Client Care

Client Care

At First Step we believe that everybody deserves every chance to turn their lives around. 'Everybody' means:

  • regardless of income (that's why it's free)
  • regardless of location (that's why we have no geographical catchment)
  • regardless of drug use goals (we support harm minimisation goals [to use safely and less] as well as abstinence goals [to stop using])
  • regardless of intoxication (this is rare, but is not an obstacle to support)
  • regardless of diagnosis (mental health and/or substance use)

'Every chance' refers to the breadth of skills in the team, and the fact that we never give up on anybody.  Many of our clients are high functioning people in work and/or study that just need some clinical support.  Others have multiple vulnerabilities and need a full range of supports for some years.  Everybody . . . every chance.

We collect and repeatedly analyse and considerable amount of key data on all our clients in order to maximise the effectiveness of treatment modalities and to be aware of changing trends. Here are some recent intake stats at First Step:



To understand the work First Step does, all at no cost to the client, we can simplify the clinical landscape a little by describing three stages of treatment, and how we work with people in each of these stages.  Of course in the real world these stages overlap, and progress comes in fits and starts (including setbacks), but the Stabilise > Support > Empower model describes our multi-disciplinary service delivery model well.

STABILISE – GPs, Drug and Alcohol Workers, Care Coordinators

When a person first presents to First Step, the initial clinical need is often for safety and stability, and the emotional need is for non-judgemental empathy. In the ‘stabilise phase’ our experienced addiction medicine doctors and drug and alcohol workers quickly intervene to achieve improvements, sometimes life-saving ones, in the client’s mental and physical health.  This may involve the use of prescription medicines and other clinical supports while also working to overcome immediate psycho-social threats such as homelessness or domestic violence.  ‘Harm minimisation’ (doing everything we can to keep the client safe) and ‘dual diagnosis’ (focussing on addiction and mental health simultaneously) are core principles of this work.

SUPPORT – Mental Health Nurses, Gastroenterologists, Psychologists, Psychiatrists and Hep C specialists

Once immediate threats to mental and physical health are minimised, First Step doctors often work with people to develop an individualised Treatment Plan for long-term, team care during this ‘support phase’.  The plan often involves the introduction of our specialised Mental Health Nurses, fully-funded by Medicare to work with our people with whatever level of intensity (daily, weekly, fortnightly) is required to work towards their treatment goals.  During the support phase, people work with their clinicians to overcome long-term factors that are preventing them from achieving the best possible physical, mental and social well-being. First Step also has psychiatrists, gastroenterologists and Hep C specialists whose expertise is called upon when required.

EMPOWER – Lawyers and employment specialists

Before someone can begin to re-engage fully in the community and thrive, they often have serious institutional obstacles to their rehabilitation, such as long-term unemployment and legal concerns (usually dating from before they ever attended First Step).  First Step’s most innovative, non-clinical work is in this ‘empower phase’ when First Step Legal, our no-cost legal clinic, and our Employment Program, work with clients to achieve outcomes that enable them to stay in treatment and get back to work.  Strong relationships with drug courts and employers enable clients attending First Step to achieve outcomes that they themselves may have found hard to imagine when they first attended the clinic.