Our first class for the Harm Reduction Psychotherapy Certificate Program led to a great discussion on how we view the terms, “addict” and “addiction”, and the implications for how we approach treatment based on the language that we use. How we conceptualize and think about addictive behaviors shapes how we approach the therapeutic process. Several themes emerged as we discussed these terms and how addictive issues arise out of a complex interaction of factors. The need to offer individualized, compassionate treatment focused on any positive change was also a focus of the discussion.
We reflected on the disease model paradigm and abstinence-only mindset that has dominated the field while acknowledging the movement towards a harm reduction paradigm which is focused on the complex interaction of psychobiosocial factors and the need to meet individuals where they are in terms of their willingness and readiness for change. We also began a dialog about the need to focus on our own subjective experiences of our clients and how to create a safe therapeutic space where clients can work through feelings of shame and ambivalence about change. The need to offer strategies for positive change while also addressing the multiple meanings and functions of substance misuse emerged as a focus of the discussion as well. The balance between providing active strategies for change and helping clients develop awareness of the deeper meaning and dynamics of their relationship to substances will continue to be a theme in our discussions.
We will continue to write about our experiences in this class and look forward to hearing your comments.
Andrew Tatarsky, PhD
Jenifer Talley, PhD