Andrew Tatarsky

Moderation Management gives famous Hemmy Award to George Clooney during the Golden Globes.

Hollywood, California (PRWEB) January 26, 2012

International film super star, producer, and director, Mr. George Clooney, can add another unique honor alongside the awards for his achievements at this year’s Golden Globe Awards as the first recipient of Moderation Management’s “The Hemmy Award.”

Consistent with Mr. Clooney’s leadership roles and humanitarian efforts, Clooney sent out a clear message when he said, “I’ve made a little New Year’s deal that I wouldn’t be drinking for a while. I’m giving my liver a chance to catch back up.” By making such a public statement, Mr. Clooney has unintentionally taken on a leadership role in endorsing a realistic healthy attitude about alcohol. His unflinching statement brings a contemporary tone toward what should be considered normal drinking in today’s global society. Moderation Management commends Mr. Clooney’s mature statement for setting a valuable positive standard to the world.

“The Hemmy Award” (named after Ernest Hemingway) was awarded to Mr. Clooney by Moderation Management, a national non-profit 501-C organization created to educate the general population, to support moderate alcohol consumption, and to prevent alcoholism. Founded in 1994 as a Professionally-Reviewed Program, Moderation Management (MM) provides free research-based information regarding alcohol use, moderate drinking guidelines, and treatment alternatives for taking control over alcohol misuse and abuse.

Mr. Clooney has spontaneously joked on camera to the Hollywood community, “this isn’t a permanent change.” Mr. Clooney made it clear that it’s smart and healthy to step away from drinking from time to time, without implying permanent abstinence must be the next step. His personal statement has consequently made him a role model, advocating for a “normal point of view toward alcohol,” and that speaking out about one’s own drinking should not be seen as a stepping stone to ruining careers or needing rehab.

Moderation Management’s methods are listed on MM’s website moderation.org and the guidelines are expanded on in the book, “Responsible Drinking,” which recently won the Association for Behavorial and Cognitive Therapies’ (ABCT) Self-Help Book of Merit Award – authored by Frederick Rotgers, Psy.D. , Marc F. Kern, Ph.D. and Rudy Hoeltzel.

Please refer any questions to Dr. Kern at the following email HabitDoc(at)aa2(dot)org or http://www.HabitDoc.com

The Committee on Psychoanalysis and Addictions Treatment of PPSC, on Saturday, March 24,  will present Andrew Tatarsky, PhD, who will discuss “Keeping Your Head When the Patient Is Still Using: Integrative Harm Reduction Psychotherapy and the Therapist’s Countertransference”:

When treating excessive substance use and other dangerous behaviors, the therapist’s countertransference can often get in the way. Dr. Tatarsky will discuss both the challenges and opportunities inherent in working with active users. Through clinical case examples, the presenter will demonstrate how an integrative harm reduction approach can help the therapist steer an effective course between either enabling or alienating the patient.

For more information and registration click here to go to the following link  http://www.ppsc.org/copat-spring-2012/

The Center for Optimal Living is starting a Mindfulness-based Emotion Management Skills Group this Wednesday January 18 at 6 PM.

This group will provide an introduction to mindfulness and emotion management techniques. These skills are designed to promote a more accepting and compassionate response to thoughts and emotional patterns that cause distress. Specifically, we will discuss how mindfulness skills can be used to manage difficult emotions, cope with stressors, and track urges to use. How these emotional states contribute to substance misuse and other problematic behaviors will also be explored in the group.

Sessions will incorporate mindfulness-based techniques as a way to foster a less reactive stance towards stressors and interpersonal conflicts. Another focus of the group will be on relationship skills and the barriers associated with connecting with others. Discussions will center around how to develop more authentic and meaningful connections with others.

Emphasis will be placed on providing practical skills that can be readily applied in daily life to reduce distress. This will be done through an exploration of current habitual patterns and how we may begin to slow down and notice these automatic reactions. Participants will be guided through mindfulness-based exercises to increase the connection between the mind and body. Sessions will consist of an introduction to breathing and mindfulness skills, cognitive- behavioral techniques such as using thought records to monitor patterns associated with intense emotional states, and grounding exercises.

For more information, please contact Jenifer Talley, Ph.D. at jenifertalley327@gmail.com or (212) 523-1072.

The New School for Social Research

Presents a 2-day workshop led by Andrew Tatarsky, Ph.D

Effective Psychotherapy of Substance Use Problems:
An Integrative Harm Reduction Approach

Friday, February 10th, 2012 10:00 a.m. – 4:00 p.m.
at Kellen Auditorium (66 5th Ave., Ground Floor, Room N101)
and
Saturday, February 11th, 2012, 10:00 a.m. – 4:00 p.m.
at Wolff Conference Room (6 East 16th St., Room 1103)

This workshop will introduce Dr. Tatarsky’s Integrative Harm Reduction Psychotherapy (IHRP) described in his book, Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems, and a series of recent papers.  An accumulation of evidence supports the complex psycho-biosocial view that addictive behaviors reflect an interplay of biology, personal and interpersonal meaning, habit and social context that is unique to each individual.  IHRP emphasizes that the therapeutic alliance and relationship create the necessary context where exploration of the multiple meanings and functions of addictive behavior takes place as well as does active strategizing for positive behavior change.  This model suggests that the concept of harm reduction is essential to the effective treatment of substance misuse and other risky and addictive behavior.

