Integrative Harm Reduction Approach in Treating Substance Misuse

Dr. Andrew Tatarsky, Psychologist

Excerpt: scientific revolution

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  • 6h of continuing education
  • 35 lessons that last from 5 to 15 minutes each
  • 1 certificate of achievement
  • 1 power-point
  • 1 bibliography
  • 1 course evaluation
  • 4 months unlimited access
  • 7-day money back guarantee
  • 95% of participants who completed the satisfaction survey declare they would recommend this course to a colleague


Accumulating evidence is moving us away from moral, criminal, and reductive disease models and instead toward understanding substance use as a psychobiosocial process with multiple dimensions and individual variations. This shift calls for a personalized, integrative harm reduction psychotherapy for problematic substance users.

Dr. Tatarsky will discuss the limitations of the dominant disease model and abstinence-only recovery narrative and introduce the psychobiosocial model of addiction and IHRP based on it. IHRP integrates harm reduction principles into psychotherapy and substance use treatment.

It combines relational psychoanalytic, cognitive behavioral, and mindfulness techniques in a harm reduction frame to support positive change in substance use and related issues. IHRP’s seven therapeutic tasks will be described: managing the therapeutic alliance with harm reduction listening, the relationship as agent of healing, enhancing self-regulation and self-management skills, assessment as treatment, embracing ambivalence, harm reduction goal setting, and personalized planning for positive change.

Specific skills and strategies that participants can begin using immediately will be demonstrated. Given that Canada has legalized marijuana (MJ), the workshop will give special attention to understanding the potential benefits and risks associated with MJ and the application of IHRP to develop ideal relationships with MJ.

About the expert

Picture of Andrew Tatarsky [en]

Dr. Andrew Tatarsky has developed integrative harm reduction psychotherapy (IHRP) for treating the spectrum of risky and addictive behavior. IHRP brings psychoanalysis, CBT, and mindfulness together in a harm reduction frame. The therapy has been described in his book, Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems, and in a series of papers. Dr. Tatarsky holds a PhD in clinical psychology from the City University of New York and is a graduate of New York University’s Postdoctoral Program in Psychoanalysis and Psychotherapy. He is founder and director of the Center for Optimal Living in NYC, a treatment and training center; founding member and past-president of the Division on Addiction of New York State Psychological Association, and a member of the Medical and Clinical Advisory Boards of the New York State Office of Alcoholism and Substance Abuse Services. Dr. Tatarsky has trained professionals in harm reduction both nationally and internationally.

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Learning objectives

  • Identify four of the seven therapeutic tasks of Integrative Harm Reduction Psychotherapy.
  • Define the psychobiosocial process model of addiction. 

  • Learn the four core harm reduction engagement skills: empathic listening, collaborative inquiry with an alliance around compassionate curiosity, empathic reflection and checking in with therapeutic humility.
  • Learn “urge-surfing”, a technique for interrupting addictive urges and action to facilitate healing, growth and positive behavior change. This brings mindfulness and breath to the urge enabling pause.

Learning material

This workshop includes theory as well as clinical examples. It includes videos ranging from 5-15 minutes in length. The PowerPoint of the workshop can be downloaded.


  • Powerpoint
  • Handouts
  • About Marijuana

  • 1. Introduction
  • 2. Scientific Revolution
  • 3. Marijuana Accounts, Addiction and Medical
  • 4. Define Marijuana
  • 5. Medical Marijuana
  • 6. Ten Perspectives on Marijuana
  • 7. Questions from the public
  • The need for a new paradigm

  • 8. Our Challenge- How can we make treatment more appealing for people
  • 9. Harm Reduction Embodies Compassionate Pragmatism
  • 10. Harm Reduction as Engagement Strategy
  • 11. Questions from the public 2
  • 12. Stages of Change
  • 13. We need a new model for understanding substance misuse to inform more effective treatment
  • About addiction

  • 14. Define Addiction
  • 15. Moral modal, criminal modal, Many meanings
  • 16. Trauma
  • 17. Learning and Spirituality
  • 18. Social context and Psychobiosocial Model
  • 19. Valerie's case
  • 20. Questions from the public 3
  • How harm reduction pscychotherapy works and how to use it?

  • 21. Harm Reduction Psychotherapy
  • 22. Integrative Harm Reduction Psychotherapy Domains
  • 23. Seven Therapeutic Tasks of IHRP
  • 24. Managing the Therapeutic Alliance
  • 25. Enhancing Self-regulation Skills
  • 26. Question from the public 4
  • 27. The Urge is the Axis of Change
  • 28. Questions from the public 5
  • 29. Urge Surfing Exercise
  • 30. Assessment as Treatment
  • 31. Exercice about Urge surfing
  • 32. Embracing Ambivalence
  • 33. Goal Setting
  • 34. Ideal Use Plan
  • 35. Questions from the public 6
  • Bibliography

CE Credits

Download a certificate of successful completion.


This training is intended for mental health professionals.

What our customers are saying

« Thank you so much for this course; it is a practical course with updated approaches and sources.
As a suggestion, it is more helpful if some role playing is added to this course. »

A mental health professional (Canada)

« The ideas were very clearly presented and the material very useful.I enjoyed listening throughout. »

A (Canada)

« One of the best online trainings I have attended so far.. It has been incredibly well presented, helpful and inspiring. Thank you! »

A (Slovakia)

« Very interesting and easy to follow. »

A mental health professional (Canada)

« Very helpful and enlightening, and progressively thought provoking in terms of looking at new ways of effective change in therapeutic ways including systemically. »

A mental health professional (Canada)


  • 6h of continuing education
  • 35 lessons that last from 5 to 15 minutes each
  • 1 certificate of achievement
  • 1 power-point
  • 1 bibliography
  • 1 course evaluation
  • 4 months unlimited access
  • 7-day money back guarantee

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The courses offered by ASADIS are accredited by different professional organisations. In addition, ASADIS is approved by the Canadian Psychological Association to offer continuing education for psychologists. ASADIS maintains responsibility for the program.

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