New Ways of Helping Substance Misusers

As a psychotherapist and Master Addictions Counselor for many years I am pleased that we are learning new ways of helping substance misusers. Until recently if one was unable (for whatever reason) to grasp the traditional 'abstinence model' as success they felt like and were often treated as failures. Today the shame imposed by ones self and by others is no longer necessary. There is an additional mode of treatment called 'Harm Reduction' that is shame free and forward moving toward a healthier way of being, and sometimes meets up with the complete abstinence model. Dr. Andrew Tatarsky, a long-time pioneer in this area explains the distinctions here very nicely:

“How Does Harm Reduction Substance Use Treatment and Psychotherapy Relate to Abstinence-based Treatment?

  1. Harm reduction psychotherapy brings a therapeutic orientation of harm reduction settings and a harm reduction orientation to treatment settings.

  2. Harm reduction is a framework for setting up helping relationships "meeting people where they are" across the entire spectrum of diversity and along the entire continuum of care. 
    • Accept all positive changes/reductions in harm as success
    • Start where people are-radically!
    • Affirm small incremental changes as well as quantum change
    • Collaboration is at the heart of empowering change
  3. Harm reduction is an umbrella philosophy that engages people around all motivational stages of change and supports the full range of positive change goals including safer use/behavior, reduced use, moderation and abstinence.
  4. We begin wherever people are ready to begin and support them in moving toward and achieving their optimal goals as they define them.
  5. This "extends the reach of traditional substance use treatment" to the large group, arguably the majority, of problematic substance users who are not ready, willing or able to embrace abstinence as a goal.
  6. This lowers the threshold for entering treatment and helps bridge the continuum of care from public health harm reduction practices, to harm reduction psychotherapy, medication-assisted treatment to, and including, abstinence-oriented treatment.
  7. We don't need to know the destination to begin the journey of healing, growth and positive change!”