During this interactive 2-day workshop, Dr. Tatarsky will define the harm reduction mode and will discuss its history, evolution, and theory.  Epidemiological and clinical rationales will also be discussed. IHRP’s seven therapeutic tasks and specific techniques will be described. Participants will have opportunities to practice skills and technique with interactive exercise and  are encouraged to bring case material and clinical challenges for discussion.

As a result of attending this training, participants will be able to:

1. Describe the theory and clinical rationale of IHRP
2. List at least three of the seven therapeutic tasks
3. Practice engagement skills
4. Enhance the therapeutic alliance with clients
5. Explore the benefits of guided relaxation and breath-work

Workshop Sponsored by: The New School for Social Research, Department of Psychology.

Concentration in Mental Health & Substance Abuse Counseling, 212-229-5727 ext. 3097, email: MHSAC@newschool.edu

Workshop is approved by NYS-OASAS for 12 clock hours of Renewal and Initial credit.   Enrollment will be limited.

Fees: $300 ($150/day); New School students/faculty/staff: $150 ($75/day);
Beth Israel/St. Luke’s-Roosevelt employees: $150 ($75/day); CMHSAC students: $60 ($30/day)

More information and publications describing Integrative Harm Reduction Psychotherapy can be downloaded for free at www.andrewtatarsky.com at the Media/Professional Publications page.

Dr. Andrew Tatarsky has specialized in the field of substance use treatment for individuals, group, couples and families for 30 years as a psychologist, supervisor, program director, lecturer and author. He holds a doctorate in clinical psychology from the City University of New York and is a candidate in New York University’s post-doctoral program. He is the Director of The Center for Optimal Living, a treatment and training center in New York City.

Download Registration:
Word DOC or Adobe PDF

The Center for Optimal Living Presents:
Integrative Harm Reduction Psychotherapy
A 2-part Training led by Andrew Tatarsky, Ph.D

Part I: Introduction to Integrative Harm Reduction Psychotherapy
Friday, December 9th, 2011 9:30 a.m. – 4:30 p.m.
Location in NYC: To be determined

and

Part II: Techniques and Strategies of
Integrative Harm Reduction Psychotherapy
Friday, December 16, 2011, 9:30a.m. – 4:30 p.m.
Location in NYC: To be determined

This workshop will introduce Dr. Tatarsky’s Integrative Harm Reduction Psychotherapy (IHRP) described in his book, Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems, and a series of recent papers. An accumulation of evidence supports the psychobiosocial view that substance use problems and other risky behaviors reflect an interplay of biology, personal and interpersonal meaning, habit and social context that is unique to each individual. IHRP emphasizes the therapeutic alliance and relationship as the necessary contexts in which exploration of the multiple meanings and functions of these problems and active strategizing for positive behavior change can take place.

Part I: Description, goals, objectives -

This one-day workshop will introduce participants to the theory, rationale and history of integrative harm reduction psychotherapy. Through lecture and interactive activities, participants will be able to:

• Understand harm reduction’s core principles
• Describe a person’s substance use in terms of the Psychobiosocial, Multiple
• Meanings and Stage of Change models
• Identify the Seven Therapeutic Tasks of IHRP

Part II Description, goals, objectives

In this one-day workshop Dr. Tatarsky will describe and demonstrate the foundational skills and strategies of the Seven Therapeutic Tasks of IHRP. Participants are encouraged to bring case material and clinical challenges for discussion. Through lecture and interactive activities, participants will be able to:

• Utilize strategies for establishing therapeutic alliance, building self-management skills, Urge-surfing and embracing ambivalence
• Utilize the Microanalysis and Unwrapping the Impulse techniques for assessment
• Utilize the Ideal Use Plan technique for developing a personalized plan for positive change

Dr. Andrew Tatarsky has specialized in the field of substance use treatment for individuals, group, couples and families for 30 years as a psychologist, supervisor, program director, lecturer and author. He holds a doctorate in clinical psychology from the City University of New York and is a candidate in New York University’s post-doctoral program. He is the Director of The Center for Optimal Living, a treatment and training center in New York City.

Registration form: Word DOC or Adobe PDF

TREATING THE PERSON

Substance Misuse is not just a Brain Disease: The Personal and Social Meanings of Drugs and the Critical Role of Integrative Harm Reduction Psychotherapy

Nov. 2, 2011
A Plenary talk delivered to The National Drugs Conference of Ireland 2011
Andrew Tatarsky, PhD

It is a great honor to have been invited to address this conference and I want to thank Tim Bingham and the Irish Needle Exchange Forum for the opportunity. It is a special pleasure because Ireland is the birthplace of my great grandmother Catherine McAree.

Drug Treatment is in Crisis around the World

We are here together to address an international crisis. We are not doing a good job of helping the millions and millions of people with drug and alcohol problem anywhere on the planet! The US government estimates there are 80,000,000 Americans with abuse, dependence or binge use problems and we treat a tiny, tiny fraction of them ineffectively. Some version of this exists in every nation on the planet and I am sure it exists here in Ireland. It is not because we don’t care. We spend billions on the international war on drugs, research and the treatment industry. We care that our loved ones are dying of overdose, suffering, missing work, creating problems in their families, taxing our medical systems and so on. So is it the cunning baffling disease of addiction, the evil drug sellers? Or is it our adherence to old, wrong ideas, misinformation, ideology and fear? I put to you that we may be more comfortable with our wrong, overly simplistic ideas and solutions than with new ideas that may work better.

