Synopses & Reviews
This book presents an innovative model for the treatment of clients with alcohol and substance abuse problems. For the first time, the goals and methods of harm reduction are incorporated into a multidimensional psychotherapeutic approach. Denning demonstrates that traditional, abstinence-based approaches are inappropriate for many persons who seek help for psychological or emotional problems, and shows how effective therapeutic work can be conducted even with individuals who are still using drugs. The focus is on reducing the damage done by drug use while respecting each client's needs, priorities, and life choices. A comprehensive clinical rationale is provided, and readers are taken step by step through assessment and treatment. Intervention strategies are described in depth, illustrated with extended case examples. Topics covered include addressing the difficulties with affect and trust that are often found in substance using persons, neurobiological aspects of addiction, and working with dual- and multi-diagnosis patients. Applications to consultation and training are also discussed. Grounded in psychodynamic, cognitive-behavioral, and public health principles, this book will be of immediate practical value to clinicians in a wide range of settings.
Review
"Harm reduction has been recognized as an evidence-based practice component, and Patt Denning's book provides social work students an alternative view of substance abuse and recovery. The book's emphasis on reducing the harm of substance abuse is a long overdue alternative to the disease approach. In addition, it is consistent with a strengths perspective as it emphasizes progress over pathology."--Tom Broffman, PhD, LICSW, Department of Sociology, Anthropology, and Social Work, Eastern Connecticut State University
"This book is recommended reading for all therapists, social workers, counselors, and students training for these professions. For too long, practitioners have worked out of extremist, 'all or nothing' models whose strategies have proven to be unsuccessful with most clients who come to us with problems and also happen to use drugs or alcohol. Based in research data and clinical experience, Denning's model truly reflects client-driven therapeutic practices and interventions. The book broadens the clinician's understanding of the role of drug use in the person's life and the effects of chronic drug use on the person's capacity for self realization. Liberally peppered with case vignettes, it provides a full 'tool kit' of strategies and interventions to help clients maximize their health, happiness, and contentment with their lives." --Edith Springer, ACSW, Senior Trainer, Harm Reduction Training Institute (a joint project of the Harm Reduction Coalition and the Lindesmith Center/Open Society Institute), New York City
"An excellent and long overdue work. While interest in harm reduction has burgeoned over the past decade, relevant professional resources have barely kept up with the pace. This book is highly integrative and inclusive, inspired by the disciplines of public health, cognitive-behavioral therapy, personality theory, traditional addiction treatment, motivational interviewing, relapse prevention, and more. Denning makes extensive use of case examples, and these examples reveal that she is a seasoned, well-informed clinician. Along with clinical success stories, she courageously presents the 'failures' that led her to the practice of harm reduction psychotherapy. Clinicians will recognize their own patients (and clinical struggles), and they will learn harm reduction strategies that make sense. I recommend this book to anyone interested in addiction treatment." --Bruce S. Liese, PhD, ABPP, Professor of Family Medicine and Psychiatry, University of Kansas Medical Center
"This courageous and compellingly honest book is at once a professional autobiography, a primer on addictive behavior, a casebook, a reminder about the basics of the psychotherapeutic relationship, and a call to action. Denning is a mature clinician who shares with us the process and fruits of her development as a psychotherapist specializing in addiction and multidiagnosis clients. To replace the outdated conception of addiction as a disease, she explicates harm reduction psychotherapy, an invaluable, empirically supported, practical, and flexible alternative. All practicing psychotherapists need to be familiar with it." --A. Thomas Horvath, PhD, FAClinP, President, Practical Recovery Services, La Jolla, California
"This book provides a blueprint for therapists who wish to provide...an integrated approach to the treatment of a variety of addictive behaviors, with or without the co-occurrence of other psychological or behavioral disorders. For the first time, clients who wish to receive therapy to help them cope with an ongoing alcohol or other drug problem will not be turned away at the door by either substance abuse counselors (who insist upon abstinence as the only acceptable treatment goal) or by mental health therapists (who often refer active drug users to substance abuse treatment before they will accept them for psychotherapy)....Denning provides a trail-blazing journey into the new world of harm reduction therapy." --from the Foreword by G. Alan Marlatt, PhD, University of Washington
Review
"This pioneering book presents an integrated, realistic psychotherapeutic approach for individuals with substance use problems. The second edition develops the treatment model in great detail and provides a wide range of valuable harm reduction resources--for example, guidelines for combining psychotherapy with medication for patients with serious comorbidity. An excellent practical reference for general mental health practitioners and addiction specialists."--Linda Carter Sobell, PhD, ABPP, and Mark B. Sobell, PhD, ABPP, Center for Psychological Studies, Nova Southeastern University
"The substance abuse treatment community in the United States ignored this evidence-based approach for way too long. This important book shows how practitioners can treat clients at the precise point where they are capable of making changes. It features examples, case studies, and valuable information on applying harm reduction principles in group work, supervision, and other contexts, in addition to individual psychotherapy. This is a 'must read' for anyone in the field of addictive disorders."--Robert J. Meyers, PhD, Emeritus Research Associate Professor of Psychology, University of New Mexico; Director, Robert J. Meyers, PhD, and Associates
