> ## Documentation Index > Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt > Use this file to discover all available pages before exploring further. # Substance use preset — stages of change > Prochaska's transtheoretical model laid out as a 5-stage progression with the relapse loop. One preset in this category — the Prochaska & DiClemente transtheoretical model (TTM), the foundation underneath most motivational-interviewing work. ## Stages of change Five boxes laid out horizontally with arrows between them: 1. **Pre-contemplation** (blue): not yet aware 2. **Contemplation** (indigo): weighing it 3. **Preparation** (amber): planning 4. **Action** (green): doing the thing 5. **Maintenance** (green): keeping it going Below the row: a red return arrow labelled *"Relapse — return to any earlier stage."* The relapse loop is part of the model, not a failure of it. **Use it for:** any substance-use or behavior-change work where the clinical question is *"where is this client right now in their relationship with change?"* The stages give you both a shared vocabulary and a way to match the intervention to the stage. The matching principle: * **Pre-contemplation** — don't push for action. Stay curious; build awareness. * **Contemplation** — explore ambivalence; weigh costs and benefits. * **Preparation** — concrete planning; specific commitments. * **Action** — support and reinforcement; troubleshoot obstacles. * **Maintenance** — relapse prevention; reinforce identity shift. Pushing for action when a client is in contemplation is one of the most common ways MI-rooted work goes wrong; the diagram makes the mismatch visible. **The clinical move:** drop the preset, ask the client to place themselves on the line. Often the first surprise is that they put themselves further back than you expected — or further forward. Either way, the conversation opens differently than if you'd asked *"are you ready to change?"*. The relapse arrow is clinically important. Normalizing return to earlier stages — especially from Action back to Contemplation — reframes relapse as a known part of the model rather than a failure of effort. **Search keywords** the picker matches against: *Prochaska*, *DiClemente*, *transtheoretical*, *TTM*, *motivational interviewing*, *MI*. Pairs well with the choice point preset ([Mindfulness + ACT](/whiteboard/presets-mindfulness-act)) — Action and Maintenance work is full of choice points; mapping the stages and the choice points side by side gives both the long view and the moment view. ## Related articles All 29 worksheets. Choice point pairs with action-stage work. ABC model for behavioral analysis.