From Disease Model to Psychobiosocial Model

Our models or paradigms for understanding things determine how we act on them. We are in the midst of a scientific revolution in how we understand substance misuse and addiction. We are moving from on old simplistic disease model, an addictive experience we reify as a disease that is assumed to be biological in origin and is only arrested by complete and total abstinence, toward an emerging new psychobiosocial model in which biology and behavior interact with meaning and social context in complex ways that are unique to each person and give rise to the phenomena.

Integrative Harm Reduction Psychotherapy

My more than 30 years of clinical experience working with people with drug and alcohol problems have convinced me that this more complex way of understanding substance misuse and addiction suggests that an integrative harm reduction psychotherapy can dramatically increase our ability to help people with drug use problems heal, grow and create positive change in their lives. I will try to make this case to you in the next half hour. These ideas have been presented in my book, Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems and a number of journal articles and book chapters.

Personal and Social Meanings of Drug Use

For many, if not most problems users, alongside the brain changes associated with acute and chronic use and the powerful conditioning of habits that accompanies them, the multiple personal and social meanings that substances carry and express are powerful motives for understanding continued use in the face of negative consequences, the definition of the addictive experience. An appreciation of the reasons people use, the personal, subjective, often hidden dimension of drug use is critical to every aspect of treatment: engagement, therapeutic alliance, assessment, diagnosis, treatment planning and successful outcomes for the entire spectrum of substance use problems. Failure to adequately appreciate this is a key contributor to treatment’s poor success.

Substance Use/Addiction is (Not Just) a Brain Disease

This is particularly important to consider in light of increasing knowledge about the brain basis for substance misuse, a very welcome development that has important positive implications for treatment and social policy.

In August it was reported in the LA Times that the American Society of Addiction Medicine declared, “Addiction is a brain disease”. It said addiction is “not simply a behavioral problem involving too much alcohol, drugs, gambling or sex”. Instead, the society notes, “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.”

This follows an earlier statement in a 2004 report, by National Institute of Drug Abuse,  Director Dr. Nora D. Volkow, and NIAAA Director Dr. Ting-Kai Li, published in the December 2004 issue of Nature Reviews Neuroscience. Dr. Volkow said, “Drug addiction is a brain disease…Although initial drug use might be voluntary, once addiction develops this control is markedly disrupted. Imaging studies have shown specific abnormalities in the brains of some, but not all, addicted individuals.”

And even earlier, in 2001, former NIDA director, Alan Leshner, said, “A core concept that has been evolving with scientific advances over the past decade is that drug addiction is a brain disease that develops over time as a result of the initially voluntary behavior of using drugs. The consequence is virtually uncontrollable compulsive drug craving, seeking, and use that interferes with, if not destroys, an individual’s functioning in the family and in society. This medical condition demands formal treatment. It is as if drugs have highjacked the brain’s natural motivational control circuits, resulting in drug use becoming the sole, or at least the top, motivational priority for the individual.”

These statements are very compelling and have positive implications for society’s view of addicted people and their treatment. Once and for all we should be able to stop blaming addicted people for their illness. They should be treated not shamed, kicked out of treatment for the illness and incarcerated.

These statements make it sound like the science is in. The problem is the brain changes brought about by chronic drug misuse. The reasonable inference is that the solution will be found in brain interventions, new medications, stopping the toxic agent that caused the disease, complete and total abstinence, getting the addict to accept the disease, perhaps even a vaccine. Seems like great news. These statements can be interpreted to suggest that it is the brain changes associated with chronic drug use that are the sole explanation and not psychology and social context.

This would be a mistaken interpretation even according to Alan Leshner, the person who coined the phrase “drug has highjacked the brain’s natural motivational control circuits”. Dr. Leshner speaks to this more or less when he said later in the piece I quoted above, “Many people erroneously still believe that biological and behavioral explanations are alternative or competing ways to understand phenomena, when in fact they are complementary and integratable. Modern science has taught that it is much too simplistic to set biology in opposition to behavior or to pit willpower against brain chemistry. Addiction involves inseparable biological and behavioral components. It is the quintessential biobehavioral disorder.”

Brain + Behavior + Multiple Meanings

I would like to build on Leshner’s statement and suggest that problematic substance use is not just driven by brain changes and conditioning but is also motivated by the personal meanings and functions the behavior takes on. People use drugs for reasons, reasons that may feel vital to the user’s survival. Some of them are clear to the user and some are out of people’s awareness. These reasons become intertwined with biology, conditioning and social context in ways that are unique for each person. Ignoring the meaning dimension is likely to set up failure as these powerful motives are kept out of the treatment.

