AOD workers are specialists in their field. It is important to acknowledge, however, that it is the client who is the expert on themselves. It is important that AOD workers listen to what clients want to achieve from treatment and use this as the basis of creating shared treatment goals. Listening to what clients want will assist in identifying other services that may need to be engaged. Listening will also assist with collaboratively developing a treatment plan that is tailored to the client and considers their social and treatment context and readiness for change [129]. Tailoring treatment to clients’ individual needs is associated with greater client-reported care satisfaction and perceived benefit from treatment [127, 130].
In terms of clients’ AOD use, the goal of abstinence is usually favoured, particularly for those whose mental health conditions are exacerbated by AOD use, or for those whose AOD use is more severe [131]. Abstinence is also preferred for those with more severe mental disorders (or cognitive impairment) because even low-level substance use may be problematic for these people [132]. Those taking medications for mental health conditions (e.g., antipsychotics, antidepressants, mood stabilisers) may also find that they become intoxicated even with low levels of AOD use due to the interaction between the drugs.
Although abstinence is favoured, it is recognised that many people with co-occurring conditions prefer a goal of moderation. In order to successfully engage with the client, AOD workers should discuss treatment considerations with their client, accommodate a range of treatment goals and adopt a harm reduction approach [129, 133, 134].