An integrative approach to harm reduction psychotherapy: A case of problem drinking secondary to depression

Although drug and alcohol abuse continues to be widespread in our society, traditional approaches to treatment have had limited success at engaging and retaining clients, and have shown poor outcomes overall. Harm reduction is a new approach to treating substance abuse that may be more acceptable and effective for this large clinical population. This article describes the harm reduction paradigm and the author's use of harm reduction within a psychotherapeutic approach that integrates cognitive and behavioral interventions with a psychodynamic understanding of substance use as personally meaningful. The approach is illustrated by a case of a client who presented with alcohol abuse secondary to depression. © 1998 John Wiley & Sons, Inc.