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.

Need help finding the right therapist?
Find Your Match

Meet the specialists


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

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 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

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 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 have worked in substance use field since 2016, mostly with the adolescent population. I work through a harm reduction point of view as one it can be dangerous to suddenly quit "harder substances" but also because it makes it less likely for relapse to occur. This treatment has also worked for those individuals who self-harm, by finding healthier ways to cope while reducing the negative coping skills being currently engaged.

— Juzmin Molina, Licensed Mental Health Counselor

Harm reduction recognizes that a person’s relationship to drugs and alcohol is often complex, and takes a non-judgmental approach to helping people reduce the negative impact of substance use, abuse or dependence in their lives. One essential Harm Reduction principle, that is qualitatively different from the 12-Step model, is that any amount of improvement is a good thing.

— Paul Silverman, Marriage & Family Therapist in San Francisco, CA

When working with people who are coping with self-harm, addiction, and body image issues I take a self-harm approach. I have found that an abstinence only approach does not work for many people who are scared to completely give up a behavior that might be their only source of comfort. I work with clients in order to help the reduce the problematic behavior in order to help reduce the harm they are causing to themselves or loved ones. Sometimes this leads to client's dropping the maladaptive behavior completely or sometimes it means helping them manage it to the best of their ability. Of course this approach is not right for everyone. For people who need a higher level of care I offer educational consulting for inpatient treatment and make referrals as necessary.

— Elizabeth Sockolov, Associate Marriage & Family Therapist in Petaluma, CA

I work with clients with a range of goals related to their substance use, from a trauma informed perspective. I can work with clients pursuing abstinence, moderation, harm reduction, or seeking to process beneficial aspects of their substance use, particularly related to cannabis, ketamine, or psychedelics. For the past 5 years I have been director of the harm reduction counseling program for Chicago Recovery Alliance.

— Geoff Bathje, Psychologist in Chicago, IL

As a clinician with experience working with addiction, homelessness, sex work, and abuse, I take a strong harm reduction approach. I understand that change does not happen overnight, and have extensive knowledge of harm reduction-based coping strategies.

— Natalie Winicov, Clinical Social Worker

2.5 years in addiction counseling with focus on harm reduction

— Jennifer Rosselli, Licensed Mental Health Counselor in Acton, MA

Sometimes people are unable to stop a harmful habit or behavior (such as drug use, or spending habits) until other areas of their lives feel more manageable (like their work, or home lives). In these situations, while stopping the habit would be ideal, it may not be feasible. Instead I may work with you on identifying the underlying cause of a symptom (the habit) and then collaborate with you on how to reduce the harm caused by the habit, while also working on the underlying cause.

— Halley Palmer, Licensed Clinical Social Worker in Buzzards Bay, MA

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

I have been practicing harm reduction since 2005, when I started volunteering to hand out bleach kits to youth experiencing housing insecurity and homelessness outside of my hometown: Detroit, MI. Since then, I have worked with sex workers, folks living with various addictions, people in recovery, individuals who self-harm, clients facing chronic suicidality, and others often navigating risk, to do so as safely as possible, and with dignity.

— Lance Hicks, Clinical Social Worker

Many of my clients often are attempting to manage either previous trauma or another overwhelming issue by using the tools that they have on hand which have worked to contain the symptoms, but often create their own problems. This can include substance use, self injury or another form of addiction. I work in a non shaming way with the client to help them incorporate more safety and expand their options for managing their pain.

— Catherine Keech, Licensed Marriage & Family Therapist in Oakland, CA