Harm Reduction Psychotherapy, Essay Example

Summary

The harm reduction psychotherapy is described by Tatarsky and Kellogg (2010) as an effective way of managing addiction. The authors describe the theoretical foundations of the therapy as one that uses a patient-centered, integrative approach. Aligning therapy with other aspects of the intervention, creating a personalized play through therapeutic alliance is highlighted as the main success factor of this type of psychotherapy. Therapists, according to the authors (Tatarsky & Kellogg, 2010) need to have certain skills to enhance the power of alliance between the patient and the therapist. These skills are collaboration, active listening, reflection,  and empathy. Therapists need to set a goal for reducing harm together with the patient. The therapeutic goals should be based on the assessment, which itself can also result in coming to a shared understanding about treatment plans with patients.

The active strategies to initiate, facilitate, and maintain positive change during psychotherapy, according to the article include: providing education for patients about reducing harm, assessing and controlling urge, identifying and reflecting on the reasons behind substance addiction, discussing alternative responses to urges, and creating a game plan together. The case illustration presented in the article clearly demonstrates how therapists can build a trusting relationship with patients to help individuals change their attitudes and behaviors. The therapist encounters several difficulties to gain the trust of the patient, but active listening uncovers the reasons behind the self-destructive behavior: childhood trauma.

Pros and Cons

The method described in the study highlights the importance of taking a patient-centered approach when designing interventions and therapies. However, presenting only one case without providing statistical data on the effectiveness of the approach makes the account less credible, and extremely subjective. While the argument is backed by literature research and review of related theories/studies, there are several limitations of the article. First, there is a lack of reasoning why reducing harm is a better alternative than promoting abstinence. Even though the information provided for therapists on skills to develop when trying to gain patients’ trust is comprehensive and well demonstrated through the case review, it does not cover the application process of other scenarios.

Overall, it is clear that the article is a useful resource for therapists who deal with substance dependent patients and would like to improve the quality of care, as well as the outcome of the therapy. However, the study lacks credible evidence that would make it suitable for implementing it in evidence-based practice.

Reflections and Potential Applications

While the results presented by the authors in the case review indicate that the method is effective for reducing the risk of self-harm related to substance abuse, I do not agree that harm reduction is a better option than promoting abstinence. Indeed, even the authors state that the main goal should be to find alternative actions for patients when urge to abuse substances arises. Eliminating drug abuse and self-harm, while empowering patients to cope with stress triggers, mental health issues, and situations that trigger substance abuse should be the main goal of the patient-centered therapy. I agree that mental health professionals should take an integrated approach and try to understand the reasons behind the substance abuse, while developing new coping mechanisms that are less harmful. The main takeaway of the article for therapists is that without trust and agreement, shared development of goals, mental health professionals cannot help patients recover from substance addiction.

References

Tatarsky, A., & Kellogg, S. (2010). Integrative harm reduction psychotherapy: A case of substance use, multiple trauma, and suicidality. Journal of clinical psychology, 66(2), 123-135.