Title : Implications for goal-setting in recovery support design

Time is a central yet often under-theorized dimension in drug addiction recovery, shaping how individuals perceive progress, sustain motivation, and integrate behavioural change. Goalsetting, a well-established mechanism in behavioural psychology, provides a structured means through which individuals organize their actions across time. Goal-setting functions as a corrective cognitive framework by anchoring behaviour to explicitly defined future states. Short-term goals create proximal reinforcement and support early abstinence by reducing the subjective temporal distance between effort and reward. Long-term goals, by contrast, facilitate identity reconstruction and meaning-making, allowing individuals to conceptualize recovery as a coherent life trajectory rather than an isolated behavioural intervention. Empirical studies indicate that effective recoveryoriented goals share several characteristics: they are temporally structured, hierarchically organized, and dynamically adjustable. Temporal structuring, such as daily, weekly, and milestone-based goals, helps individuals manage the extended and nonlinear nature of recovery. Hierarchical goal systems link immediate behaviours (e.g., attending therapy sessions) to distal outcomes (e.g., occupational reintegration), strengthening perceived contingency between present action and future benefit. Dynamic adjustment of goals, over time, accommodates fluctuations in motivation, cognitive capacity, and environmental stressors, which are common during recovery. Neurocognitive evidence further suggests that goal-directed behaviour engages executive control networks that are often compromised in addiction, particularly within prefrontal regions implicated in planning and temporal integration. Repeated engagement in goal-oriented activity may therefore contribute not only to behavioural stability, but also to gradual restoration of cognitive functions related to time management and self-regulation. Goal-setting mediates the relationship between time perception and recovery outcomes by transforming abstract future-oriented change into actionable temporal sequences. Understanding recovery as a temporally extended process supported by adaptive goal structures has implications for treatment design, relapse prevention, and long-term recovery maintenance. We hypothesize that setting at least one short-term and at least one long-term goal contributes to substance use recovery through maintaining connections with other people in recovery. Our study reports on design implications from a statewide effort in the state of Alabama, USA to systematically collect goal-related data from community recovery resource centres throughout the state. Alabama, USA has historically had the highest opioid prescription rates in the US and has topped the overdose death rate. While those numbers are decreasing in Alabama, they are also decreasing across the USA. Illuminating “connecting points” with those in recovery is critical to this sustained progress.

Sue Feldman, RN, MEd, PhD, FACMI, is Professor and Director of Graduate Programs-Health Informatics in the School of Health Professions at the University of Alabama at Birmingham. Her research focuses on health information systems for social good and social protections. Her international and domestic research in health, wellness and social-benefit initiatives has been funded by The World Bank, The Asian Development Bank, The Centers for Disease Control and Prevention, and The Centers for Medicaid and Medicare Services. Awards include Changemaker in Health, Mentor of the Year, Faculty Innovator of the Year. She is a graduate of Claremont Graduate University.