Harm Reduction Therapy

Harm reduction, or harm minimization, accepts that idea that many people can’t or won’t completely stop using drugs or alcohol. The term “harm reduction” refers to a framework for helping reduce the harmful consequences of use when abstinence is not a realistic option. Although harm reduction was originally and most frequently associated with substance use, it is increasingly being applied to a multitude of other behavioral disorders. A core tenet of harm reduction is a relaxation on the emphasis on abstinence as the only acceptable goal and criteria of success. Instead, smaller incremental changes in the direction of reduced harmfulness of drug use are encouraged and accepted. Think a therapist armed with harm reduction techniques might be right for you? Reach out to one of TherapyDen’s harm reduction experts today.

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I have spent many years exploring and learning harm reduction therapy as it relates to addiction, hoarding disorders, and management of mental health symptoms.

— Sarah Vogt, Clinical Social Worker in West Bend, WI

As a therapist, my expertise in harm reduction therapy is based on extensive training and experience. I prioritize compassion, non-judgment, and meeting clients where they are in their journey. I successfully support clients in reducing harm associated with substance use by using a client-centered and strengths-based approach. My commitment to harm reduction is rooted in a compassionate and non-stigmatizing approach that respects clients' autonomy and promotes positive change at their own pace.

— Peter Addy, Licensed Professional Counselor in Portland, OR

Harm Reduction aims to decrease the negative consequences of a person's drug use without necessarily reducing the consumption of drugs. It honors an array of goals - not just abstinence. Although harm reduction is most commonly applied in a substance use context, it can be applied to any behavior that is concerning to you (self harm, isolation, overworking, etc). It can be helpful for reducing the downsides of that risky, exciting thing you do or that familiar coping mechanism you cherish.

— Aerin Riegelsberger, Associate Clinical Social Worker in Oakland, CA

Harm Reduction work involves instilling hope, focusing on safety, and not waiting for someone to go through the pain and lasting damage of hitting “rock bottom.” For over two years, I ran a Harm Reduction residential program for veterans, and now I supervise a Drop-In counseling center for veterans with a Harm Reduction focus. I have attended the national Harm Reduction conference and learned from some of the leaders of this progressive approach to helping people who use substances.

— Jacob Donnelly, Licensed Clinical Social Worker in Berkeley, CA

Harm reduction can assist in helping clients who are ready to begin stages of change without completely eradicating undesired behaviors, such as self-harming, by replacing them with less harmful behaviors.

— Mariah Masell, Social Worker in Grand Rapids, MI

Harm reduction work is grounded in substance use treatment, and its tenets can also apply to other arenas. Its deeply relevant for people who are engaging in self harm, emotional or binge eating, as well as for people who are very good at beating themselves up emotionally. Any way in which we can reduce the harm, hurt, and suffering of another human being is a gift.

— T.Lee Shostack, Clinical Social Worker in , MA

My career has been spent working towards reduced harm for all clients. That often requires out of the box and individualized thinking. Often, mental health treatment is given and it is required that a client fit into the modality to 'succeed'. Harm Reduction leads to more authentic and improved outcomes as it meets the person where they are at and builds upon small successes. It is an Empowerment-based practice utilizing one's own knowledge, skills and experience.

— Laurie Smith, Licensed Clinical Social Worker in Plymouth, MI

Harm reduction begins with the basic assumption that it is possible to have healthy relationships with the behaviors and substances you choose to engage with in your life. Harm reduction does not demand abstinence, but sometimes taking a break can help you get a new perspective. If you are concerned that you have an unhealthy relationship with a substance, habit, or even a person, let's take an honest look together to find ways to reduce harm and increase your sense of satisfaction in life.

— Lucius Wheeler, Licensed Professional Counselor in , OR

My approach to supporting clients with alcohol or drug challenges is inclusive of those who may not desire or be ready to completely stop using. Sobriety may be your goal, or you may simply aim to decrease your use or have a healthier relationship with substances. While moderation may not work for everyone, we can certainly work to reduce negative impacts in your life. I also support the use of medication management (such as to reduce cravings).

— Zena Caputo, Licensed Marriage & Family Therapist

I have worked with this approach within LGBTQ+ populations and with people struggling with addiction. I have also presented professionally on this topic.

— Margaret Keig, Licensed Marriage & Family Therapist in Maitland, FL

Harm reduction is a proactive and evidence-based approach that incorporates a spectrum of strategies that meet people “where they are” on their own terms and may serve as a pathway to reduce the negative personal and public health impacts of behavior associated with alcohol and other substance use at both the individual community level.-SAMSA. I have used this model for more than just substance use; because humans are complex, and attempt "escape" in many different ways.

— Holli Engelhart, Licensed Clinical Social Worker in Edina, MN

Although this is most frequently used in substance use treatment, it can also apply in other arenas. If there is harm to self or others, in what ways can we reduce the harm being enacted? What problems can we remove by making our actions less harmful to ourselves or others? Harm reduction can apply to whether or not we allow other people to "rent space in our heads" or to whether we accept hurtful statements from others. Reducing harm, hurt, and suffering is an incredible gift.

— T.Lee Shostack, Clinical Social Worker in , MA

Drinking water, wearing a seatbelt and using condoms are all types of harm reduction. Let's talk about the gentle way to get more clarity and groundedness in your life and reduce negative consequences.

— Treah Caldwell, Licensed Professional Counselor in Brookhaven, GA

Harm-Reduction used to be a term that professionals were afraid to use, particularly when it comes to treating substance use disorders. Harm reduction is more than treating individuals with behavioral disorders with dignity and respect. It is also about reducing the harm to the community. This is done by providing strategies that aims to minimize the negative health, societal, and legal consequences associated with substance use.

— Brian McCann, Social Worker in Chicago, IL

At the core of harm reduction therapy is a respect for human rights. Working from a harm reduction approach means that I meet you where you are and on your own terms when it comes to substance use of any other behaviors deemed "harmful" by society. My question is, "what would you like your drug use or sexual behaviors to look like," and we can work from your answer to determine how you can be safe and comfortable.

— Liz Silverman, Licensed Clinical Social Worker in Brooklyn, NY

Professor Bisher is an addiction specialist helping men quickly overcome compulsive sexual behavior (porn and sex addiction). He brings an empathic & empowering approach with a focus on achieving sustainable sobriety quickly.

— Blair Bisher, Addictions Counselor in Needham, MA