Since my transition several years ago from a traditional abstinence-based treatment approach to harm reduction psychotherapy, many clients whom I continued working with through my transition have remarked at how dramatically the harm reduction approaches have empowered them to move forward in their therapy and in their lives.
One client offered to share her experiences here to allow others to learn more about what harm reduction approaches can possibly do for them. Every effort has been made to keep her identity anonymous:
"AS A PERSON that has experienced both the rigid abstinence-only format of rehabilitation and the more flexible process of harm reduction treatment approaches, my preference is for harm reduction.
It's been almost two years since I lifted my head out the sand and discovered that harm reduction approaches offer me so many ways to be more effective as a therapist and addiction treatment consultant.
When I began using harm reduction principles such as 'people use drugs for reasons' 'meet your kid where she's at', I was worried that parents would think that I was condoning their kid's drug use. Well, I was pleasantly surprised that once parents understood the ideas a little better, they were more willing to embrace a different perspective and began to use these ideas to work at improving their relationship with their child.
I talked about the influences in my transition to integrating harm reduction principles into my work with my clients as well as my advocacy efforts to help change the failed public health policies that criminalize and stigmatize those with substance use problems.
An essay by Paul Carr in last weekend's Wall Street Journal which describes how he stopped drinking and what he learned along the way, is a great example of a harm reduction approach to an alcoholic figuring out what he needed to do to get and stay sober and the changes he’s made in his life that have worked so far. He talks about his ‘relationship’ with alcohol and the positive and negative aspects of that relationship leading to the changes that he made in his life.
Many of the comments/responses on the website following the article are disheartening to me because they reflect the gigantic gap in the recovery and treatment community about what elements are helpful for people to get and stay sober. Sadly, there’s an air of arrogance and even contempt from both treatment professionals and those in recovery for this man who found a way that works for him.
As an addictions counselor, it’s always a pleasure to work with parents who have the instincts and skills to maintain good communication with their teenager as well as the courage (and energy!) to set appropriate and consistent boundaries and limits.
Sometimes, however, these skills can be a double-edged sword and work against us, especially when the emotional and behavioral instability of our child keeps pushing us out of our parental ‘driver’s seat’ and into the passenger seat—or even worse, the back seat.
Being in the family back seat contributes to the fear that develops when we start losing control of a child’s behavior. This fear often motivates us to become even firmer in our resolve to ensure our child’s safety while keeping ourselves sane along with the rest of our family.