The Meaning Dimension

I will give you a sense of this from experiences reported to me by my patients over the years. The acute effects that drugs have on the brain are rewarding and become meaningful in relation to the whole person in his or her social context. These brain changes becomes wrapped in meaning, take on multiple meanings that add to or determine their reinforcing effects. People use drugs because they feel good or work and are reinforcing in some way. The pleasure may be particularly important in relation to a life in which there are few other sources of pleasure available such as lives of poverty, homelessness or increasingly common work lives in which the hours demanded leave little time for self-care and recreation. The temporary escape afforded by getting high may be compelling in relation to a perfectionistic, self-critical personality style that does not allow one to relax because one’s work is never done, one’s achievements are never good enough, one is filled with anxiety about the threat of failure or depression over feeling that one has already failed. I see this picture every day in my patients. The release afforded by the drug effect is frequently a release from a generalized sense of inhibition, an inability to express one’s feelings, needs and vulnerability spontaneously in life such that one feels dead, cut off, disconnected and tense. In this personal context the high may enable one to have the temporary experience of feeling alive, able to connect with others, to express anger, sexuality, grief and enthusiasm, temporarily feeling whole.  Drug use may also express feelings and needs in the act of using that people are unable to express in words interpersonally. Such as anger at feeling controlled by a boss or spouse that one feels too vulnerable or insecure to express directly. While I don’t feel safe enough to tell you I resent the way you speak to me when I drink too much, I can continue to drink too much to defy your efforts to control me and express my anger by killing you off in my mind when I am drinking. Or excessive drug use may be my cry for help, the way I express my need to be cared for, my way of saying I am in agonizing emotional pain and never learned how to ask for help in the abusive family I grew up in. Please don’t reject me as my parents did, help me learn how to care for myself in a healthier way.

The Psychobiosocial Process Model of Misuse and Addiction

Trauma and Dissociation

Sometimes the reasons for using are very much in the user’s awareness. If you ask many people with empathy, curiosity and respect why they use they will tell you. However, in people who have experienced trauma early in life such as significant physical, emotional or sexual abuse, loss or abandonment, deficient parenting or mental illness in the family, substance use may become meaningful in ways that are dissociated and outside the user’s awareness. If you ask the user why, he or she may not be able to say more than I felt like getting high. Trauma is typically coped with by dissociating, cutting off feelings, getting rid of parts of oneself that threaten to bring about more trauma by overwhelming one’s capacity to function or threaten more attacks. Anger, sadness, grief, shame, humiliation, aliveness, curiosity all may become threatening and need to be suppressed and denied. These vital parts of the self may live in vague discomfort, just out of awareness, leaving the trauma survivor feeling tense, dead, tuned out, like a ghost, or like Frankenstein, as one of my patients described herself. These vital parts of the self may find expression in substance use. The substance use can provide the user a temporary experience of being able to connect with these parts and feel alive. The “addict self” may both contain the parts of me that were unwanted, beaten and humiliated and the parts of me that want to live and survive in a family that does not want them. I want so badly to be loved that I will be good, submissive and pleasing. However, my own needs for recognition and self-assertiveness build up with such overwhelming frustration and intensity that I must use drugs to give myself a small window of escape to just be myself and not have to worry about other’s feelings. I see this dynamic repeated over and over with my patients.

Early trauma also typically results in problems managing intense emotional states, self-hate and other self-esteem problems, mistrust of others and a loss of faith in the world and the future and pervasive feelings of anxiety, panic and dread. All these problems render people likely to find states of intoxication relieving in some way. I have seen trauma in my patients early lives so frequently that I am beginning to think that excessive substance use is a meaningful reaction to trauma as an attempt to cope with what may otherwise be unmanageable pain.

When drugs carry and express important personal and social meanings for the user, the thought or giving the drug up or cutting back may be experienced as a threat to one’s psychic stability and capacity to function in the world. Where drug use has taken on conscious and unconscious meanings, it may take some time, with proper exploration in a safe therapeutic relationship for the person begin to identify the meaning and function of the drug use so that alternative less harmful routes of expression or satisfaction can be found. If you begin to ask why people use, be prepared to hear stories filled with pain and trauma.

Empirical Support

There is an increasing amount of empirical research that supports my observations that substance use is often a meaningful response emotional difficulty often the result of early traumatic experiences. For example, studies have found as much as 86% of women with significant substance use problems have histories of early sexual of physical abuse and men with histories of sexual abuse have a significantly greater incidence of serious substance use problems that men without these histories. Another source of empirical support comes from the Adverse Childhood Experiences Study. Looking at the relationship between adverse childhood experiences including recurrant physical and emotional abuse, sexual abuse, loss of a parent, and growing up with a mentally ill parent, they found strong correlations between number of these experiences and later incidence of smoking, alcoholism and injection drug use. They conclude that “addiction is an understandable…compulsive use of psychoactive materials in response to abnormal prior life experiences…the basic cause of addiction is primarily experience-dependent during childhood not substance dependent”.

Psychotherapeutic Implications: Integrative Harm Reduction Psychotherapy

In my view, along with medical and behavioral interventions, people with drug problems need therapeutic contexts that will help them to clarify the meanings and positive functions that drugs have for them while they continue to use, this is my definition of a harm reduction psychotherapy. Expecting someone to give up a drug that fulfills a vital role in one’s life before he or she has identified the meaning and discovered a new solution will be met by understandable resistance. The harm reduction principles of meeting people where they as unique people with their own goals, and readiness to change and embracing all reductions in drug related harm are the ideal conditions under which to establish treatments that make this possible. The therapeutic translation of these principles is a primary emphasis on therapeutic alliance initially and throughout treatment. Therapeutic alliance is possible when the patient feels understood fully with empathy and respect.

