Harm Reduction for Joe Six-Pack

The Bridge , Fall 2007, page 3.

A REVIEW OF: Over the Influence: The Harm Reduction Guide For Managing Drugs and Alcohol

AUTHORS: Patt Denning, Jeannie Little, Adina Glickman

PUBLISHER: Guilford Publications, New York , 2004. Paperback. 328 pages.

Harm reduction, one of the alternatives to the disease model of addiction, has slowly been gaining acceptance in the psychological community. Over the last ten years, a number of books have been published that explore the various facets of harm reduction—and extend it in new directions. These books have by and large been aimed at addiction professionals.

Now there’s a new book that’s designed to bring the principles of harm reduction to the general reader. This book, Over the Influence, reflects the coming of age of harm reduction as a therapeutic alternative. It‘s focused on what works and how to do it.

Harm reduction is sometimes described by its practitioners as holistic and humane. In Over the Influence, it comes across as realistic and doable. The book coolly walks away from the moralistic overtones that have dominated this field for the last hundred years, providing instead a practical course of action with the conciseness and clarity of a workbook.

Power to the People

Over the Influence is aimed at reaching people who often opt out of therapy. By giving them the tools to explore their relationships with psychoactive substances—including evaluating both the benefits and the harm they may have suffered—this book opens a door to those who would normally stay far away from anyone labeled “counselor” or “addict.”

The authors accomplish this through the use of conversational language, humor, worksheets that readers can fill in, real-life stories, and information presented in dialogs. For example, the book opens with, “Do you know anyone with diabetes who has ever been refused insulin by his doctor because he won’t stop eating ice cream or drinking alcohol?” In another section, the authors make it clear that readers have at least two choices regarding their drug use: “1. Change. 2. Don't change.” And later, readers are offered such practical advice as an entire chapter on “How To Take Care of Yourself While Still Using.”

The underlying assumptions are clear: People have the power to choose and make large-scale decisions that will affect their lives. With this kind of empathetic approach, Denning, Little, and Glickman are clearly striving to make information available to as wide an audience as possible.

Tested in the Real World

Two of the authors of this book are directors at the Harm Reduction Therapy Center in San Francisco. Patt Denning, PhD and licensed clinical psychologist, has served on the faculty of two schools of psychology and is widely recognized as an expert in drug treatment. Over the Influence is a popularized version of the ideas she first set out in her 2000 academic work, Practicing Harm Reduction Psychotherapy. Jeannie Little, LCSW, is the Executive Director of HRTC and trains other mental health professionals on chemical dependency, dual diagnosis, harm reduction, and group treatment of substance abuse. And Adina Glickman, LCSW, has been guided by the principals of harm reduction since the beginning of her work as a therapist.

This wide array of clinical experience has given these well-established professionals ample opportunity to try out their theories with real people—and thus refine their approach.

If you’re considering trying the harm reduction approach with your clients, you may find this book to be a useful information resource to recommend to them. While not something that can be scanned in an afternoon—it’s no comic book—Over The Influence has the information and the street-smarts to reach those who may need it most.

Other Resources on Harm Reduction

Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors.

G. Alan Marlatt, Ed. Guilford Press, 1998.

Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems.

Andrew Tatarsky, Ed. Jason Aaronson, 2002.

Motivational Interviewing: Preparing People for Change (2nd ed).

William R. Miller and Stephen Rollnick. Guilford Publications, 2000.

Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions.

Patt Denning, Guilford Publications, 2000.

Responsible Drinking. A Moderation Management Approach for Problem Drinkers. Fred Rotgers, Marc Kern, Rudy Hoeltzel. New Harbinger. 2002

***********************************************************

Gayle Paul, M.A., is a licensed Marriage and Family Therapist in private practice in San Francisco and Oakland. Ms. Paul was previously the Clinical Supervisor of interns for Bay Area Community Resources, and she's been treating individuals, couples, and adolescents since 1994. Gayle was recently quoted in Teen Vogue, and she can be reached at GaylePaul@comcast.net. You can find more information at www.GaylePaul.org.

Christopher St. John is a freelance writer living in the San Francisco Bay Area. His work has appeared in Hippocrates, The Therapist, The San Francisco Chronicle and other publications.