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A Harm-Reduction Approach to Addictions – Andrew Tatarsky

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More than one-third of Americans struggle with problematic substance use and other risky or addictive behaviors, but they often have a great deal of ambivalence about changing them.

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More than one-third of Americans struggle with problematic substance use and other risky or addictive behaviors, but they often have a great deal of ambivalence about changing them.

Even with clients whose issues are mild on the severity spectrum, it’s difficult getting to the heart of the complex reasons, unique to each person, for this roadblock to change.

This workshop offers a comprehensive psychobiosocial model for understanding and working with these behaviors through Integrative Harm Reduction Psychotherapy (IHRP), which can be immediately incorporated into your practice.


  1. Assess how addictive behavior reflects the interplay of biology, meaning, habit, and social context.
  2. Determine why the harm-reduction stance is essential to effective treatment across the spectrum of addictive severity.
  3. Evaluate seven therapeutic tasks that combine relational psychodynamic, CBT, and mindfulness interventions to address addictive behaviors and the whole person.
  4. Use strategies to address risky behaviors including Urge Surfing, Unwrapping the Urge, Microanalysis, Embracing Ambivalence, Decisional Balance, and the Ideal Use Plan.

Introduction

  • Addiction as a Dilemma
  • Valerie Case Study

Compassionate Pragmatism

  • Compassion
  • Pragmatism

Harm Reduction Principles

  • Curiosity, Respect, Acceptance
  • Small Incremental Change
  • Collaboration
  • Public Health/Medical Harm Reduction

Challenges & Diversity of People with Risky & Addictive Behavior

  • Clinical Challenges
  • Limitations in the U.S.
  • The Tyranny of “Abstinence-Only”
  • Motivational Stages of Change
  • Scientific Revolution/Paradigm Shift

Theoretical Models

  • Multiple Meanings Model
  • Relational Psychoanalysis & Meaning
  • Cyclical Psychodynamics
  • Psychobiosocial Model

Integrative Harm Reduction Psychotherapy

  • Seven Therapeutic Tasks of IHRP

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