Denning, Patt, et al. Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions. New York: Guilford Press. April 2000, 270 pages.
 This book presents an innovative model for the treatment of clients with alcohol and substance abuse problems. For the first time, the goals and methods of harm reduction are incorporated into a multidimensional psychotherapeutic approach. Denning demonstrates that traditional, abstinence-based approaches are inappropriate for many persons who seek help for psychological or emotional problems, and shows how effective therapeutic work can be conducted even with individuals who are still using drugs. The focus is on reducing the damage done by drug use while respecting each client's needs, priorities, and life choices. A comprehensive clinical rationale is provided, and readers are taken step by step through assessment and treatment. Intervention strategies are described in depth, illustrated with extended case examples. Topics covered include addressing the difficulties with affect and trust that are often found in substance using persons, neurobiological aspects of addiction, and working with dual- and multidiagnosis patients. Applications to consultation and training are also discussed. Grounded in psychodynamic, cognitive-behavioral, and public health principles, this book will be of immediate practical value to clinicians in a wide range of settings.
Contents:
I. Overview of Harm Reduction Psychotherapy
- What Is Harm Reduction?
- The Development of Harm Reduction Psychotherapy
II. Harm Reduction Psychotherapy in Action
3. The Treatment Program: Assessment as Treatment
4. Treatment Design: How to Think about a Case
5. Clinical Cases Using Harm Reduction Psychotherapy
6. Dual- and Multidiagnosis Patients
III. Integrating the New with the Old
7. Harm Reduction Psychotherapy: Applications and Adjustments
Appendices:
A. Overview of Psychoactive Drugs
B. References for Specific Drug Effects
C. History of Drugs and Attitudes toward Them
D. Self-Help Reading List
E. Alternative Self-Help and Professional Resources
F. Specific Treatment Modalities/ Techniques
"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....Liberally peppered with case vignettes, the book provides a full 'tool kit' of strategies and interventions to help clients maximize their health, happiness, and contentment with their lives."
-- Edith Springer, ACSW, Harm Reduction Training Institute, New York City
"Excellent and long overdue....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....Clinicians will recognize their own patients (and clinical struggles), and they will learn harm reduction strategies that make sense."
-- 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....To replace the outdated conception of addiction as a disease, Denning 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, Practical Recovery Services, La Jolla, CA
"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
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