- Paperback: 392 pages
- Publisher: Jason Aronson, Inc. (June 10, 2007)
- Language: English
- ISBN-10: 0765703734
- ISBN-13: 978-0765703736
- Product Dimensions: 6.1 x 0.9 x 9.2 inches
- Shipping Weight: 1.2 pounds (View shipping rates and policies)
- Average Customer Review: 8 customer reviews
- Amazon Best Sellers Rank: #552,922 in Books (See Top 100 in Books)
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Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems
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Personal dignity and responsibility as well as compassion and the recognition that one's steps take place one day at a time are fundamental to both harm reduction and 12-step approaches to drug addiction. Tatarsky's excellent new paradigm rescues these principles with courage, compassion, and intellectual rigor. Harm reduction psychotherapy has come of age. (Ethan Nadelman, executive director, Lindesmith Center Drug Policy Foundation)
Although this book is a good read for substance misuse specialists too, its readership should be predominantly out with the specialist field. It should be on the bookshelves of the legions of individual psychotherapists who claim no expertise with substance misusers, but who are probably working with some anyway. (Addiction Research and Theory)
Andrew Tatarsky's book, using cases submitted by practitioners from different psychological schools of thought, clearly elucidates the way harm reduction philosophy can be integrated into clinical work. The cases are varied, the practitioners have unique styles and varying approaches, and the realistic conclusions offer the reader a way to integrate slow, incremental change at the client's pace into whatever treatment model they currently use. No longer do therapists have to send people away to become abstinent before they can work with them; no longer do therapists have to feel responsible to set goals for their clients' drug use. This is a must-read for today's psychotherapists who want to practice state-of-the-art healing. (Edith Springer, Edith Springer Associates)
About the Author
Andrew Tatarsky, Ph.D., holds a doctorate in clinical psychology from City University of New York. He has a private practice in New York City specializing in harm reduction psychotherapy with drug and alcohol users and is co-director, with Dr. Mark Sehl, of the Harm Reduction Psychotherapy and Training Associates, a treatment and training organization. His perspective on substance use problems has evolved over twenty years of experience working in the area as psychotherapist, supervisor, program director, teacher, writer, and public speaker. He is a founding member and Past President of the Addiction Division of the New York State Psychological Association and Chairperson of Mental Health Professionals in Harm Reduction.
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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).
"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.