Electronic Thesis and Dissertation Repository

Harm Reduction in Psychotherapy

Jillian Cramer, Western University

Abstract

With approximately 22 people dying due to opiate-related harms everyday in Canada (Government of Canada, 2023), there is a great need to offer low-barrier, evidence-based services for people who use substances across various disciplines, including healthcare, social services, and psychotherapy. This qualitative study examined the experiences of Canadian social justice-informed counsellors who work with clients who use substances from harm reduction frameworks of care. Seven counsellors were interviewed on their personal experiences implementing harm reduction in psychotherapy. Through a reflexive thematic analysis, five themes surfaced: axiology of harm reduction work, development of therapist surrounding harm reduction, main focuses of harm reduction work, external influences, and barriers to care. This research highlights various facets of working with clients who use substances amidst the current Canadian sociopolitical climate surrounding harm reduction and substance use, and discusses potential gaps and implications surrounding the provision of socially just care to people who use substances.