Participants showed equally significant improvements with cognitive therapy, alcoholics anonymous, and a harm reduction approach. Marlatt, who was also the director of the universitys addictive behaviors research center, was one of the first researchers to understand the. Her publications for professionals include practicing harm reduction psychotherapy. Harm reduction therapy is the treatment approach of the harm reduction movement. He conducted pioneering research in harm reduction, brief interventions, and relapse prevention. The wisdom to know the difference harm reduction handout. The harm reduction therapy center exists to provide integrated mental health care and substance use treatment to people who, because their relationship with drugs is so intertwined with other emotional and social aspects of their lives, need more than simple just say no solutions and mainstream programs.
He was a recipient of honors including the jellinek memorial award for outstanding. Larimer works in this session with a high school boy who regularly drinks to excess. It is important to be clear that the message of harm reduction is not antiabstinence. The zerotolerance position, implicit in the relapse prevention model, has been a conspicuous failure in areas such as drug addiction and alcoholism. Practicing harm reduction psychotherapy, second edition. Alcohol use and harm reduction within the native community fransing daisy, lisa r. I present ten case studies, one of my own and nine from other harm reduction therapists. Andrew tatarsky, an innovative clinical psychologist practicing in manhattan, has produced a timely and targeted professional documentofpractice. Compared a 12 step program, cognitive intervention with focus on relapse prevention, and harm reduction met showed that each of the treatments were equally effective and that treatment matching was not necessary.
Andrew tatarskys integrative harm reduction psychotherapy ihrp as described in his book, harm reduction psychotherapy. Overview of harm reduction highlights of harm reduction. This ground breaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by different therapists, that vividly illustrate this treatment approach with a wide variety of clients. The rp model proposed by marlatt and gordon suggests that both immediate determinants e.
The therapist accepts the client on his or her own terms and tries to reduce barriers to treatment. For example, at one end of the spectrum, harm reduction may seek to reduce the risk of hiv transmission by supporting needle exchange programs. What we do chrt the center for harm reduction therapy. Harm reduction first emerged as a public health alter native to the moralcriminal and disease models of drug use and addiction marlatt, 1996. The center for optimal living is built on innovative, personalized treatment. According to tatarsky 2002a however, the big book of aa is the original harm reduction text and abstinence can be the best harm reduction approach. Abstract harm reduction is a paradigmshifting idea that has the potential to significantly improve the treatment of problem substance users. Harm reduction is a practical approach to preventing alcoholrelated harm, and evidence is mounting that it is more effective than traditional abstinenceonly approaches to prevention. What led to your specialization in the treatment of addictions at a time few psychologists were choosing that specialty.
The book this groundbreaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies that vividly illustrate this approach with a wide variety of clients, treated individually and in groups by different therapists. Its a multifaceted approach that brings together psychodynamic, relational, cognitive, behavioral, motivational, stages of change, and mindfulnessbased therapies in a harm reduction frame. Extending the reach of traditional substance use treatment. Bridging the worlds of harm reduction and addiction.
This deemphasis of abstinence is consistent with harm reduction philosophies and, more specifically, marlatts harm reduction therapy for substance use. The founder of harm reduction therapy talks about meditation, college drinking, 12step programs, and the limitations of abstinenceonly interventions. Alan marlatt on harm reduction for substance abuse. Harm reduction therapy is suited for anyone who is questioning whether their use of drugs and alcohol is a problem and is seeking effective solutions. He adds that marlatt was extremely systematic in his approach to his research. A new treatment for drug and alcohol problems 9780765703736. In this model, any reduction in the frequency or intensity of sexual offending is construed as positive. I can help you keep track of your drinking, and see whats going on. Andrew tatarsky born august 11, 1955 is an american psychologist, founder and director of the center for optimal living. Harm reduction keeps focus of attention is the damage done by the behavior and not the behavior itself.
