Starting Where the Client Is: Harm Reduction Guidelines for Clinical Social Work Practice
- 5.3k Downloads
Harm reduction has gradually entered social work discourse and is now seen as a promising approach for treating individuals with drug and alcohol problems. However, beyond statements and data supporting the utility of a harm reduction approach, few guidelines for clinical practice have been detailed in the social work literature. This lack of concrete detail regarding how harm reduction is actually practiced limits the potential implementation of the model into day-to-day clinical work. This article reiterates that harm reduction is a viable approach to clinical social work practice with individuals who have drug- and alcohol-related problems and for whom traditional approaches may be inappropriate. It focuses on harm reduction therapy as an emerging treatment model that can be implemented by clinical social workers and mental-health and substance use treatment providers. The article identifies and elaborates several basic tenets that can be incorporated into clinical social work. It is hoped that social workers who learn how harm reduction is implemented in clinical practice will be more apt to incorporate its principles into their work.
KeywordsHarm reduction Clinical social work Harm reduction therapy Addiction Addiction treatment Drug and alcohol treatment
- Anderson, K. (2010). How to change your drinking: A harm reduction guide to alcohol (2nd ed.). New York: HAMS Harm Reduction Network.Google Scholar
- Bigler, M. O. (2005). Harm reduction as a practice and prevention model for social work. Journal of Baccalaureate Social Work, 10(2), 69–86.Google Scholar
- Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. London: Routledge.Google Scholar
- Center for Harm Reduction Therapy. (2016). How you can help. Retrieved from http://harmreductiontherapy.org/helping-opportunities/.
- Denning, P. (2000). Practicing harm reduction psychotherapy: An alternative approach to addiction. New York, NY: Guilford Press.Google Scholar
- Denning, P., & Little, J. (2012). Practicing harm reduction psychotherapy: An alternative approach to addiction (2nd ed.). New York, NY: Guilford Press.Google Scholar
- Denning, P., Little, J., & Glickman, A. (2004). Over the influence: The harm reduction guide for managing drugs and alcohol. New York, NY: Guilford.Google Scholar
- Felitti, V. J. (2003). The origins of addiction: Evidence from the adverse childhood experiences study. (Published in Germany as “Ursprünge des Suchtverhaltens: Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen.”) Praxis der Kinderpsychologie und Kinderpsychiatrie, 52, 547–559. English version: http://www.acestudy.org/files/OriginsofAddiction.pdf.
- Fisher, J. (1999). The work of stabilization in trauma treatment. Retrieved from www.janinafisher.com/resources.php.
- Harm Reduction Coalition (2011). Guide to developing and managing syringe access programs. Retrieved from http://harmreduction.org/issues/syringe-access/tools-best-practices/manuals-and-best-practice-documents/syringe-access-manual/.
- Jewish Currents (2011). Interview with Ethan Nadelmann, Executive Director of Drug Policy Alliance. Retrieved from http://jewishcurrents.org/megaphone-ethan-nadelman-drug-policy-alliance-6131.
- Khantzian, E., Halliday, K. S., & McAuliffe, W. E. (1990). Addiction and the vulnerable self: Modified dynamic group therapy for substance abusers. New York, NY: Guilford Press.Google Scholar
- Little, J. (2015). What’s under the harm reduction umbrella? Part one. The Fix. Retrieved June 28, 2015 from http://www.thefix.com/content/ under-harm-reduction-therapy-umbrella-part-1.
- Little, J., & Franskoviak, P. (2010). We’re glad you came: Harm reduction therapy in community settings. Journal of Clinical Psychotherapy. In Session, 66(2), 175–188.Google Scholar
- Lower East Side Harm Reduction Center. (2014). Our funders. Retrieved from http://www.leshrc.org/page/our-funders.
- Magidson, J. F., Young, K. C., & Lejuez, C. W. (2014). A how-to guide for conducting a functional analysis: Behavioral principles and clinical application. The Behavior Therapist, 37(1), 4–12.Google Scholar
- Marlatt, G. A. (Ed.). (1998). Harm reduction: Pragmatic strategies for managing high-risk behaviors. New York: Guilford Press.Google Scholar
- Marlatt, G. A., & Gordon, J. (Eds.). (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford Press.Google Scholar
- Miller, W. R. (2006). Motivational factors in addictive behaviors. In W. R. Miller & K. M. Carroll (Eds.), Rethinking substance abuse: What the science shows, and what we should do about it. New York: Guilford.Google Scholar
- Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York: Guilford Press.Google Scholar
- Najavits, L. M. (2004). Assessment of trauma, PTSD, and substance use disorder: A practical guide. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (2nd ed., pp. 466–491). New York: Guilford Press.Google Scholar
- National Association of Social Workers (NASW). (2012). Alcohol, tobacco, and other drugs. Social work speaks: National Association of Social Workers policy statements, 2012–2014 (pp. 28–33). Washington, DC: Author.Google Scholar
- National Association of Social Workers (NASW). (2013a). National standards for social work practice with clients with substance use disorders. Washington, DC: Author.Google Scholar
- National Association of Social Workers (NASW). (2013b). A social work perspective on drug policy reform: Public health approach. Washington, DC: Author.Google Scholar
- National Institutes of Drug Abuse. (2014). Drug facts: Heroin. https://www.drugabuse.gov/publications/drugfacts/heroin. Accessed 16 Feb 2016.
- Patel, A. B. & Fromme, K. (2014). Expectancies and their influence on drug effects. In Encyclopedia of psychopharmacology (pp. 1–5). Retrieved from http://link.springer.com/referenceworkentry/10.1007%2F978-3-642-27772-6_174-2.
- Rothschild, D. (2015). The “third wave” of substance use treatment. The Fix. Retrieved from http://www.thefix.com/content/third-wave-substance-use-treatment.
- Substance Abuse and Mental Health Services Administration (2013). SAMHSA’s working definition of recovery: 10 guiding principles. Retrieved from http://store.samhsa.gov/shin/content/PEP12-RECDEF/PEP12-RECDEF.pdf.
- Substance Abuse and Mental Health Services Administration (2014). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Author.Google Scholar
- Tatarsky, A. (2002). Harm reduction psychotherapy: A new treatment for drug and alcohol problems. Northvale, NJ: Jason Aronson.Google Scholar
- van Wormer, K. (2004). Harm reduction. Social Policy Journal, 3, 19–37.Google Scholar
- Zinberg, N. (1984). Drug, set, setting: The basis for controlled intoxicant use. New Haven, CT: Yale University Press.Google Scholar