That there are stages of change.  The stages of change are;

1.  precontemplation- they don't realize that they have a problem

2.  contemplation-realize that their behavior is problematic

3.  preparation- really preparing to change

4.  action- activates a plan to change, implements plan

5.  Maintaining- maintaining, and sustaining a change in life

1.  Enable occupations by helping you do things easier, like staying awake.  Numbs you

2.  As a coping mechanism:  a-attempts to decrease anxiety; b-

mask distress, c- appear more confident, d-gain acceptance of other users, to enhance perception, occupation; religious spiritual, to develop a meaning to life, to cope with occupational imbalance

a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one or more of the folowing occurring within a 12 month period:

a. recurrent use resulting in a failure to fulfill major life roles

b.  recurrent use where it is physically hazardous, or recurrent use with legal problems

c.  persistent use despite persistent or recurrent social, or interpersonal problems caused by or worsened by the effects of the substance

A maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by 3 or more of the following in the same 12 month period:

*tolerance

*withdrawal

*taken in larger amounts or over a longer period than intended

*persistent desire or unsuccessful efforts to cut down or control use

*Great deal of time is spent in activities necessaqrty to obtain, use, or recover from the use of the substance

*important social, occupational, or recreational activities are given up or reduced because of use

*the use is continued despite knowing of having persistent physical or psychological problems likely to have been caused by or made worse by the substane

*can be with physiological or psychological dependence

Phase 1. Acute Crisis-accompanied by medical issues

Phase 2.  Withdrawal from substance-painful consequences keep BP under control

Phase 3- Sequalae of Substance Abuse-legal problems, social, family etc

Phase 4- Focus on predisposing causes- what caused this in the first place.  AA more accepted than rational recovery.  Rational recovery is not being labeled an alcoholic.