This focuses on tools that humanistic practitioners can use to assist those suffering from addiction in a personcentered manner using new harm reduction philosophies and techniques. Tatarsky is known for developing integrative harm reduction therapy ihrp, a treatment for the spectrum. For a lot of these kinds of people, harm reduction therapy is the best alternative. This paper argues that the notion of harm reduction can provide a more useful framework for the management of sex offenders. Barry lessin 2017, who runs a private practice in philadelphia and is the cofounder of families for sensible drug policy, maintains five core beliefs of harm reduction that he tells.
Pragmatic strategies for managing highrisk behaviors marlatt, g. Gordon alan marlatt november 26, 1941 march 14, 2011 was a leading clinical psychologist in the field of addictive behaviors from the 1980s through the 2000s. Download for offline reading, highlight, bookmark or take notes while you read practicing harm reduction psychotherapy, second edition. An alternative approach to addictions, edition 2 ebook written by patt denning, jeannie little. An alternative approach to addictions patt denning. A personal report from the first national harm reduction conference in the united states g. Relapse prevention rp is an important component of alcoholism treatment. If you look at the outcomes of the ten cases, about half of them chose and successfully achieved moderate drinking, and about half of the cases chose and successfully achieved abstinence. Alan marlatt and associates, this is the authoritative work on harm reduction. Her book, practicing harm reduction is the bible in this alternative approach to treating addiction. This groundbreaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by. Individuals chrt the center for harm reduction therapy.
Alan marlatt applications to addictive behaviors and highrisk sexual behaviors. In 2015, she was invited to speak on her work at the white house and was honored with the new investigator award for her harm reduction treatment development in the university of washington scienceinmedicine lecture series. Alan marlatt memorial research award for her contributions to alcohol research. Harm reduction is a framework for helping drug and alcohol users who cannot or will not stop completelythe majority of usersreduce the harmful. Mark sehl, of the harm reduction psychotherapy and training associates, a treatment and training organization. Mar 15, 2011 many people claim to be pioneers in addiction treatment, but few have left a more important legacy than g. Born in vancouver, british columbia in 1941, marlatt received his ph. D othis groundbreaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by different therapists, that vividly illustrate this. Harm reduction is any action that attempts to reduce the harm of substance or other behaviors harm reduction has a top down public health component and a grass roots user driven approach. Marlatts harm reduction is a historically first if i am not mistaken overview of harm reduction paradigm. Widely recognized as an expert on drug treatment and dual diagnosis, she is one of the main developers of harm reduction psychotherapy. Over the influence the harm reduction guide for managing. Using mindfulness in a harm reduction approach to substance abuse treatment.
A personal report from the first national harm reduction conference in the united states, marlatt 2. Oriented toward working with the whole person, harm reduction pro. Develop an understanding of the key aspects of the harm reduction therapy model and its relevance in addictions counseling today. A new treatment for drug and alcohol problems, and will demonstrate how this treatment for substance abuse can be expanded to effectively treat other risky and addictive behaviors. Patt denning is the creator of the revolutionary san franciscos harm reduction therapy center. Relapse prevention an overview of marlatt s cognitivebehavioral model mary e. Most frequently associated with substance use, harm reduction also applies to any decisions that have negative consequences associated with them. Many people claim to be pioneers in addiction treatment, but few have left a more important legacy than g. Marlatt, director of the addictive behaviors research center at the university of washington and professor of psychology, focused much of his clinical and research life on relapse prevention and harm reduction, opening doors.
The first major harm reduction text, this provocative and timely volume examines a wide range of current applicationsfrom needle exchange and methadone maintenance programs. Basic principles and strategies of harm reduction g. Harm reduction is an increasingly recognized approach to the management of substance abuse and other behaviors that may pose serious health risks. A continuation of the editors series, remaining humanistic in a managed care world. Harm reduction is the single most effective approach to drug and alcohol problems because harm reduction uses pragmatic, evidencebased strategies that work. Applications to addictive behaviors and highrisk sexual. Alan marlatt, an expert on harm reduction and relapse prevention, works with an africanamerican client who is addicted to heroin and. H arm reduction therapy is an innovative approach that focuses on reducing the harmful consequences of drug use. Pdf using mindfulness in a harm reduction approach to. Alan marlatt, professor of psychology at university of washington, who died of melanoma on march 14, at age 69. My vision for applying harm reduction to therapy is called integrative harm reduction psychotherapy ihrp. Some harm reduction advocates might argue that gradualism is not necessary because harm reduction already includes abstinence as part of its continuum of care. Pdf harm reduction therapy for cooccurring disorders.
