Book Review: Addiction and Change: How Addictions Develop and Addicted People Recover

• Author: Chantal Plourde
• Published date: 01 May 2005
• Date: 01 May 2005
• DOI: http://doi.org/10.1177/0734016805275709
• Subject Matter: Articles

Addiction and Change: How Addictions Develop and Addicted People Recover,by

Carlo C. DiClemente. New York: Guilford Press, 2003, 317 pp.

DOI: 10.1177/0734016805275709

As implied by the title, this book describes addiction using the Transtheoretical Model

(TTM) of intentional behavior change developed over a 20-year period. This model first

emerged from a study involving individuals who recovered from smoking addiction. This

time, Carlo C. DiClemente presents a perspective that takes into account how individuals

become addicted and the process from which they can free themselves by following a com-

mon path. In this book, the author offers a panoramic view of the continuum of addictive

behavior change, including problematic behaviors such as substance abuse, tobacco, eating,

gambling, and so on.

Divided into four parts, this book begins by introducing the author’s conception of addic-

tion and of recovery (as a change process), then pinpoints the process’splace among the other

processes (social/environment, genetic/physiological, personality/intrapsychic, coping/

social learning, conditioning/reinforcement, compulsive/excessive behavior,

biopsychosocial) that have worked on the comprehension of addiction. As well as offering a

better comprehension of the TTM’s place, this brief section shines an interesting light on the

strengths and weaknesses of traditional models used to explain dependency.As described by

the author, the TTM bring together ideas from many different perspectives, by focusing on

the individuals’ pathways leading up to behavior change and by identifying key elements

involved in this process: The TTM is meant to be a common ground. Still, in the book’s first

section, the author presents the history and does an overview of the model. Basically,it can be

said that DiClemente views addiction as a process of intentional behavior change and defines

four stages in the TTM: contemplation, preparation, action, and maintenance. He then pro-

poses that the same process marks both the path to addiction and the path to recovery and sug-

gests ways to tailor interventions to people at different points in the change process. While

identifying the limits of the categorization and the difficulties in classifying individuals, this

book includes a detailed explanation of the tasks and goals for every stage of change. The

TTM includes four broad dimensions that can be used to describe any path leading into and

out of addictions. These dimensions are the stages, processes, markers, and contexts of

change.

What makes this book distinguish itself from others implicating Carlo C. DiClemente

about the TTM is discussed in the second part of the book where the author applies the TTM

to the addiction process (which he called the road to addiction). The author explains that a

process similar to the path through recovery also characterizes the one to addiction. More-

over, he suggests that the stages of the addiction process can be applied to the process in

which an individual becomes addicted. The process, well described in this book, is very use-

ful to help the reader understand the pathways into and out of addictions through a panoramic

overall view of the phenomenon.

In the last part of the book, Carlo C. DiClemente takes time to discuss interesting and inno-

vative thoughts that are at the top of his priorities in offering an integrated framework and a

global view of the intentional behavior change process to his readers. He offers a whole part

of his book to what he calls “designing interventions” associated with the change process

(prevention, designing interventions for recovery, and research on addiction and change) and

the major part of the discussion is done through an innovativeand challenging perspective.

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