"The second edition of Practicing Harm Reduction Psychotherapy is a book whose time has come. Harm reduction is finally recognized as a basic concept that needs to inform the treatment of all clients with substance use problems, particularly those who have co-occurring disorders. Denning and Little clearly position harm reduction as a current, integrated, nondogmatic, client-centered treatment approach."--Shulamith Lala Ashenberg Straussner, DSW, LCSW, Silver School of Social Work, New York University
"Denning and Little have earned an international reputation for their research and clinical practice. Highlighting the principle of 'doing patients no harm,' the authors explain the theoretical background of harm reduction psychotherapy and describe how to conduct it. The book is packed with vivid, intriguing examples. I recommend it to a broad readership of mental health professionals and students."--Hendrik G. Roozen, PhD, Novadic-Kentron Treatment Services and Erasmus University Medical Center, The Netherlands
Review
"This is a great book that has radical reform implications for treating drug users."--American Journal of Psychiatry
Review
"This well-written book....[would be] useful in training graduate students in the integration of addictions treatment into everyday clinical practice—a useful skill to possess given the high rates of addictive disorders in the general population."--Journal of Studies on Alcohol
Review
"Accessible to a wide array of practitioners....[Combines] discussion of research and theory with clinical case application....The book delivers on its promise of presenting an approach that is an alternative to the status quo in American SUDs treatment services."--Clinical Psychology Review
Review
"An essential tool for the modern practitioner who treats any patient using drugs."--Addiction
Review
"The real strength in this book lies in its optimism that it is possible to treat 'extremely damaged individuals'...the principle of excluding no-one from treatment is most welcome."--Alcohol and Alcoholism
Review
"Introduces the reader to a new and innovative way to view addictions and provides a nontraditional approach to the treatment of individuals with substance abuse difficulties....A must read for all mental health and substance abuse practitioners."--Canadian Journal of Counselling
Synopsis
Demonstrating that traditional approaches to addictions fall short for many substance abusers with psychological problems, this book shows how effective therapeutic work can be conducted with clients still using alcohol or other drugs. For the first time, the goals and methods of harm reduction are incorporated into a comprehensive psychotherapeutic approach--one that can be initiated without waiting for, or insisting on, abstinence. Clinicians learn concrete strategies for assessing the client's personality, behaviors, and resources; enhancing motivation for change; making collaborative treatment decisions; and implementing a range of different interventions.
Synopsis
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 problems. Written by pioneers in the field, the book shows how to do effective therapeutic work with people still using alcohol or other drugs. It provides clear guidelines for conducting comprehensive assessments, making collaborative treatment decisions, and implementing interventions that combine motivational, cognitive-behavioral, and psychodynamic strategies. The focus is reducing drug-related harm while also addressing co-occurring psychological and emotional difficulties. Detailed clinical illustrations are featured throughout.
New to This Edition
*Reflects over a decade of research advances and the tremendous growth of harm reduction clinical practice and training.
*Section on applications, with chapters on community-based settings, harm reduction groups, and working with families and friends.
*Chapters on biological and psychodynamic aspects of treatment.
*Expanded discussions of trauma, cultural sensitivity, and ethics.
*Supplemental resources and training information at the authors' website: www.harmreductiontherapy.org.
About the Author
Patt Denning, PhD, one of the primary developers of harm reduction psychotherapy, is Director of Clinical Services and Training at the Harm Reduction Therapy Center (HRTC) in San Francisco, which she founded with Jeannie Little in 2000. HRTC provides a full range of mental health services to dually diagnosed individuals and trains hundreds of professionals each year. Dr. Denning has worked in community mental health and private practice since 1975, specializing in differential diagnosis, psychopharmacology, psychotherapy with seriously disturbed patients, HIV, and substance use disorders. She is a Diplomate Fellow in psychopharmacology and a certified addiction specialist through the American Psychological Association's College of Professional Psychology. Jeannie Little, LCSW, is Executive Director of HRTC. Since 1994, Ms. Little has developed harm reduction treatment services for multidiagnosed clients, beginning at Healthcare for Homeless Veterans and then in private practice and at HRTC. A certified group psychotherapist, she specializes in group treatment of substance use disorders and dual diagnosis. Ms. Little is a trainer in the areas of dual diagnosis, group treatment, and professional development of staff who work in a variety of social service and housing settings. She is coauthor, with Patt Denning and Adina Glickman, of a book for the general public,
Over the Influence: The Harm Reduction Guide for Managing Drugs and Alcohol.
Table of Contents
I. Setting the Stage 1. Why Practice Harm Reduction Psychotherapy? 2. What Is Harm Reduction Psychotherapy and Whom Is It For? II. Harm Reduction Psychotherapy as an Integrated Treatment 3. Assessment as Treatment 4. Developing a Treatment Plan 5. The Fundamentals of Harm Reduction Psychotherapy 6. The Psychodynamic Matrix of Harm Reduction Psychotherapy 7. Motivational and Cognitive-Behavioral Contributions to Harm Reduction Psychotherapy 8. The Role of Biology in Harm Reduction Psychotherapy III. Applications 9. Harm Reduction Psychotherapy in Community-Based Settings 10. Harm Reduction Psychotherapy in Groups 11. The Power of Connection: Working with Families and Friends of Drug Users 12. What Does It Take to Practice Harm Reduction Psychotherapy? Appendix A. Differential Diagnosis Appendix B. Harm Reduction Supervision, Edith Springer Appendix C. Additional Resources Appendix D. Recommended Readings