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Stepped, person-centered care adapts to work realities. Night shifts distort circadian rhythms and increase risk for use and missed care. Moving sessions to the client’s alert window increases retention and allows skills practice when most needed. The MAC incorporates a sleep plan (consistent wind-down routines, light exposure timing, caffeine limits), screens for shift-work sleep disorder, and uses brief fatigue-management techniques (microbreaks, hydration, stretching). Monthly visits (C) are too sparse during instability. Punitive approaches (A, D) undermine alliance and rarely improve attendance without addressing structural barriers. Measurement-based care tracks attendance, craving windows, and sleep metrics; if needed, add contingency management for on-time sessions. Coordination with employers or EAPs (with consent) may enable consistent scheduling. This pragmatic alignment with the client’s life increases engagement, reduces relapse risk linked to sleep loss, and supports sustained behavior change.