November 3, 2026
Medically Reviewed by: Dr. Guia Marie Canonizado , Medical Doctor & Nurse, Medical Content Specialist

Reviewed by Mel Samuels, BSocSci Psychology, Managing Director, Liberty Home Rehab. Reviewed: 3 November 2026.

Many families wait for the moment their loved one “hits rock bottom” or suddenly decides to stop. In reality, motivation rarely works like that. It tends to build gradually, fade, and build again. Understanding how motivation works can help both the person who is struggling and the people around them.

In this guide we explain the stages of change, why ambivalence is a normal part of the process, and how families can support someone who is not yet sure about getting help. Our article on motivational interviewing for addiction goes into the approach in more detail.

Key takeaways

  • The stages of change are precontemplation, contemplation, preparation, action and maintenance.
  • Mixed feelings, or ambivalence, are a normal part of change.
  • Listening, open questions and respect build motivation more than lectures.
  • People do not need to be completely ready before seeking help.

Motivation is not fixed

It is common to think of people as either motivated or unmotivated. Psychological research suggests motivation is better understood as a changing state, shaped by circumstances, relationships and how a person is spoken to. SAMHSA’s guidance on enhancing motivation describes it as a dynamic process rather than a fixed personality trait.

This is encouraging. It means motivation can be strengthened.

The stages of change

One widely used framework is the transtheoretical model, often called the “stages of change”, developed by psychologists James Prochaska and Carlo DiClemente. It describes several stages people move through:

  • Precontemplation. The person does not yet see their behaviour as a problem, or is not considering change.
  • Contemplation. They recognise there may be a problem and feel two ways about it.
  • Preparation. They are planning to change and may take small steps.
  • Action. They are actively making changes, such as entering treatment.
  • Maintenance. They are working to sustain change over time.

People do not always move through these stages in a straight line. Moving back and forth is normal and is part of the process rather than a failure.

Ambivalence is normal

Most people with addiction have mixed feelings. They may want things to be different while also fearing life without the substance, or worrying about what change will involve. This is called ambivalence.

Ambivalence is not the same as not caring. It is a natural part of considering any big change. Helping someone explore both sides, without pressure, often moves things forward more than arguing.

What helps build motivation

Approaches based on motivational interviewing focus on respect, empathy and the person’s own reasons for change. In everyday life, families and friends can use some of the same principles:

  • Listen more than you lecture. Ask open questions such as “How do you feel about your drinking lately?”
  • Reflect back what you hear. This helps the person feel understood.
  • Notice their own reasons for change. People are more persuaded by what they say themselves.
  • Avoid labels and blame. These tend to increase defensiveness.
  • Respect their choices, while being honest about your concerns and your boundaries.

What tends to reduce motivation

Some well-meant responses can make change feel harder:

Counsellor listening to a client exploring the stages of change
  • Repeated criticism or shaming.
  • Threats that are not followed through.
  • Taking over every decision.
  • Comparing the person unfavourably with others.

Readiness for treatment

People do not need to be completely certain before seeking help. Many enter treatment with mixed feelings, and motivation often grows once they feel safe, understood and less alone. A good treatment team will work with wherever someone is, rather than expecting them to arrive fully ready.

How to respond at each of the stages of change

Knowing where someone is in the stages of change can help you choose a response that fits, rather than one that pushes them away.

  • Precontemplation: share information without arguing, and keep the relationship open. Pressure at this stage usually increases resistance.
  • Contemplation: ask open questions about the pros and cons they see. Let them hear their own reasons for change.
  • Preparation: help with practical steps, such as finding information about treatment or booking an assessment.
  • Action: notice and acknowledge effort, and support the routines that help.
  • Maintenance: stay interested in their recovery over the long term, including after formal treatment ends.

Moving back a stage is common and does not mean starting from zero. Each attempt usually teaches something useful about what helps and what gets in the way.

If you are worried about someone who is drinking heavily, our guide on how to help an alcoholic offers practical next steps. You can also read about motivational interviewing at Liberty Home Rehab.

How Liberty Home Rehab can help

Liberty Home Rehab is a private addiction and mental health rehab in Cape Town for adults aged 18 and over. Our team includes psychiatrist Dr Imraan Tayob, medical doctors, social workers and lived-experience professionals who understand from first-hand experience how uncertain the early stages of change can feel.

We offer programmes of 28, 42, 56, 70 or 84 days across three phases, with secondary care at Liberty Home Rehab Manor and tertiary step-down care at Liberty Home Rehab Lodge. Both facilities are registered.

Liberty Home Rehab offers residential treatment in Cape Town. Medically supervised detox happens on site, registered nurses are on site 24/7, doctors are on call 24/7, and admission can be immediate, subject to bed availability. If you are looking for rehab in Cape Town, our team will talk you through the options in confidence.

Frequently asked questions

Does someone have to want help for treatment to work?

Wanting help is helpful, but it does not need to be complete. Motivation often develops during treatment.

Can I make my loved one ready to change?

You cannot control another person’s choices, but how you communicate can influence how open they are to change.

What if they go back to old habits after deciding to change?

Moving between stages is common. It is a signal to review support and plans, not a reason to give up.

What are the 5 stages of change?

Precontemplation, contemplation, preparation, action and maintenance. People often move back and forth between them before change lasts.

Talk to us

If you or someone close to you is thinking about change, even with mixed feelings, contact Liberty Home Rehab on +27 60 014 4200. A conversation does not commit you to anything.

If you are in South Africa and need to talk to someone today, the South African Depression and Anxiety Group (SADAG) also offers free support and information.

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