Harm Reduction is an approach to counseling that values first and foremost reducing harm in a person’s life. It is an orientation or philosophy, but it is based in scientific research that has shown that clients are more likely to remain in treatment if they feel respected and therapy is collaborative. It doesn’t help to just tell someone to stop drinking or getting high. Oftentimes, it makes people want to rebel and do the opposite. So having your therapist insist that in order for them to help you need to be clean and sober just doesn’t work. In fact it is paradoxical or ironic. “If I knew how to control my drinking or to stop snorting cocaine I wouldn’t need to come to you in the first place.” So a Harm Reduction approach acknowledges that a client is going to do what a client is going to do and there is not a whole lot that a therapist can do to make that person change unless the person is ready and motivated to change on his or her own.
There are hundreds of examples of harm reduction in society these days. There is ample research to suggest needle exchange programs reduce HIV/AIDS, illness, crime etc. Many treatment programs now encourage patients to reduce the frequency of drug or alcohol use, the amount of use, the time someone is drinking or drugging and the strength of a substance. For example, a first attempt might be to limit drinking to weekends or to limit the amount of drinks to 4 or 5 over a long evening. That might seem like a lot to some, but it’s far better than drinking 18. Switching to beer from liquor is a harm reduction technique. Stopping hard drugs and only drinking and smoking pot is a harm reduction technique. For many people, a harm reduction technique is the first step to the recognition that their behavior is having very real detrimental consequences. We also hope that many of our patients will eventually give abstinence a try. But you can’t work with a patient who doesn’t want to come to therapy and insisting on abstinence doesn’t work. How many therapists does it take to change a light bulb…? One, but the light bulb has to want to change. This captures the Harm Reduction model and the importance of clients recognizing and understanding their intrinsic motivation to make changes in their lives.
Recovery and Harm Reduction in Philadelphia- http://www.williamwhitepapers.com/blog/2013/10/recovery-and-harm-reduction-in-philadelphia.html – Selected Papers of William L. White.
Harm Reduction Definition Wikipedia – https://en.wikipedia.org/wiki/Harm_reduction
Harm Reduction for Alcohol-http://hams.cc/ – Supports safer drinking, reduced drinking or quitting.
Center for Optimal Living NY – http://centerforoptimalliving.com/ Model practice for Harm Reduction in NY.
Practical Recovery – https://www.practicalrecovery.com/ – Model practice for Harm Reduction in CA.
Moderation Management http://www.moderation.org/ A not for profit lay person led web site with meetings, links to therapists and support for individuals seeking a harm reduction approach.