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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Meet the specialists

 

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

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
 

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

The use of harm reduction therapy includes a focus on the here- and-now, what is creating barriers in success, and how to lean into discomfort to create change.

— Heather Pierucki, Licensed Clinical Mental Health Counselor in Honolulu, HI
 

Self-Harm Reduction Therapy helps people work through their pain & suffering, instead of staying “stuck” and increasing it. Distress Tolerance is a DBT Skill that I teach clients, so they learn safe ways to survive crisis situations without making them worse. When we can accept reality for what it is, we can free ourselves from our own personal prison, and safely move forward to build a healthier life worth living.

— Cassie Konnoly, Licensed Mental Health Counselor in Lacey, WA

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
 

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

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
 

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

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 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

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
 

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

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 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