviour or state. For an example, let’s pick a mundane behaviour and pretend that we want to stop sitting in red chairs, we only want to sit in blue chairs. Let’s pretend we want to make this change because we notice that in red chairs, because only red chairs have cushioning, we sink in to the seat and find it harder to pay attention. Blue chairs don’t encourage day-dreaming because they have harder plastic seats and backs, so we sit more upright. So even though we’ve grown accustomed to sitting in red chairs, we only want to sit in blue chairs from now on. We make a decision and an effort to only sit in blue chairs.
One day, let’s say we’re having a good day, maybe we’re not really paying attention because we’re thinking about something especially pleasant, and we go to sit down and we sit in a red chair.
That’s all relapse is, a return to a previous behaviour. In this case, sitting in a red chair.
Going back to the “Trans Theoretical Model,” relapse was originally thought to be a final stage, and only optional. It took recognising relapse as a very natural and common phenomenon for the model to work.
This means that relapse is not only very common and exists in the vast majority of peoples’ change journeys, but it is, importantly, also not a sign that an effort has failed. It is unlikely someone will decide to make a change, learn a new behaviour, and never go back to a previous behaviour. The fact that someone tried to make a change and learned a new way of making lasting change more likely is the important part.
It just remains important, substance use or any other behaviour change, that we keep trying and do our best not to let relapse stop us.
References:
Prochaska, J. O., Norcross, J. C., DiClemente, C. C. (1995). Changing for good. New York: Avon.
About the Author 
Bill Arbuckle has worked in the field of addiction treatment since 2009. Bill specializes in treating addiction and trauma using Accelerated Experiential Dynamic Psychotherapy (A.E.D.P.) and Eye-Movement Desensitization and Reprocessing (E.M.D.R.).
Bill also has personal experience with addiction and substance use. He found the way out, back to the light, and works to help others do the same. He is the founder of Hard Road Counselling, a practice that specializes in addiction counselling in Vancouver, British Columbia.