Integrative harm reduction psychotherapy offers the user a therapeutic space or relationship wherever the user is regarding goals, “meeting the user where the user is” and embracing “any positive change”. This makes the therapeutic alliance possible. In turn, this enables the mutual collaborative exploration of the variables that contribute to the substance misuse. As the variables are identified it now becomes possible to bring together biological, psychological and social interventions to address them. Ignoring these powerful motives for using will subvert other well meaning efforts to support positive change. It is also reminiscent of early traumatic neglect and re-traumatize the patient. By not allowing or inviting, if necessary, the abused, unwanted agonizing aspects of the patient that are often revealed in the exploration of substance use into the room, the message is, we don’t want to hear it, keep it to yourself and the drug use remains the best available solution. Creating a safe relational space for people to bring these unwanted parts of themselves enables the possibility of healing, growth and positive change regarding substance misuse and the whole person.

The Center for Optimal Living offers comprehensive therapeutic services for people-and their families-dealing with substance use problems and other risky, excessive and addictive behaviors.

Our Model and Approach

We “start where the person is” regarding needs, motivation, goals, strengths, cultural background, preferences and other unique qualities to develop a personalized therapy in which goals, strategies, modalities and therapeutic style are determined collaboratively with each patient. Our approach is based on the evidence-supported Integrative Harm Reduction Psychotherapy model developed by Dr. Andrew Tatarsky in collaboration with many others. Our services incorporate psychodynamic, cognitive, behavioral, motivational, relapse prevention, experiential and mindfulness interventions.

Relationship, Understanding, Skills-Building: Our Active Strategies for Positive Change

The relationship between the patient and clinician makes the process of healing, growth and positive change possible. We understand problematic behavior as reflecting an interplay of physical, psychological, emotional, interpersonal, social and cultural factors that is unique to each person.  As these factors are identified they are addressed concurrently with the problem behavior. We offer active strategies to promote positive change in problematic behaviors and related feelings, thoughts and behaviors. To the extent that problematic behaviors carry personal and social meaning, these meanings may need to be expressed, understood, and addressed as we engage in promoting positive change.  All positive changes in problem behavior (reducing, safer use, moderating and abstaining) are seen as successes.

We are pleased to introduce our clinical team and describe the groups we are currently starting.

The Clinical Team

Andrew Tatarsky, PhD (Executive director)

Dr. Andrew Tatarsky has specialized in the field of substance use treatment for over 30 years as a psychologist, supervisor, program director, lecturer and author.  He holds a doctorate in clinical psychology from the City University of New York and is a candidate in NYU’s Postdoctoral Program in Psychoanalysis and Psychotherapy.  He is the director of The Center Optimal Living, a treatment and training institute, a founding board member of the Division on Addictions of New York State Psychological Association, Chairman of the Board of Moderation Management, Clinical Advisor to the New York State Office of Alcoholism and Substance Abuse Services and on the boards of several harm reduction organizations. His book, Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems has been published in the United States, Chile and Poland.  Dr. Tatarsky is in private practice in NYC and trains nationally and internationally.

Michael Benibgui, PhD

Michael Benibgui, Ph.D. is a clinical psychologist, and published research scientist. He has directed federal and state funded mental health and substance abuse treatment programs as well as clinical research trials for various non-profit organizations in New York City. Dr. Benibgui currently serves as project director of a SAMHSA (Substance Abuse and Mental Health Services)- funded dual-diagnosis treatment program at Services for the UnderServed, a large NYC social services agency. Prior to that he served as clinical director and program director of two similar state and federally funded mental health programs at GMHC, and assistant project director of a large scale, NIAAA (National Institute of Alcohol Abuse and Alcoholism) clinical trial at New York State Psychiatric Institute, Columbia University Medical Center, which investigated a novel medication-assisted motivational psychotherapy to help participants change their alcohol consumption towards safer levels.  His research focus has centered on substance abuse and mental health treatment with cultural and sexual minority populations, and people living with HIV/AIDS, and on the bio-psycho-social factors related to mental health in LGBT young adults, with a specific focus on the health impacts of minority stress and discrimination. His clinical approach is rooted in integrative harm reduction psychotherapy, motivational interviewing, cognitive-behavioral and psychodynamic principles. He has particular expertise in adapting a wide range of evidence based approaches to the individual needs of clients. Achieving balance in life, work, and play are seen as optimal goals of the collaborative therapeutic work. He serves on the board of directors of Moderation Management, a non-profit, peer-led, support group network for people concerned about their drinking who desire to make positive lifestyle changes and as a member of the Executive Committee of the New York State Psychological Association Division on Addictions. Originally from Montreal, Canada, he completed his graduate training at both Concordia University and McGill University, and can conduct psychotherapy in English, French, and Hebrew.

