The Reduction of Harm Model for Teens with Addiction

Most people have heard of the 12-step model for treating addiction, developed by Alcoholics Anonymous (AA). However, there are other models that parents, caregivers, and teens may want to know about.


Although the 12-step method has been incredibly successful and has supported millions of people around the world with achieving sobriety, there are some aspects to this model that some individuals don’t like. For instance, some do not like the presence of spirituality in the AA model, while others don’t like that it was developed in 1935 and still tends to the “alcoholism is a man’s disease” thinking.


And there is a large community of people who do not believe in the abstinence model, meaning that the goal for those who want to heal from addiction is no use of alcohol or drugs whatsoever.


There are other treatment methods, such as the Reduction of Harm model, that does not strive for complete abstinence, although abstinence can be a long-term goal. The Reduction of Harm model recognizes that abstinence is not the best option for a newly recovering addict. It might be difficult to take in the idea of abstinence while still heavily using drugs or drinking. Instead, drug counselors and experts in this form of treatment focus on a reduction of harm.


The reduction of harm model is relatively new to the addiction and recovery field. Historically, this model respects adolescents for where they are in life. There is no judgment that is placed on a teen for having an addiction. Instead, treatment is focused on reducing the amount of harm. For instance, if a teen can go from drinking every day to drinking only on the weekends, then he or she has made some improvement. And if a teen can cut back on his or her marijuana use, including no longer mixing it with drinking, then there is improvement. By not judging adolescents for their drug use, this model helps to reduce the stigma of drug and alcohol use. For this reason, the reduction of harm model more and more popular among mental health professionals.


Harm reduction is an evidenced based practice of identifying ways in which the physiological, psychological, social and financial burdens of substance and/or alcohol use can be minimized through education and empowering an individual. Although abstinence for a teen might be the end result and perhaps the desired goal, a reduction of harm accepts an adolescent where he or she is at and does not stigmatize them for their substance use. For instance, if an adolescent were to seek treatment for an addiction, a drug counselor working under the Reduction of Harm model might explore ways that a teen could reduce the harm of the addiction. Perhaps that might be drinking two nights a week instead of four. Or it might be refraining from driving while drinking. Or it might be not to drink or use drugs when on medication.


Some of the practices involved in a reduction of harm model include:

  • Determining the physical needs and concerns to keep an individual safe and healthy. This might include the need for medical detoxification and other medical intervention that might require a medical facility.
  • Utilizing motivational interviewing techniques such as open ended questions, rolling with resistance, asking permission, using positive affirmations and feedback in order to determine the current level of use. This is done through dialogue and drug tests. Once the current level of use is assessed, this is then used as a baseline from which a reduction of harm begins.
  • Developing a teen drug treatment plan which are directly related to goals for reducing harm and identifying triggers to prevent relapse.
  • Identifying a teen’s goals and action steps involving substance use, safe using, reduction of use – if possible, and relapse prevention.
  • Providing psycho-educational information and tools based on a teen’s desire to change and their current level of use.
  • Based upon the information gathered, providing a teen with resources such as linking them up with other models , if they are appropriate, depending upon where he or she is in recovery. For instance, if a teen is actively seeking treatment and has reduced his or her drinking to only when triggered by emotional events, connecting that person to an Alcoholic Anonymous community might be helpful.


Although the Reduction of Harm model is relatively new, it is becoming more and more popular among professionals in the drug treatment field.