The challenge of harm reduction psychotherapy networker. In harm reduction therapy, any treatment goal that helps reduce harm to an individual is valid both abstinence and moderate drug and alcohol use fall under. Patt denning, phd, is director of clinical services and training at the harm reduction therapy center, san francisco. D this groundbreaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by different therapists, that vividly illustrate this treatment approach with a wide variety of clients. My book describes how this plays out within harm reduction therapy. And we dont want anyone to have to suffer any more than they already are. The humanistic roots of harm reduction apa divisions. Marlatt conducted pioneering work on understanding and preventing relapse in substance abuse treatment and was a leading proponent of the harm reduction approach to treating addictive behaviors. Harm reduction diverges sharply from the currently accepted treatment model for alcohol and drug problems. Harm reduction guide to coming off psychiatric drugs, a text from the icarus project and the freedom center, deftly tackles a delicate issue in mental health. While some do believe that abstinence is a part of harm reduction marlatt et al. Harm reduction principles and strategies are designed to minimize the destructive consequences of illicit drug use and other behaviors that may pose serious health risks. Rather than defining drug use as a disease or a moral failing, harm reduction proponents stake out a humane and practical alternative meeting clients where they are at to help them understand the risks involved in their behaviors and make. Harm reduction therapy, and harm reduction therapy groups, particularly the dropin groups discussed in this paper, extend a lowthreshold welcome to people with unresolved substance abuse problems.
This excellent book brings together researchers and practitioners who have made significant contributions to the growth and acceptance of harm reduction as an integral, viable, and effective approach to minimizing the negative consequences of highrisk behaviors. Relapse prevention an overview of marlatts cognitivebehavioral model mary e. On gradualism and the building of the harm reduction. Harm reduction with high school students illustrates a brief intervention for working with risktaking high school students that emphasizes helping students to recognize the potential outcomes of their risky behavior and creating motivation for change. Alan marlait university of washington abstractthe purpose of this paper is to describe what harm reduction is, how it devel oped, how it works, and why it is becoming a major approach in. Relapse prevention for cannabis abuse and dependence. Basic principles and strategies of harm reduction, marlatt ii. Theres a fire in my house and youre telling me to rearrange my furniture. Alan marlait university of washington abstractthe purpose of this paper is to describe what harm reduction is, how it devel oped, how it works, and why it is becoming a major approach in the addictive behaviors field.
Harm reduction and individually focused alcohol prevention. Pdf integrating harm reduction therapy and traditional. Marlatt and others continued to refine this experimental design and the study triggered a rash of studies using the design, according to frederick rotgers, a harm reduction therapist and president of the society of addiction psychology. He has a private practice in new york city specializing in harm reduction psychotherapy with drug and alcohol users and is codirector, with dr.
An alternative approach to addictions this acclaimed clinical guide, now substantially revised and updated, has helped thousands of clinicians put the proven principles of harm reduction into practice with therapy clients who have substance use. Recognizing the complexity and multiple meanings of these issues, we promote. Alan marlatt, 9781462502561, available at book depository with free delivery worldwide. Peeles diseasing of america is an intense but poignant critique of the 12step recovery industry. Marlatt s harm reduction is a historically first if i am not mistaken overview of harm reduction paradigm. More recently, harm reduction therapy hrt has come forth as a humane and pragmatic alternative to traditional abstinencebased addiction. Harm reduction is an umbrella term for interventions aiming to reduce the problematic effects of behaviors marlatt, 1998. View patt dennings profile on linkedin, the worlds largest professional community. People who seek us out have tried abstinencebased approaches and found them to be ineffective or undesirable. The author is a phenomenal clinician and great writer as well as a fantastic teacher. Harm reduction is a pragmatic approach that meets people where they are at. Integrative harm reduction psychotherapy is for individuals and families struggling with substance use issues, other risky or addictive behaviors, and a wide range of mental health issues.