Wendy Miller, PhD

Dr. Wendy E. Miller is a Clinical Psychologist in private practice for 25 years in NYC.  She is on the faculty of The Women’s Therapy Centre Institute where she supervises and teaches a course on doing short term group therapy for eating problems based on the model of attuned eating developed by Susie Orbach.  She is also a candidate at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis.  She received her PhD from George Washington University and completed training in sex therapy at Downstate Medical Center.  She has been trained in Sue Johnsons Emotionally Focused Couples Therapy.  Her passionate interest in working with sexuality and couples stems from an appreciation of the difficulty of sexual and emotional connection for many individuals and from a deep belief in the healing potential of relationship.  Her approach draws from relational, cultural, psychodynamic and feminist principals.  In addition, Dr. Miller is interested in working with couples where there is substance use/misuse that is causing distress to one or both of the partners.  She is developing a model of how to work with these couples from a harm reduction perspective.

John P Pasagiannis, PhD

Dr. John P Pasagiannis is a licensed clinical psychologist with over seven years of clinical experience with substance use issues, mood disorders, and other problematic behaviors. He works from an integrative harm reduction model that draws upon psychodynamic, cognitive behavioral and motivational enhancement traditions. He believes that this approach is best suited for the development of a collaborative therapeutic relationship that promotes safety, empowerment, the development of coping skills, insight and well-being. Dr. Pasagiannis specializes in working with artists and young adults. He has worked with actors, photographers, musicians and artists. His personal journey as a musician in the New York alternative music scene has given him a unique perspective and empathy for the challenges facing artists pursuing careers in the entertainment industry. His group work with young adults is guided by a deep appreciation of the complex interaction between the period’s developmental needs, increased academic pressures, individuation processes, and sociocultural dynamics. Dr. Pasagiannis received his doctorate degree in Clinical Psychology from Adelphi University in New York and completed a yearlong fellowship at Saint Luke’s/Roosevelt Hospital Out-patient Clinic. He worked as the Supervising Clinical Psychologist at Cumberland Diagnostic & Treatment Center’s Chemical Dependency Out-patient Program where he provided risk assessments, crisis management, evaluations, individual and group therapy for adults and adolescents. Dr. Pasagiannis acted as liaison between Cumberland and the buprenorphine program at Woodhull Hospital and supervised psychology interns. Currently he is a consultant at LA PALESTRA, Center for Preventative Medicine, and, as a member of its multi-disciplinary team, collaborates with nutritionists, physicians, physical therapists and exercise instructors. He was a Leopold Schepp Foundation and Glass Institute Scholar and served on NYSPA’s Division on Addictions Executive Committee.

Marlene Reil, PhD, CASAC

Dr. Marlene M. Reil is a licensed psychologist specializing in co-occurring mental health, substance use, and physical health disorders. Using a variety of evidence-based and promising practices in her work including motivational interviewing, cognitive behavioral therapy, contemplative psychotherapy, and integrated wellness self-management, she helps clients build on their own inner strengths and enhance their capacity to cope with life’s stressors. Formerly the coordinator of the Office of Health Integration at the New York City Department of Health and Mental Hygiene,  Dr. Reil co-directed the Mind Your Health Peer Coaching Program, a peer health and wellness coach training program, and also co-authored the City Health Information publication ”Improving the Health of Adults with Serious Mental Illness” in 2010. She has a PhD in psychology with a concentration in substance abuse counseling from the New School for Social Research in New York City, is a certified alcohol and substance abuse counselor, and has been trained in psychoanalytic psychotherapy. Dr. Reil is also an educator at a nonprofit healthcare training and capacity building organization and provides training on mental health and substance abuse topics as they relate to at-risk individuals and individuals with chronic health disorders such as HIV/AIDS. She is passionate about assisting people who wish to manage their excessive behaviors by integrating mindfulness practices while building self-esteem and a healthy self-image. She is a well-known expert in tobacco dependence treatment.

Jenifer Talley, PhD

Dr. Jenifer Talley received her doctorate in clinical psychology from Virginia Tech and is a New York State licensed psychologist.  She specializes in the treatment of trauma and addiction and has worked as a Supervising Psychologist at the Women’s Health Project of St. Luke’s-Roosevelt Hospital for the past three years.  In addition, she is the Assistant Director of the Concentration in Mental Health and Substance Counseling at the New School for Social Research where she participates in the training and supervision of students in the master’s program in psychology. Working from a harm reduction framework where she believes in the importance of honoring the client’s role and choice in the treatment process, her integrative approach combines elements of mindfulness-based cognitive therapy, cognitive-behavioral therapy, motivational enhancement, and dialectical behavior therapy.  By cultivating a safe therapeutic relationship where she is attuned to her clients’ evolving goals and needs, Dr. Talley views therapy as a collaborative process. Her approach focuses on the development of practical skills to reduce self-judgment, promote self-compassion and manage difficult emotions. Mindfulness skills are integrated into individual and group sessions and are seen as an essential component of treatment.  Her experiences have taught her the importance of slowing down and focusing on the present moment.  She has seen how simply focusing on the breath can provide relief from distress.   From the mutual exploration of how the mind and body are connected, there will be an opportunity to reflect on how thoughts, feelings, physical sensations, and behaviors may be contributing to substance misuse and other issues.

Our Groups

We offer comprehensive evaluation, stabilization and treatment planning. For each plan we consider the appropriateness of individual, group, couple and family therapy.

We are currently accepting patients for the following groups. Please call Dr. Andrew Tatarsky at 212-633-8157 for further information or to discuss making a referral.

