Thread by @NanouTheNomad

Twelve years ago (!!) one of my first introductions to #harmreduction was doing my ⁦MPH⁩ capstone project with Drs Collins & Clifasefi and now I am going to their talk at #harmred22!

"We realized how we talked to people as treatment professionals was not effective for people most severely impacted by substance use, racial injustice, and socioeconomic stressors, & people we were working w/ had more effective sustainable ideas for how to revision treatment.”

things people wanted: help people work towards own goals, don't require abstinence, offer group AND individual counseling options

HaRT counseling components
- Client led tracking of substance-related harm & other outcomes
- Elicitation and ongoing discussion of harm reduction goals
- Discussion of safer-use strategies and relative risks

ideally pair with pharmacological supports i.e. methadone

How do you convey mindset?
Transparency about your role
Colearning about relative risks of behaviors (& always ask permission before sharing those risks)
Deferral to clients’ decision making

be explicit: “I will not require, ask or advise you to stop or cut down your substance use or change your use in any way you do not want to”

Client-led tracking:
Clients often interested in numbers! Move away from abstinence vs. nonabstinence dichotomy.

Can track frequency of use, amount of use on typical or heaviest day
They also use Short Inventory of Problems (SIP-AD) to track substance-related harm

Set SMART goals - but can be goals that have nothing to do with substance use! "over the next ____ weeks, what would you like to see happen for yourself? some people call this a goal, vision, or intention..."

Here’s their website! They also have book (aimed at counselors/therapists) on the way ! depts.washington.edu/harrtlab/

Now off to a roundtable about harm reduction & abolition & meet up with @stahlidarity 💜💜 yay for reunions with mentors and family and friends!