Challenges to Implementing the Harm Reduction Approach

Abstract

ABSTRACT The social work literature recently has supported greater use of the harm reduction approach in professional practice. Implementing this approach, however, presents its challenges. We explore how practitioners in a housing program for people with histories of psychiatric disabilities, substance use disorders, and homelessness perceived the harm reduction approach. Prior to the opening of this new program, agency staff completed a questionnaire and participated in focus groups designed to explore their perceptions and level of support of the harm reduction approach used in the program. The goal of this evaluation was to understand the challenges of implementing a harm reduction approach in programs serving people with dual diagnosis and the implications this has for program administrators, staff, and clients. We found that practitioners, overall, favored the approach's pragmatism and its focus on client engagement, but many were frustrated by its perceived ambiguity regarding long-term outcomes and client expectations. We conclude with recommendations for how program administrators can facilitate the effective implementation of the harm reduction approach. KEYWORDS: Harm reductionmental illnesssubstance use disordersMICA clientsco-occurring disordersdual disordershomelessness The authors wish to thank the Emmett J. and Mary Martha Doerr Center for Social Justice, Education, and Research at St. Louis University School of Social Work for their support.