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 tenant 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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Harm reduction is just that--reducing harm wherever possible. I use this type of therapy for people who struggle with alcohol use, thc use, other substances, or other behaviors that could be done in a safer, less risky way. Abstinence works for some people but not for others. I won't put you into a one- size-fits all box.

— Amber Holt, Clinical Social Worker in Gig Harbor, WA

I provide a safe, nonjudgmental space for you to be yourself. I strongly believe therapy happens when the therapist can meet you at where you are.

— Serena Hsieh, Licensed Marriage & Family Therapist in Arcadia, CA

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

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

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 Orlando, FL

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 Intern in Ashland, OR

I studied over 10 different models of recovery, including Women For Sobriety, Rational Recovery, Seven Weeks To Sobriety, and Solution Focused Problem Drinking, to name a few. My belief is that many addiction and mental health issues are trauma based. I love Harm Reduction the most because it is a first step into what's underneath.

— Diane Adams, Clinical Social Worker in Alberton, MT

People aren't perfect and relapse is not failure. I've learned through my experience with clients who misuse substances that living and working conditions are not always optimal for promoting abstinence. In these cases, harm reduction is very useful but not always offered or tolerated in treatment programs. As a certified advanced alcohol and drug counselor, I embrace and utilize any proven therapies that are beneficial to my clients.

— LATEISHA ELLIOTT, Licensed Professional Counselor in Huntsville, AL

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

When working with clients who have substance use concerns I will meet them where they are at in their journey. I do not believe it is my decision as a counselor to force sobriety, or to encourage a client to take steps that they are not ready for. I believe in reducing the harm of using any substance and following the client's lead in the change process.

— Lauren Lewis, Licensed Professional Counselor in Loveland, CO

I got my start in counseling working at a Suboxone clinic. I understand there are many shades of gray with regards to substance use, and I believe that harm reduction is the most respectful approach to treatment. For folks in need, the Madison County Health Department provides a syringe exchange, as well as free testing for HIV and Hep C.

— Meg Brown, Associate Professional Clinical Counselor

Rebecca has worked with a lot of individuals who have current maladaptive coping strategies (e.g. nonsuicidal self-injurious behavior, substance use, etc.), and she has worked with client in harm reduction strategies that are the first step towards self-care.

— Rebecca Neubauer, Licensed Clinical Social Worker in Los Angeles, CA

Harm reduction means meeting you where you are and supporting you in the goals you have. That could include sobriety, reduction in use or exploring anywhere in between. There are no ultimatums.

— Frances Shelby, Therapist in Austin, TX