About this course

Learning Objectives

• Create a non-judgmental, collaborative stance that reduces shame, increases disclosure, and supports ongoing treatment engagement, resulting in engagement with clients who use substances.
• Explain substance use as a functional, meaning-driven behavior by identifying its regulatory, relational, and adaptive roles within a client’s life context.
• Create a detailed “microanalysis” of substance use episodes, mapping triggers, thoughts, emotions, decisions, and outcomes to guide individualized treatment planning.
• Apply harm reduction treatment by collaboratively developing individualized goals (including non-abstinence goals), tracking incremental change, and adjusting interventions over time.
• Assess and respond to risk by identifying immediate dangers (e.g., overdose, drug interactions), providing practical safety guidance, and determining when higher levels of care are necessary.
• Use the therapeutic relationship as a primary mechanism of change by managing countertransference, building trust over time, and creating corrective emotional experiences that support integration and self-regulation.

Learning Levels

• Intermediate

Course Instructor(s)

• 

  Andrew Tatarsky, PhD

  Dr. Andrew Tatarsky is one of the world's leading innovators in addiction treatment and the pioneering force behind harm reduction psychotherapy. In 1998, authored the groundbreaking book Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems, and went on to develop Integrative Harm Reduction Psychotherapy (IHRP)-a model that has transformed how clinicians understand and treat substance use, compulsive behaviors, and emotional suffering.

  Across three decades, Andrew has become the field's most influential voice challenging the limits of abstinence-only care and reshaping the global conversation about addiction. His thinking integrates psychoanalysis, mindfulness, and cutting-edge behavioral science into a coherent, humane, and radically effective clinical approach.

  He is the Founder and Director of The Harm Reduction Therapy Training Center, and previously founded and directed The Center for Optimal Living. He is a Senior Advisor at Silver Hill New York and also serves on the Medical and Clinical Advisory Panels for the New York State Office of Addiction Services and Support. Andrew holds a PhD in Clinical Psychology from the City University of New York and a Certificate in Psychoanalysis from New York University's Postdoctoral Program and is a Professor of Professional Practice at The New School.

Disclosure

References

• Cramer, J. (2024). Harm reduction in psychotherapy [Master's thesis, The University of Western Ontario]. ProQuest Dissertations & Theses Global. https://www.proquest.com/openview/68fd56e6a4febf79bc6c840447a44791/1?pq-origsite=gscholar&cbl=18750&diss=y
• Denning, P., & Little, J. (2024). Practicing harm reduction psychotherapy (2nd ed.). Guilford Press.
• Kellogg, S. (2024). With love and intensity: Some reflections on chairwork, harm reduction psychotherapy, and the treatment of addictions. New York: Chairwork Psychotherapy Initiative. https://www.researchgate.net/profile/Scott-Kellogg/publication/378035247_With_Love_and_Intensity_Some_Reflections_on_Chairwork_Harm_Reduction_Psychotherapy_and_the_Treatment_of_Addictions/links/65c3cc4a79007454976a7325/With-Love-and-Intensity-Some-Reflections-on-Chairwork-Harm-Reduction-Psychotherapy-and-the-Treatment-of-Addictions.pdf
• Krawczyk, N., Allen, S. T., Schneider, K. E., Solomon, K. T., Shah, H., Morris, M., Harris, S., Sherman, S. G., & Saloner, B. (2022). Intersecting substance use treatment and harm reduction services: Exploring the characteristics and service needs of a community-based sample of people who use drugs. Harm Reduction Journal, 19(1), 95. https://doi.org/10.1186/s12954-022-00676-8
• Perera, R., Stephan, L., Appa, A., Giuliano, R., Hoffman, R., Lum, P. J., & Martin, M. (2022). Meeting people where they are: Implementing hospital-based substance use harm reduction. Harm Reduction Journal, 19(1), 14. https://doi.org/10.1186/s12954-022-00594-9
• Reiman, A., & Lessin, B. (2025). Harm reduction approaches with adolescents who use substances. Taylor & Francis.
• Rothschild, D. (2025). A convergence of treatments and ideas: Psychoanalysis meets harm reduction therapy. Psychoanalytic Inquiry, 45(9), 756-767. https://doi.org/10.1080/07351690.2025.2541546