Artist’s Group

This integrative harm reduction psychotherapy group is designed to address the special needs of artists. The group will meet each artist where he/she is at in relation to current challenges in their lives. Substance use and other potentially harmful behaviors contain multiple meanings which need to be acknowledged and articulated and can be used to address the various pressures that confront artists. Issues to be explored may include the use of substances and other behaviors to facilitate, enhance or address blocks in the creative process, manage overwhelming emotional states associated with artistic expression, regulate pre and post-performance affective states, balance competing responsibilities, and cope with the various pressures of increasingly complex business interactions and decisions. As the various functions of the use are explored and articulated, group members will be encouraged to develop active strategies that promote positive change in problematic behaviors and related feelings and thoughts while minimizing harm.

John Pasagiannis, PhD
Monday 3:30-5:00 PM

Young Adult Group

This group is conducted in a collaborative manner amongst college age people who face similar life challenges. Young adulthood is a transitional and often confusing time that contributes greatly to identity definition and self-image formation. The process orientation of the group encourages young adults to express their age appropriate concerns amongst their peers. This period’s stressors may include conflicts with parents, separation-individuation issues, relationship ruptures, increased academic pressures, money issues, changes in social environment, time management, and the function of drug use in the context of these stressors. As the group explores the meanings and functions of drug use within young adult culture, we will explore the pros and cons of use and misuse and engage in consideration and application of alternative ways of managing increasingly complex life experiences the members bring to the group.

John Pasagiannis, PhD
Wednesday 4-5:30 PM

Lunchtime Harm Reduction Psychotherapy Group

This group is open to adults with a range of substance use issues and other risky behaviors who are in a variety of stages of change. The group will provide a safe, supportive space to explore the nature and meaning of members’ substance use and how it relates to the full range of other personal and life issues people face.  The group has a strategic focus on assessing harm, embracing ambivalence about change, setting harm reduction goals and developing individualized plans for positive change. A general goal might be for members to develop their healthiest relationship to substances whether that is safer use, reduced use, moderation or abstinence. The group enables open exploration, sharing of strategies and focus on interpersonal process in the group.  A variety of techniques are taught including: “Urge Surfing”, awareness and relaxation training, self-monitoring, Decisional Balance,  ”Microanalysis” of use patterns, the “Ideal Use Plan”, the “Game Plan” and “18 Alternatives”. We also explore how relational issues get enacted in the group and can get reworked in the group process.

John Pasagiannis, PhD
Monday 12-1 PM

Self-Management Skills Building Group

This group is comprised of a series of psycho-educational, didactic, and experiential exercises for those thinking about making changes to behaviors that have a high potential for negative consequences (substance/alcohol misuse, compulsive shopping / spending,  gambling, overeating, compulsive sexuality, and others). The group will complement and consolidate learning and insight that occurs in concurrent individual therapy. Participants will learn practical strategies to assist them along their path towards change, if they ultimately choose to do so. Sessions will be time limited (8 sessions) and afford participants to graduate from one level of skill acquisition complexity to another as they meet their own change goals. Concrete skills that will be addressed include self monitoring, identifying triggers, urge surfing and moderation / harm reduction techniques. The format will be personalized to the specific challenges brought up by group members. These exercises may take the form of in group role plays, in session and homework assignments, as well as other creative interventions best suited to the makeup of the group. Trust building amongst participants and group cohesion will be a special initial focus and will be monitored throughout the process.

Michael Benibgui, PhD
Wednesday 6-7:30 PM

Gay/Bi Men’s Group

This group will provide clients at varying stages of motivation for change with an opportunity to explore and gain insight into the patterns of behaviors and inter-personal relationships that have contributed to life challenges and emotional problems. This group will also address the management of risk taking behaviors with regards to drugs / alcohol use and risky sexual behaviors, with an objective of reducing harm and developing healthier relationship to these behaviors. Participants will learn how to self monitor and develop a change plan to successfully moderate these behaviors, as they see fit, and as informed by group feedback. This group will also afford participants with an experiential opportunity to address issues of intimacy, trust, and existential meaning through the exploration of self and group dynamics.

Michael Benibgui, PhD
Tuesday 7:30-9 PM

Managing Strong and Difficult Emotions

This group will offer skills to increase the capacity to tolerate and accept intense emotions such as fear, anger, depression, and shame from a non-judgmental and compassionate perspective.  The group will explore how emotional states contribute to substance misuse and other problematic behaviors.  Sessions will incorporate mindfulness-based techniques as a way to foster a more accepting and less reactive stance towards stressors and interpersonal conflict.  The group will also focus on relationship skills, barriers to connecting with others, and how to develop more authentic and meaningful relationships.  Emphasis will be placed on providing practical skills that can be readily applied in daily life to reduce distress.  Sessions will consist of an introduction to breathing and mindfulness skills, cognitive-behavioral techniques such as using thought records to monitor patterns associated with intense emotional states and grounding exercises to promote an increased awareness of the connection between the mind and body.

Jenifer Talley, PhD
Tuesday 6-7:30 PM

Harm Reduction Psychotherapy Group For Women

This group is designed to be a supportive and safe environment for women at various points on the continuum of change to explore the function and meaning behind substance use and other problematic behaviors.  As part of this group, members will gain a more nuanced understanding of how certain thought patterns, emotional states, and relationships may be impacting their decisions to engage in potentially harmful behaviors.  Skills to identify and manage urges to use will also be incorporated, along with relaxation techniques and positive coping statements.  Through the development of these skills, members will learn how to cultivate a more compassionate stance towards themselves and others.

