Historically, changing an addictive behavior was assumed to be the same as taking action. People with addictions were viewed as changing when they quit drinking, smoking, or abusing other substances. Action-oriented therapies were readily available but only a small percentage of addicted individuals entered therapy, only about 50 percent completed therapy and only 25 to 35 percent were successful in overcoming their addiction following therapy. Action-oriented therapies impacted on a small percentage of addiction problems on a population basis.

In the late 1970s one-thousand ordinary people attempting to stop smoking taught us that change is a process which unfolds over time and involves progress through six stages of change: pre-contemplation, contemplation, preparation, action, maintenance, and termination. Creating therapies that match the needs of people at each stage of change has permitted us to reach, retain, and impact on more people than we ever imagined possible...