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about Harm Reduction Therapy

Harm reduction psychotherapy

Harm reduction psychotherapy is a model created by Patt Denning as an alternative to traditional treatment models.  Essentially it incorporates basic tenets of harm reduction and applies them to a psychotherapy setting. 


In this model, it is accepted that issues with drugs and alcohol are biopsychosocial in nature.  Meaning that use, or addiction, is rooted in our biology, our psychological make-up and our social network or environment. 

Harm reduction psychotherapy seeks to meet people where they are.  It places the utmost importance on assisting people to first reduce harm to themselves or others caused by drug and alcohol use.  This approach also places great importance on getting to know each person and their relationship with drugs and alcohol. 


Harm reduction therapy views each person as an individual who has complex needs that may extend beyond just addressing substance misuse.  (Need help with the terminology?)

Harm reduction psychotherapy is different than other addiction treatment programs

Traditional drug and alcohol treatment models use a prescriptive approach and make assumptions about your substance use.  In these models, typically abstinence/sobriety is the only acceptable goal.  When people are not sure about that as a goal or feel they aren’t ready, they are often labeled as “unmotivated”. 


Additionally, most other issues are seen only within the context of drug and alcohol use.  Because of this, many approaches, assume that nothing can be addressed until the alcohol or drug use is addressed.  This often frustrates people who go in for help. 

Abstinence may or may not be your goal

Harm reduction is not against abstinence; it is one of many goals that a person may have.  Whatever your goal, I will work to support you through collaboration, pragmatism and compassion at a pace that works for you. 


Sometimes people use several different substances but feel that not all of them are problematic.  Harm reduction psychotherapy would support you in decreasing or ceasing what substances you feel are causing the issue, while respecting that not all use is problematic. 


For example, you may have weekend meth benders that are jeopardizing your job and relationship.  You may also drink alcohol a few times a week but feel that your alcohol use is controlled and not problematic. 


It is possible for some people to quit some substances, but not all of them.  For others, this approach may not work.  Your desire to try out different approaches or only quit some substances will be respected.


Reducing harm with Substance Use Therapy

Together, we will discuss your drug and alcohol use and your triggers or reasons for using.  Anywhere there is an opportunity to make use safer, I will bring this up to you.  Harm can be reduced by using less, changing certain patterns around your drug and alcohol use, not using certain substances at the same time, etc. 

One of the most well-known examples of harm reduction implemented as a successful public policy is designated drivers.  That campaign did not suggest that people should not drink, or even encourage people to drink less.  It simply accepted that people will drink and often in excess—and when they do, they should have a sober person drive. 


Harm reduction is non-judgmental and pragmatic.  If something can be made a little better and a little safer, then that is a positive step forward.

Harm reduction and connection

I had the opportunity to discuss the importance of harm reduction with my friend and colleague Juliane Taylor Shore, LPC-S, LMFT-S, founder of IPNB Psychotherapy of Austin.  We discuss harm reduction as it pertains to substance use therapy, as well as dispel some myths about this model and talk about the importance of compassion and connection.

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