Jenifer Talley, PhD
Monday 5-6:30 PM

Creating the Path to Tobacco-Free Living

The goal of this eight-week group is to help people who use tobacco who are thinking about cutting down or stopping tobacco use to gain the knowledge and skills they need to plan and carry out a tobacco reduction or cessation plan. Participants will explore their relationship to tobacco and the role tobacco use plays in their lives. They will examine the benefits and risks associated with tobacco use and will evaluate approaches to tobacco reduction and cessation including using nicotine replacement therapy or cessation medications in conjunction with supportive counseling. Group members will discuss methods of identifying and anticipating triggers to tobacco use, techniques of coping with withdrawal, and ways of preventing relapse. Participants will be encouraged but not required to make a cessation or reduction attempt during this eight-week group.

Marlene Reil, PhD, CASAC
Monday 6:45-8:15 PM

Harm Reduction Psychotherapy Group

This group is open to adults with a range of substance use issues and other risky behaviors who are in a variety of stages of change. The group will provide a safe, supportive space to explore the nature and meaning of members’ substance use and how it relates to the full range of other personal and life issues people face.  The group has a strategic focus on assessing harm, embracing ambivalence about change, setting harm reduction goals and developing individualized plans for positive change. A general goal might be for members to develop their healthiest relationship to substances whether that is safer use, reduced use, moderation or abstinence. The group enables open exploration, sharing of strategies and focus on interpersonal process in the group.  A variety of techniques are taught including: “Urge Surfing”, awareness and relaxation training, self-monitoring, Decisional Balance,  ”Microanalysis” of use patterns, the “Ideal Use Plan”, the “Game Plan” and “18 Alternatives”. We also explore how relational issues get enacted in the group and can get reworked in the group process.

Andrew Tatarsky, PhD
Tuesdays 6-7:30 PM

For further information about our activities please call 212-633-8157 or email atatarsky@aol.com.

Presented by
Andrew Tatarsky, PhD, and Scott Kellogg, PhD

All clinicians who work with addicted and dually-diagnosed patients run into situations in which they feel stymied and blocked and/or are filled with strong conflicting emotions toward their patients. This session will allow participants to engage in a dialogue which will, hopefully, enable them to see their patients in new ways and find empowering ways of moving their work forward.

Dr. Andrew Tatarsky will briefly discuss his Integrative Harm Reduction Psychotherapy (IHRP) and will then work with a case from one of the participants.

Dr. Scott Kellogg will briefly discuss his integration of IHRP, Schema Therapy, and Transformational Chairwork. He will then do an experiential chairwork session that is centered on working through countertransference issues with one of the participants.

Andrew Tatarsky, PhD, is the creator of Integrative Harm Reduction Psychotherapy. He is the Director of the Center for Optimal Living, a founding member and past president of the Division on Addiction of New York State Psychological Association, Chairman of the Executive Board of Moderation Management Network, founding executive board member of the Association for Harm Reduction Therapy and founding chairman of Mental Health Professionals in Harm Reduction. His website can be found at: http://andrewtatarsky.com/site/

Scott Kellogg, PhD, is a Clinical Assistant Professor in the Department of Psychology at New York University, a Psychotherapist and Supervisor at the Schema Therapy Institute, and the President of the Division on Addictions of the New York State Psychological Association. He is the Director of the Transformational Chairwork Training Program. Information on his work with Chairwork can be found at: http://transformationalchairwork.com/

PAPER (PDF)
Integrative Harm Reduction Psychotherapy:  A Case of Substance Use, Multiple Trauma, and Suicidality

PLEASE NOTE: We will be asking all participants to abide by the rules of clinical confidentiality so that we can have a safe and comfortable discussion.

When: October 21, 2011; 3:00-4:30 PM

Where: New York University, 6 Washington Place, Room 159, NYC.

The members of the Mental Health and Harm Reduction Project organizing committee are: Michele Stocknoff, LMSW (mstocknoff@hotmail.com), Kathryn Grooms, LMSW (kathryn@kathryngrooms.com), and Scott Kellogg, PhD (scott.kellogg@nyu.edu).

Dr. Andrew Tatarsky will present at the Future of Clinical Psychology conference sponsored by the New York State Psychological Association’s Division on Addiction on October 28th, 2011 at in New York City.

The conference was organized in response to alarm about the profession’s current status. The conference will reaffirm the many strengths that psychologists have and identify, explore and create compelling strategies and solutions for the future. The conference will include: 1) speakers with innovative and vibrant practices and organizations and, 2) who have been wrestling with new visions for the future.

Dr. Tatarsky will present on Integrative Harm Reduction Psychotherapy as a growing and increasingly relevant area that clinical psychologists can make a significant contribution to. He will discuss his own path from the discovery of the harm reduction paradigm 18 years ago through developing integrative harm reduction psychotherapy, writing a seminal book on the topic, training professionals internationally in the approach and starting the Center for Optimal Living in NYC to offer comprehensive therapeutic services based on the approach. He will offer tips and advice for building a successful career in harm reduction based on his own experience.

Choose a download for more information and registration:
Word Document | Adobe PDF