The study is making an attempt at presenting the important role played by case conceptualization in preventing the difficulties that may occur in substance addiction patients, irrespective of the therapeutic type used. Conceptualization or formulation of the case means devising explanatory schemes or models of the problems confronting the patient during the therapeutic actions such as the patient’s convictions, way of thinking and beliefs system. We paid a special attention to the model proposed by the cognitive- behavioral approach, that is conceptualization on the case level, on the symptom problem level and on the situational level. We accomplished exemplification by presenting a case level model for changing the addictive behavior, represented by the five stages of change decision – making (precontemplation, contemplation, action and maintenance) by a patient with alcoholic addiction admitted for several times to the substance addiction department in our hospital. By the agent of that very patient we uncovered his problem agenda his motivation for changing and the stage of decision making in order to prevent relapses.