Of the thousands of people suffering with problems related to their use of alcohol or other drugs, most never ask for help. Of those who do, many are not satisfied with either the treatment they receive or the outcomes they experience. The Harm Reduction Therapy Center began with a vision: to change the way people with alcohol or other drug problems were treated, and to improve their success in overcoming the harms they are experiencing.

 The Way It Was

Since the early 1940’s people had only two options to deal with alcohol or drug problems: the old medical model of long inpatient stays and ineffective medications, or the new 12 Step self-help groups of Alcoholics Anonymous. By the early 1990’s, in part due to cost-cutting, most treatment had become 28 day “rehabs” , the vast majority based on 12 Step practice, followed by life-long attendance at AA or NA meetings.

For opiate dependence, methadone was (and still is) offered in restricted settings for those who were considered “untreatable” by the conventional standard of total abstinence from all psychoactive drugs. Other drugs were barely mentioned in the treatment literature.

Most ominous – drinkers and drug users were viewed as inherently dishonest and manipulative, in need of being confronted with their denial and flawed character.

Our Vision of What Needed to Change

Through listening to people talk about how alcohol and other drugs became a part of their lives, and through intensive reading what research was telling us about the nature of drug problems and the variety of solutions that work, we began to think “outside the box”. Several radical ideas took hold and influenced our development of harm reduction therapy:

  • People could be trusted to tell us the truth provided they could trust us not to judge them or punish them for that truth.
  • People needed support, respect, and real-life skills to overcome what had become serious problems with their alcohol or drug use.
  • People with significant problems with substances often had other, equally important issues that affected their use and their ability to change their behavior.
  • People with substance abuse issues often had serious histories of trauma or significant mental health issues that had not been addressed.
  • People who provided treatment needed to be much more competent and skilled at mental health and behavioral interventions.
  • 12 Step-based treatment did not measurably help people, and attendance at 12 Step groups didn’t often result in sustained “recovery”

What We Did

We researched and studied the work of hundreds of professionals to determine what ideas, interventions, and strategies best fit the needs of people with complicated relationships with alcohol and other drugs. We studied our own work with clients, and learned what was helpful to them. We wrote a book and articles about our ideas of a new model for understanding and treating substance abuse issues. We recruited a group of young mental health professionals to join in our efforts to identify the most innovative and helpful treatment strategies.

And then in 2000 we opened the Harm Reduction Therapy Center to provide state of the art treatment using a model that was developed out of this collaborative and intensive process. Since then we have seen thousands of clients, written another book to and for alcohol and drug users, trained hundreds of healthcare professionals, therapists and other treatment providers, and added our experience to the greatly expanding body of knowledge regarding effective, non-12 step approaches to treating substance abuse.

Where We Are Now

 The Harm Reduction Therapy Center is now the Center for Harm Reduction Therapy – highlighting the scope of our services and starting us on a new path of expanded programs. Central to this is an expansion of our therapy services at our two private clinics in San Francisco and Oakland, CA.

We are offering comprehensive assessments – single or multi-session consultations for people who want to begin to understand their alcohol or drug use, and consultations for families who are concerned about a loved one.

We create a tailor-made program for each client that can range from weekly individual therapy to intensive treatment that includes individual, group, and family sessions. We offer medication-assisted treatment, including psychiatric medications, opiate replacement medications, and alcohol related medications. Treatment can be time-limited or open-ended. The structure and the pace of treatment is determined entirely in collaboration with each client.

Contact the Center for Harm Reduction Therapy if you would like further information about how our treatment works or if you would like to make an appointment.