Measuring treatment effectiveness is problematic when a substance abuser does not enter treatment voluntarily. Furthermore, clients' goals and EAPs' goals for recovery may be in conflict. 2. It is preferable to determine treatment effectiveness by those changes in behavior, lifestyle, and quality of life that each substance abuser considers important for recovery. 3. The author found that substance abusers' goals progress through four stages: denial, dependence, behavior change, and life planning. 4. The recovering substance abuser who returns to work requires continuous follow up by the occupational health nurse. Client stage needs to be assessed and care must be planned accordingly.
