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


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

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

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

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 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

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

Change doesn't happen instantly. I work with clients who engage in risky behaviors including self-harm, substance use, disordered eating, gambling, etc but aren't ready to fully stop. These behaviors are rooted in wisdom as they serve a purpose and meet a need. We collaborate to identify these needs and develop new tools and strategies to reduce reliance on the behavior. Harm reduction helps reduce the damage related to the behavior using a realistic and non-judgemental approach.

— Julie Smith, Licensed Clinical Social Worker in Waterford, CT

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

You do not need to commit to full sobriety to begin increasing safety, health, & well-being in addiction. I will meet you wherever you are ready to begin healing whether that is reducing drug use, moderation, or full abstinence.

— Carli Watson, Licensed Clinical Social Worker in Grand Rapids, MI

This is specific for working with addiction and is not based on an abstinence model. HRT is tailored to the individual's relationship with alcohol and other drugs and incorporates other important problems: emotional disorders, family problems, social alienation, etc. It's a collaborative approach to explore the client's own barriers to change and to choose among a range of options such as abstinence, moderation, or other short-term goals.

— Ciara Jenkins, Licensed Clinical Social Worker in Yulee, FL

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

A harm-reduction approach that helps clients create an optimal relationship to substances, which may mean reduced or safer use, more controlled use, or none at all. I encourage you to use your motivation to make specific changes in your relationship with substances by using your own assessment of the place substance use has in your life. Before you can decide how to change this relationship, you must be clear about how your current use is problematic, if indeed it is.

— Ann Matney, Licensed Professional Clinical Counselor in Bozeman, MT

I believe that your safety and concern is important and should be the top priority. Even when you are using substance or drinking, you should receive treatment when you are ready not when you have stopped using. Combined with Motivational Interviewing, Harm reduction focuses on your safety even if you are using, you deserve to get the best treatment that I can provide.

— Barry Tan, Counselor