The training I led yesterday on applying Integrative Harm Reduction Psychotherapy to the treatment of adolescents and their families in Skokie, Ill. was an amazing experience of exploration and discovery. Organized by Dr. Eugene Isyanov, Director of Behavioral Services Center, the training brought together 35 clinicians of various backgrounds who exchanged ideas, tackled thorny issues, shared the very personal aspects of doing this work and engaged in skill-building exercises with gusto. Some of the themes we particularly focused on: clinical challenges presented by adolescents at various developmental phases and their families, the paradigm shift in the addictive behaviors field from the old “disease concept” to a psychobiosocial/multiple meanings process model and its implications for treatment, is addiction a substance-related disordered or a trauma-related one?, how problems of self-regulation represent vulnerability to addictive behavior, if substances are used to manage symptoms of trauma in adolescence are they adaptive?, the important of integrating self-management skills-building, exploration of meaning and body-oriented interventions into psychotherapy and addiction treatment, establishing and alliance with the patient around compassionate curiosity (Donnel Stern), engagement skills of empathic listening, collaborative exploration and empathic reflection and the therapeutic expression of the harm reduction principle of “starting where the patient is”, embracing ambivalence as a motivational intervention and support of the patient’s integration of dissociated aspects of self expressed through addictive behavior, urge-surfing and unwrapping the urge as techniques for self-managing behavior change and integrative the dissociated aspects of self contained in the urge, social and personal countertransference as the major obstacles to therapeutic engagement, presumptions about “addict”-”addiction”-patient’s goals as important aspects of countertransference to be alert to, dealing with mandating agencies that have unrealistic expectations about the patient’s progress, the need to help patients deal with these realities in empowered ways, the need for clinicians to see themselves as political/social change agents, and more!
Dr Isyanov and his colleagues contributed much of value to the day as did Dan and Karen Bigg of Chicago Recovery Alliance, one of the first trail-blazing harm reduction organizations in the country based in Chicago.
There is an exciting international community working to learn and integrate these ideas and strategies into their work and settings and the community just became a little larger and richer yesterday. I am honored to have been a part of the process and look forward to next one.
I and the Center for Optimal Living are currently planning a three day intensive training in collaboration with the mental Health and Substance Use Masters Program at the New School in New York City in September. The three days will enable us to cover all the didactic and skills-building exercises of the Seven Psychotherapeutic Tasks of Integrative Harm Reduction Psychotherapy. Stayed tuned for more details.
I hope you can participate.
Best, Andrew Tatarsky
