Product Description
Harm reduction is a framework for helping drug and alcohol users who cannot or will not stop completely_the majority of users_reduce the harmful consequences of use. Harm reduction accepts that abstinence may be the best outcome for many but relaxes the emphasis on abstinence as the only acceptable goal and criterion of success. Instead, smaller incremental changes in the direction of reduced harmfulness of drug use are accepted. This book will show how these simple changes in emphasis and expectation have dramatic implications for improving the effectiveness of psychotherapy in many ways.

CUSTOMER REVIEWS (Average Customer Rating: 4.0 based on 5 reviews)

Hard to comment by DowntownDB (LA)

1 Stars
February 26, 2009
It's about a month later and I haven't received the book yet, so it's hard to comment. Does anyone at Amazon have any idea when it might arrive? Do I need to call or follow up with someone?

Harm Reduction - Not a Paradigm Shift, but a Re-Birth of Good Therapy Paradigm by Pavel Somov, Ph.D., Author of Eating the Moment: 141 Mindful Practices to Overcome Overeating One Meal at a Time (Pittsburgh, PA, USA)

5 Stars
September 29, 2008
In my opinion, there are four post-12-step classics: Marlatt's "Harm Reduction," Peele's "Diseasing of America," Miller & Rollnick's "Motivational Interviewing," and Tatarsky's "Harm Reduction Psychotherapy." My suggestion - buy all four, read all four. Marlatt's "Harm Reduction" is a historically first (if I am not mistaken) overview of harm reduction paradigm. Peele's "Diseasing of America" is an intense but poignant critique of the 12-step "recovery industry." Miller & Rollnick's "Motivational Interviwing" is a primer on harnessing pseudo-resistance and leveraging motivation for change. Tatarsky's "Harm Reduction Psychotherapy" is a straight-forward harm reduction application book that starts its chapters from a panoramic bird's-eye view and then clinically bomb-dives into the application specifics. The book consists of 10 chapters, each consists of a nuanced analysis of the issues at hand with a relevant and indepth case study. Like all harm-reduction literature the book bristles with humanistic courage: it meets the clients "really" where they are, it validates the existential and adaptive valence of substance use, it encourages a clinically "libertarian" stance of respecting clients' goals, it bridges harm reduction with psychoanalysis and cognitive-behavioral schools of thought, it humanizes the substance use population by debunking the preconceived notions and assumptions that still bias so many of the front-line substance use providers, and most importantly the book reminds us that harm reduction is nothing new, that, in essence, it is not a new paradigm but a return to the good ol' humanistic, non-reductionistic, non-oversimplifying, client-centered clinical stance. I remember one of my first practicum sites. I was sharing - no, not an office wall, - a hallway with a Certified Addiction Counselor. This counselor, bless his good intentions, literally yelled and screamed at his clients loud enough for my own clients - across the hallway and behind the tightly shut door - to raise their brows. I don't mean to say that all CACs are like that. But this one - with Orwellian orthodoxy - was toeing a party line of abstinence with the cheer-leading vigor of the Volga bargemen, intoxicated with his own rightseousness... Tatarsky's book offers the dichotomizing "preachers" of the 12 Steps a humanistic out - by recognizing a whole spectrum of grey in between the black and white extremes of Abuse-Abstinence continuum, substance use clinicians no longer have to yell - in frustration - that anything that isn't white must be therefore black. Tatarsky's book reminds us not to over-simplify the meaning of substance use and illustrates this point particularly well in Ch. 5: "Complex Problems Require Complex Solutions." Tatarsky's "Harm Reduction Psychotherapy" is about that client-centered therapeutic silence that allows the clinician to tune in to the subtle winds of change that draft in between clients' pseudo-resistence responses. As such, Tatarsky's book is a rehab for those who run rehabs! Pavel Somov, Ph.D. Author of "Eating the Moment: 141 Mindful Practices to Overcome Overeating One Meal at a Time" (New Harbinger, Nov. 2008) - a harm-reduction application to emotional eating; and author of "Recovery Equation: Motivational Enhancement/Choice Awareness/Use Prevention: an Innovative Clinical Curriculum for Susbstance Use Treatment (Booksurge, 2003). http://www.eatingthemoment.com/logotherapy-addiction/ http://www.eatingthemoment.com/psychodrama-addiction/ www.drsomov.com

Easy to read and fascinating by L. H. Savage (New Hampshire)

4 Stars
August 17, 2005
This book is wonderful. It gives me a new way to understand my clients struggling with abstinence from using substances. I love the case examples.

A More Humane Approach

5 Stars
August 06, 2002
Those of us who struggle to control our own alcohol or drug use, or who live with someone who is trying to cut down or quit, may greet the harm reduction approach, persuasively presented by Dr. Andrew Tatarsky, as good news indeed. A practicing psychotherapist, Tatarsky is concerned with meeting clients "where they live": In the context of drug and alcohol abuse, this entails exploring the meanings these substances hold for the individual user and grounding the therapy in the process of self-discovery---rather than requiring abstinence from the outset, which is the traditional "one-size-fits-all" approach to counseling.The book describes ten cases, each from a different therapist who practiced "harm reduction" in treating his or her client. Many readers will be both riveted and moved by the experience of peering into these intimate sessions. The stories are well told (if somewhat unevenly written), and their subjects come across as real people. Even more compelling is Tatarsky's framing commentary, which draws out the significance of each case: the complex interaction of personal and social factors that led this particular individual to seek meaning (liberation, escape, validation) in drug use.As to alcohol abuse, which is a component in most of these case studies, the harm reduction approach is controversial in not prescribing an outcome from the start. It flies in the face of conventional wisdom, which holds that "problem drinkers" (read, alcoholics-in-the-making) lose control after just one or two drinks. The individuals portrayed so appealingly in this book are empowered by their therapists to explore the space between quitting altogether and drinking to excess. About half of them achieve stable moderation; the others discover for themselves that abstinence is the more comfortable and successful route to reducing the harm in their lives.Readers who are not clinicians but worry about these matters will find fresh insights in this accessible introduction to harm reduction. Personal change is an intensely emotional journey best undertaken in the company of a wise therapist or caring support group. The book should be read by every psychotherapist, social worker, and counselor who deals with problems of substance abuse, directly or indirectly---that would be just about all of them. Then, they might wish to recommend the book to those of their clients who are ready for it. This layperson was able to identify with both clients and clinicians, engaged together in life-changing work.

Move over AA, there's a new kid on the block by Robert L. Cohen (New York, NY USA)

5 Stars
July 18, 2002
Andrew Tatarsky and his contributors have brought the honesty, the sympathy, and the efficacy of harm reduction into the treatment of substance users, and it's about time!"Just Say No" has failed 95% of drug users who seek treatment to have better control over their life and their substance use. It has failed them because drug use is not a disease, and abstinence is not a cure. Men and women (and young men and young women) use drugs for their benefits, although drugs, of all kinds --licit and illicit-- are not without their risks. However the risk of developing a drug (and/or alcohol) problem does not derive solely from the drug. Tens of millions of people have had positive experiences with alcohol, marijuana, opiates, and psychydelic substances. Doesn't it make sense to identify what internal and what external factors cause a particular individual to suffer from a drug problem, rather than proclaiming drug use itself as a sickness. Standard abstinence therapies and their institutions function by glorifying guilt, helplessness, and continuous self degradation. Standard abstinence therapy fails the overwhelming majority of people. Tatarsky's book demonstrates, through well written and sympathetic case studies, another way to help people who have problems with their drug use, and it seems to be a better way. This book can make a huge difference in the lives of millions of people.

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