How do you go about talking to a friend about their addiction while being supportive and coming from a place of love?

Approaching a loved one about concerns regarding their either obvious or suspected problem with an addiction can be challenging to say the least. How is this to be done effectively? So much will depend on where they are at with acknowledging their problem. As a loved one, I believe it is important to have a basic idea of the Stages of Change people tend to go through when they change any behavior, including an addiction. This concept comes from decades of research by a group of people who wanted to understand how people change successfully. I highly recommend the book, “Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively” Forward by James O. Prochaska, John Norcross, Carlo DiClemente.

I believe it is important to understand these stages because it will determine how a loved one and even an informed counselor will approach the situation. Each stage has specific ways to help. 

Following is a brief explanation of the stages of change. When it comes to addiction, I only go over the first 5 stages of change. 

Stage 1: Precontemplation

This is what I call the proverbial “denial” stage. People in this stage are not even thinking about changing their behavior. When their behavior is brought up, they often get defensive and deny that their behavior causes any problems in their life. 

Stage 2: Contemplation

When someone is in this stage of change, they are thinking about changing their behavior. They may not know when or how but they know their behavior is a problem and they are considering making a change. When others bring up their behavior, they are much more likely to listen and not get defensive. 

Stage 3: Preparation

This is the “planning” stage of change. They are staring to do their homework and look for the best ways to go about stopping their behavior. Do they need professional help? What level of professional help to they need? This could be residential treatment, like a rehab center. This is where they will go and live for thirty plus days. They could join an Intensive Outpatient Program (IOP) or work with an individual therapist. These are the professional options. The non professional options is a support group such as AA or other Anonymous groups, Celebrate Recovery (faith based), or SMART Recovery (cognitive approach). Or, they could just decide to do it on their own without any professional or support group help. 

While they are in the preparation stage of change, they are also deciding the when they will implement the course of action they choose. This is usually within a short period of time. 

Stage 4: Action

This is what I call the “Nike” stage of change. This is when they “just do it”. They put into action their plan. They go to treatment or a support group. They stick to the date they chose to stop and do it. This does not mean their will not be slips or relapses, but if they stay in action, they get back on track and continue their plan of stopping. 

Stage 5: Maintenance

Maintenance is the stage I refer to as “recovery”. This is where they have been successful with their sobriety for a period of time and are maintaining it consistently. 

If someone will not admit they have a problem, then they obviously are in the Precontemplation stage of change. We cannot expect them to be in any other stage until they choose to get there. So how can you help in this situation? The authors of The Stages of Change teach that the best way to help someone in Precontemplation is to raise their awareness of the problems their behavior may be creating in their life. However, this does take some finesse from my experience. 

I have found that approaching the situation from a place of love, concern, and curiosity will give you the best chance for them to respond positively. It’s not a guarantee, it will just give you the best chance. 

Possible ways to to start the conversation: 

1. Can I ask what makes you believe you do not have a problem or issue with ________?
2. Would you be open to hearing some concerns I have about your drinking (or other substance or behavior)? 
   

Another good book is Crucial Conversations: Tools for Talking When Stakes are High by Joseph Grenny, Kerry Patterson, Ron McMillan, Al Switzler, and Emily Gregory. This book goes into great detail on how to have difficult conversations with others. 

Here are for steps they outline when addressing difficult topics:

1. See and Hear: 

Start by addressing the facts of what you have seen and heard. Do not talk about what you think is going on or what you assume is going on. Only state the facts. These are things that they could not refute, at least logically. 

2. Story:
 
Share what thoughts you are having about the situation. Your thoughts may or may not align with their thoughts and that is ok. This is where you can share your perceptions about the situation, right or wrong. 

3. Feel: 

Based on the facts and your story (or thoughts and perceptions about the facts), what feelings do you have. Examples may be worried, concerned, afraid etc. 

4. Act: 

What are you requesting they do? Or do you have specific boundaries that need to be set based on the behavior you have seen? You might say something like, “Have you considered talking to a professional?” Or “Would you be willing to talk to someone and get a professional opinion?”

Obviously, there is not a guarantee that this will work. Especially, if they are deep in the Precontemplation stage of change. What is being done, is they know you care and are concerned about them and you may be planting a seed for them to consider that they may have a problem and they will move themself from Precontemplation to Contemplation, thus on the way to changing their behavior!