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

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

Book edited by Andrew Tatarsky

I have been interested in what Andrew Tatarsky has to say after hearing him on a blog talk radio show hosted by Kenneth Anderson some years ago http://www.blogtalkradio.com/harm-reduction/2012/03/30/the-center-for-optimal-living, he has a website here http://andrewtatarsky.com/site/where he talks about Integrative Harm Reduction therapy which he describes as a personalized treatment for substance misuse and addiction that goes beyond the one size fits all model of abstinence.

I have mentioned Andrew Tatarsky and this book, a few times on the site as I feel he has some great ideas that can help a wide range of people. He has evolved his approach over years to make great use of Harm reduction techniques to treat addiction. I certainly do not think a one size fits all solution, such as a 12 step approach is going to work for everyone, I believe Harm Reduction, using a wide range of support methods and therapy, can be tailored to help an individual. I was certainly helped by therapists who followed the Marlett approach, rather than the 12 step model in my own recovery, even though I had used the 12 step solution for support for about a year. I see support as something different from therapy.

Ironically Monica Richardson had Andrew on her show the same day that I posted this so here is a link to their discussion. http://www.blogtalkradio.com/saferecovery/2015/03/18/andrew-tatarsky-harm-reduction-expert

The Book


Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems is probably not aimed at me, but more for professional therapists.  The chapters consist of case examples by ten different therapists and describes how they have helped individual clients. Some of the methods used were similar to the things that helped me. The methods are about making behavioural change over time, rather setting abstinence, as an only goal.

I think that this book is really important and should be read by everyone in the treatment field. There are too many people out there who have basic counsellor training, and who try to push the 12 step solution on everyone, even though it has a low success rate on its own. (there are also some awful  non 12 step counsellors!) A lot of addiction treatment is out of date and uses broad based ideas, rather than looking at the needs of an individual. This book shows how examining what is driving addiction, in different people, as well as looking at other issues affecting a patient’s life, is so important in determining how to treat them.

The book looks at the value and limitations of various solutions, including the 12 step solution. In fact the 12 step meetings were used along side therapy to provide some social support to an individual in a great account in one of the case studies. I think this helps show how Harm reduction therapy can be used along side a traditional support group, even though some people seem to think that these solutions cannot be combined.  This is different to just pushing the 12 step approach as a solution and is something that I do feel can be helpful for some people (and was for me for my early recovery). He talks about how he has modified his approach over the years after becoming disillusioned with traditional recovery “abstinence only ” solutions.

Although I mentioned that the book is aimed at people working in treatment, rather than somebody such as myself, I still found it helpful and would recommend it to people in recovery or those family members who are attempting to support somebody who wishes to beat addiction. It is certainly worth reading if you are considering therapy, because it looks at the diverse problems that people with addictions can face and why a traditional solution may not be effective. Too many people think that sending somebody to a rehab is the best way and that it is the person’s own fault if they do not remain abstinent afterwards. I view this as an unrealistic approach and that the most effective solutions are always going to be those with aims that include goals which are achievable for an individual and ones that they are motivated to work towards. I am sure people will identify with some of the problems faced by patients in the book and can look at how they were treated, and this could help them with finding the best type of support that will aid their own recovery. It takes a lot of skill to build a successful programme for an individual, while supporting them and dealing with suicidal thought or bad depression, and many in the recovery treatment world are not trained to deal with these issues effectively.

Towards the end of the book the is a good section on the pros and cons of support groups and the problems people with dual diagnosis may face. There is a good description of the “sobriety support group” which seems a great way to run a support group compared to AA and one which would have suited me! He talks about the difference between ambivalence and denial which I feel is an important concept and how that is best addressed in a group. It is a shame that there are not more groups available to people who run along the lines of the “sobriety support group”.

Books like this are important, as addiction treatment has been slow to modernise and many of those who join the addiction industry, are ex addicts with a small amount of training. This book illustrates the need for some lengthy complex treatment, for some people and why a treatment approach should be tailored to the individual. There is a tendency for there to be a them or us approach in addiction or substance abuse solutions, but this book takes a step back and looks at how a variety of methods can be used at the same time, to help people.

The book has had some great reviews and can be bought from Amazon. http://www.amazon.com/exec/obidos/ASIN/0765703521/qid=1020456010/sr=1-1/ref=sr_1_1/002-1281678-5544850

I have reviewed some other books that tend to be about alternatives to the 12 step solution on my site  here https://www.recoveringfromrecovery.com/book-reviews-recovery/ 


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