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Treatment should fit the client’s circadian realities, especially post-stimulant dysregulation. Moving sessions to periods of higher alertness increases engagement and retention. A MAC integrates a structured sleep plan (consistent wake time, light exposure, caffeine limits, wind-down routine) and adds brief morning accountability check-ins or reminders through approved, secure means. This combination addresses both physiology and behavior. Insisting on mornings for “discipline” (A) ignores readiness and risks dropout. Monthly visits (C) are too sparse during instability. Diet (D) may help energy but won’t correct sleep-wake patterns alone. Measurement-based care tracks attendance, sleep metrics, and craving trends; contingency management can reinforce on-time attendance. As stability improves, session timing can be revisited collaboratively. Coordination with medical providers to assess for sleep disorders or comorbidities ensures comprehensive care.