–Impact of use: Some clients may use substances extensively yet their use seems to have little or no impact on their biopsychosocial-spiritual functioning. Others may use very little but experience more severe impacts. The social worker should assess the client’s perceptions of the impact of substance use, as well as gather information to assess the actual impact. Although clients may be unable to identify these impacts themselves, establishing a timeline of use and biopsychosocial factors present in the client’s life can help establish connections between use and present circumstances. The level of denial the client experiences regarding the impact of substances provides the social worker with important information about the client’s readiness for change