Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions [Hardcover]

Patt Denning (Author), Jeannie Little (Author)

Book Description

ISBN-10: 157230555X | ISBN-13: 978-1572305557 | Publication Date: April 4, 2000 | Edition: 1

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.

Editorial Reviews

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

From the Back Cover

"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

See all Editorial Reviews

Product Details

• Hardcover: 246 pages
• Publisher: Guilford Press; 1 edition (April 4, 2000)
• Language: English
• ISBN-10: 157230555X
• ISBN-13: 978-1572305557
• Product Dimensions: 9.2 x 6.2 x 1 inches
• Shipping Weight: 1.3 pounds
• Average Customer Review: 4.2 out of 5 stars  See all reviews (5 customer reviews)
• Amazon Best Sellers Rank: #1,452,350 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

10 of 10 people found the following review helpful:

5.0 out of 5 stars Welcome to 21st Century Treatment, January 24, 2001

By 

Maureen Rule (Albuquerque, New Mexico) - See all my reviews

This review is from: Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions (Hardcover)

Finally, a well-written book on harm reduction therapy! This book is a must read for all in the helping professions, particularly those who work with persons using substances. Dr. Denning, a seasoned and humane practitioner, explains harm reduction psychotherapy using a sound basis of theory and research which includes a blending of techniques from motivational interviewing, psychodynamic, cognitive-behavioral, and first and foremost, truly client-centered therapy. She describes it as what Zucker terms "informed eclectism". Case histories within the text enable one to implement these techniques with relative ease, in spite of the fact, that she makes clear we have too long over-simplified the treatment of substance users. Denning challenges practitioners to examine their beliefs about drugs, their use, and the people who use them. She calls on treatment providers to set a new standard of accountability for providing helpful substance use/abuse/dependency treatment. I have long believed that to label clients "resistant" or "in denial" tells me more about the therapist than the client. Denning's book describes a marvelous blend of psychodynamic, motivational interviewing, and truly client-centered therapy. It is a breath of fresh air to have a successful model of treatment which dispels widely accepted mythology about persons who use drugs. This is a true "First Do No Harm" approach. Dr. Denning's book calls us into the 21st century with a pragmatic, humane approach toward treating folks who are persons first, and drug users, second. I commend Dr. Denning for her courage in challenging the status quo of "one size fits all" treatment. Current acceptability of treatment for substance use is appalling. Would any of us accept rates of improved quality of life for only one out of every four persons treated by physicians? This book is testament in practice to "zero tolerance + zero compassion = zero." (Marlatt, 1998)

14 of 16 people found the following review helpful:

5.0 out of 5 stars The Greatest Thing Since AA, July 18, 2000

By 

Jean g. Little (San Francisco, CA United States) - See all my reviews

This review is from: Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions (Hardcover)

This is an amazing book. Finally, a book that talks about addiction and drug use in terms of the real relationship and complex interactions that people and their emotions have with drugs and alcohol. One that moves us away from the "all or nothing" concepts of the disease model of addiction, with its demands for total abstinence from all mind-altering substances as a condition for treatment. One that appreciates the deep and varied motivations for people to use drugs and alcohol, no matter how destructive their use has become.

From a sophisticated clinician, we get an understanding of how diverse people develop diverse relationships with drugs and alcohol. There is not, as the 12-step disease model of addiction tells us, a single disease course of addiction. Instead, people have various reasons for their dependence on drugs. AND, not everyone has a problem with every drug they use. Yes, drug use and abuse is as complicated as I thought. Thank you, Dr. Denning.

Denning talks about mental illness, dual diagnosis and the self-medicating tendency of people who have significant emotional problems. This is the most humane and useful treatment of the subject that I have read.

Denning gives us a road map for an alternative means of assessment and treatment that is readable and useable. The most important aspects of the treatment process are its emphasis on collaboration, its respect for clients' self-knowledge and expertise, its accounting for the role of motivation and attachment in changing behavior, and the understanding that changing addictive behavior is an incremental process if it is an authentic one.

Finally and overall, in challenging traditional concepts of addiction, Denning gives a cogent account of the origins of harm reduction in public health efforts to prevent the spread of HIV, explains what it really is in clinical practice, and refutes the hysterical myths about it being a Trojan Horse for drug legalization. Instead, harm reduction saves lives and engages many more people in a treatment process than have been reached up to now. This book treats addiction with a combination of common sense and clinical sophistication that many of us have craved for years, if not decades.

3 of 3 people found the following review helpful:

5.0 out of 5 stars A great resource., November 6, 2001

By 

Whit Fletcher (Belmont, CA USA) - See all my reviews

This review is from: Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions (Hardcover)

Dr. Denning has written the definitive text for therapists seeking an effective alternative to traditional disease model therapy. I highly reccomend this book for experienced practitioners and those new to the field.