Journal article
Understanding the unique goals of complex support clients accessing alcohol and other drug treatment
BMC Health Services Research, Vol.25(1), pp.1-9
2025
PMID: 40176041
Abstract
Background: Actively involving clients of Alcohol and Other Drug (AOD) services in selecting their own treatment goals may help to align clients' and service providers' expectations of treatment and improve engagement with services. This study explored the type and frequency of client-selected treatment goals; self-reported progress towards their goals; client and clinician views of their progress, and the acceptability of selecting and tracking goals in a non-residential AOD treatment provider in New South Wales, Australia.
Methods: A mixed method study was conducted. Clients selected their goals during AOD treatment then self-rated their progress towards goals using the validated 11-point goal-based outcome (GBO) rating tool. Qualitative interviews were conducted with clients and clinicians. Mean GBO ratings were reported for each timepoint. Goals were thematically analysed to identify type, then descriptively analysed to identify frequency. Interviews were thematically analysed by one researcher and reviewed by a second.
Results: Among the 22 clients who completed the GBO at least once, the median number of self-identified goals was 3. The most common goals included: (1) managing mental health and (2) developing strategies to prevent relapse and manage AOD cravings. Most participants reported improvements in their selected goals; there were no participants who reported lower GBO scores at the second timepoint compared to the first. Qualitative themes demonstrate that while the GBO approach provided clarity for clients, was acceptable to clients and clinicians, and considered client expectations of treatment, the approach was difficult for those with limited literacy and reflexive thinking. Those experiencing lapse or relapse reported the linear GBO rating approach was potentially demotivating.
Conclusions: Findings demonstrate that a goals-based outcome approach can promote shared decision-making between client and clinicians about treatment goals which are valued by clients. Service providers should be aware of potential complexity of recalling selected goals and completing ratings particularly among clients with co-occurring mental illness and memory impairment. Goals that are time-specific, realistic and relevant should be prioritised to minimise risks of demotivation arising from non-linear progress towards goals.
Details
- Title
- Understanding the unique goals of complex support clients accessing alcohol and other drug treatment
- Authors
- Emily Deans (Corresponding Author) - UNSW SydneyWing See Yuen - UNSW SydneyGeorge Economidis - UNSW SydneyAnthony Shakeshaft (Author) - The University of QueenslandSara Farnbach - UNSW Sydney
- Publication details
- BMC Health Services Research, Vol.25(1), pp.1-9
- Publisher
- BioMed Central Ltd.
- Date published
- 2025
- DOI
- 10.1186/s12913-025-12559-2
- ISSN
- 1472-6963
- PMID
- 40176041
- Copyright note
- © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
- Data Availability
- The deidentified datasets generated and or analysed during the current study are not publicly available to protect privacy of participants but are available from the corresponding author on reasonable request.
- Grant note
- This work was supported by the South Western Sydney Primary Health Network.
- Organisation Unit
- School of Health - Psychology
- Language
- English
- Record Identifier
- 991242163202621
- Output Type
- Journal article
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