Since my transition from a traditional one-size-fits-all 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.

Fear about a young person's drug use can cause you to make bad decisions that can harm your child and your relationship with them. By tapping into what harm reduction and skilled parenting share, you can begin feel more at ease in dealing with your child's substance use.

Discovering that your child has started experimenting with drugs or alcohol is very troubling. Worry can quickly escalate into fear, especially when attempts to intervene fail. Many parents often feel helpless and out of control.

Confronted with the news that their child is getting high, the first question parents often ask me is, “How can I get her to stop?” The answer is, “That's not the best place to start".

As a harm reduction psychologist, I'm inspired by the courage and determination that people are able to summon up to help them cope with chronic, complex, often life-endangering problems. 

I'm sharing an example below from a mother who is kind (and brave!) enough and willing to share her story so others may have a better understanding of the rollercoaster journey that so many like her take. Her story is similar to many others with addicted children, but this is her unique path. The love of her child, her personal spirituality, along with courage and determination have supplied the hope for her to move forward in her life:

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 a harm reduction psychologist, 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.

Enabling as a badge of failure

Parents learn about the ‘evils’ of enabling when support groups and counselors, in the interest in creating healthier boundaries, encourage us to directly confront our kids and not back down to the often self-destructive manipulating that at-risk teens will engage in.