HRTC works with people who are still using drugs, who don’t know whether they want to change, and who are looking for a thoughtful alternative to “quit now and forever” treatment programs.  95% of people in the U.S. do not affiliate with 12-step-based programs or groups, either because they don’t feel welcome or they aren’t aligned with the abstinence only philosophy or spiritual orientation of these programs. Harm reduction programs offers people an alternative way, free of coercion, to explore the nature of their relationship with drugs.  From there, it becomes easier to consider change.

In harm reduction therapy, we know that people drink and use drugs for reasons.  Most people know what those reasons are when given the chance to explore their relationship with substances without judgment or mandates to change. We welcome people whose goals range from abstinence to controlled or safer use, who want to change their use of one drug but not others, or who aren’t ready to change anything about their drug use, but rather want to start by exploring how drugs interact with their life. A person can want to change one drug and not another.  In other words, we work with people who do not fit into traditional abstinence-based programs. 

Often, substance use is not the first priority of our clients.  This is welcomed.  HRTC works with people whose drug use is complicated by other emotional, psychological, or life issues.  Often times people are using substances to self medicate, to help them deal with other issues.  If these underlying issues are addressed in therapy then their relationship with substance use is likely to change.  Each person has their own story of where they came from and how they got to this place in their life, and they need to know that they have the freedom to explore whatever is most important.

HRTC is part of the public health system in San Francisco, and many of our clients have overwhelming co-occuring issues.  Histories of economic, racial, and family trauma are compounded by current lives of homelessness, poverty, exclusion, and getting caught up in the criminal justice system because of involvement with drugs.  HRTC is uniquely qualified to work with trauma, and we actively embrace working with the people who have the most challenging intersecting issues. 

HRTC historically has offered therapy to people who want to pay privately for therapy.  We maintained this “private practice” through 2020 when we joined a Northern California Association of Harm Reduction Therapists and Providers, a collaboration of approximately 25 harm reduction therapists.  Access to this very diverse and skilled group is available at the association’s website.