Transtheoretical Stages of Change
Maslow's Hierarchy of Needs
Denial Patterns
Expectations out of Recovery
100

John says, "My drinking is fine; everyone I know drinks this much." He shows no intention of changing his behavior.

Pre-Contemplation 

100

This is the most basic level of needs, including food, water, and shelter. 

Physiological Needs 

100

Someone using this denial pattern might say, "It's not that bad" or downplay the impact of their behavior. 

Minimizing 

100

Sarah feels like she is failing because her recovery isn't aligning with the timeline she created in her head. 

Unrealistic recovery expectations 

200

Sarah is weighing the "pros" of using cocaine to cope with stress against the "cons," such as the legal troubles she's facing. She hasn't decided what to do yet.

Contemplation stage

200
Aimee recently got hired at Vons and is living with her cousin. What needs are being met? 

Safety and Security needs 

200

When confronted, Maria insists her choices are caused by her partner, her job, or stress. Anything except her own actions. 

Blaming (projection) 

200

This term describes the belief that recovery will occur in a straight, linear path. 

Expectation of a "perfect" recovery 

300

David has made an appointment with a therapist and looked into local Narcotics Anonymous (NA) meetings. He plans to start attending next week.

Preparation stage

300

The desire for friends, family, and a sense of community falls under this category. 

Love and Belonging Needs 

300

This pattern involves making excuses or giving reasons to justify unhealthy behavior. 

Ex. "I only did it because I had a rough day." 

Rationalization 

300

Henry has been sober for one year. He assumed by now he wouldn't experience any triggers at all. 

Expectation of eliminating all triggers 

400

Paul has been sober for 18 months. He still attends a weekly support group and uses mindfulness techniques to avoid high-risk situations and prevent a return to his old behaviors.

Maintenance stage

400
Ernesto has been working hard on his recovery goals, but feels discouraged because no one acknowledges his progress. What needs are not being met? 

Esteem Needs 

400

A family member engaging in this pattern might make excuses for their loved one's behavior, call in sick to work for them, or bail them out of legal trouble.

Enabling 

400

This expectation shows up when a person believes others should react a certain way, like offering praise, support, or understanding, and becomes upset when they don't. 

Interpersonal expectations in recovery 

500

In this final stage, an individual no longer has any desire to return to their substance abuse behavior and is confident they will not relapse

Termination stage

500

This level represents the pinnacle of the hierarchy, encompassing the fulfillment of one's potential, creativity, and self-fulfillment. 

Self-actualization 

500

This emotional factor, often a key driver of denial, prevents individuals from seeking help due to a fear of social judgment or embarrassment.

Shame (stigma) 

500

Maria gets frustrated because she thinks her therapist is not "fixing" her. She gets upset when she realizes she has to work on herself internally. 

Passive/externally driven expectations