Schema Therapy: a Practitioner's Guide

Harm reduction is a pragmatic approach to reduce the harmful consequences of alcohol and drug use or other high-risk activities by incorporating several strategies that cut across the spectrum from safer use to managed use to abstinence. The primary goal of most harm-reduction approaches is to meet individuals “where they are at” and not to ignore or condemn the harmful behaviors but rather to work with the individual or community to minimize the harmful effects of a given behavior. The current review addresses some of the newest developments with respect to harm-reduction policy, prevention, and treatment. In particular, this review highlights policies and programs that have been evaluated in peer-reviewed journals and shown to be effective at reducing the harms associated with alcohol and drug use. The overall goal of this review is to present some of the most recent developments in the field of harm reduction.

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Update on Harm-Reduction Policy and Intervention Research

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Handbook of Alcoholism Treatment Approaches: Effective Alternatives

This study evaluated youth well-being 24-months after the conclusion of outdoor behavioral healthcare (OBH) treatment and explored how youth transition to a variety of post-treatment settings. OBH treatment involves integrating clinical treatment approaches with wilderness expeditions that average over 50 days. Transition from OBH treatment often requires that youth and family utilize aftercare services, which are typically: (a) outpatient services, which are comprised of individualized, group or family therapy, or (b) residential services, which are comprised of residential treatment centers, therapeutic boarding schools, and others. The results suggest that 80% of parents and 95% of youths perceived OBH treatment as effective, the majority of clients were doing well in school, and family communication had improved. Aftercare was utilized by 85% of the youths and was perceived as a crucial component in facilitating the transition from an intensive wilderness experience to family, peer and school environments. Results also indicated that many continued to use alcohol and/or drugs to varying degrees, had legal problems, and still had issues forming friendships with peers. OBH treatment was perceived as being a necessary and effective step in helping youths address, and eventually overcome, emotional and psychological issues that were driving destructive behavior prior to OBH treatment.

Two Years Later: A Qualitative Assessment of Youth Well-Being and the Role of Aftercare in Outdoor Behavioral Healthcare Treatment

Opioid Use Disorders.

Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems

Harm reduction, a framework for addressing substance use and other potentially risky behaviors, aims to reduce the harmful consequences of these behaviors without requiring abstinence as a goal or a prerequisite of treatment. It is an alternative to traditional treatments that require abstinence and extends the reach of treatment to substance users who are unwilling or unable to embrace abstinence. We believe this is the majority of substance users. Harm reduction has been called ‘‘compassionate pragmatism’’ (Marlatt, 1998) because it begins with the pragmatic acceptance that people are and will use drugs in ways that pose threats to themselves and their communities. Its compassionate and understanding view of these users allows for collaboration between consumers and professionals, which creates effective interventions. Harm reduction has a human rights agenda in that it is committed to bringing effective treatment to marginalized

State of the art in harm reduction psychotherapy: an emerging treatment for substance misuse.

This article is focused on improving the quality of addiction treatment. Based on observations that patients are leaving treatment too early and/or are continuing to use substances during their care, the authors propose six actions that could help reorient and revitalize this kind of clinical work: (1) conceptualize and treat addictive disorders within a psychiatric/mental health framework; (2) make the creation of a strong therapeutic alliance a core part of the healing process; (3) understand patients' addictions and other problems using models based on multiple internal parts, voices, or modes; (4) make contingency management and the use of positive reinforcement systems a standard and central practice in all treatment settings; (5) envision long-term change and healing through the lens of identity theory; and (6) integrate the growing developments in recovery culture with formal treatment.

https://www.tandfonline.com/doi/pdf/10.1080/07347324.2012.635544

Re-envisioning Addiction Treatment: A Six-Point Plan

Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence. This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies. A case is presented that illustrates the application of this approach with life-threatening substance use that was related to multiple trauma and suicidal depression.

Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality.

Over the last 70 years, the treatment of drug and alcohol problems has been an exciting, creative, heroic, and, at times, contentious endeavor. Although this is beginning to change, the numerous fa...

Andrew Tatarsky

Papers

Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems

State of the art in harm reduction psychotherapy: an emerging treatment for substance misuse.

Re-envisioning Addiction Treatment: A Six-Point Plan

Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality.

The Addiction Treatment Roundtable: A Clinical Wisdom Study