Recovery from addiction involves a significant change in behavior. The factors that regulate the persistence of dependence and motivation to control addictive behavior reflects aspects of the decisional balance between reflective and impulsive systems. Psychological changes that occur during recovery from addiction involve motivation and have been modeled as “Stages of Change” as an aid to therapists with a diversity of clients in various phases of recovery (Fig. 8) (DiClemente, 2007). Addicted individuals often fluctuate from precontemplation, e.g. no interest in changing their drug use and likely denial of problems, to contemplative, e.g. risk-reward analysis of the benefits of recovery vs. the negatives of addiction. These stages are consistent with an increasing involvement of frontal cortical function in behavior. The stages of preparation and action, taking specific steps to implement behavioral change, likely involve frontal-subcortical balance with increasing attention shifting to directed motivation and socially responsive behaviors. Lack if executive function leads to normal repetitive addictive behavior. This model of behavioral change has been criticized for focusing on conscious decision making and planning (West, 2005), when addiction involves associative learning
