Date of Conferral
8-18-2025
Degree
Ph.D.
School
Social Work
Advisor
Sean Hogan
Abstract
Historically, substance use disorder (SUD) treatment in the United States has been firmly grounded in abstinence-only treatment approaches. Harm reduction as a treatment model has gained additional traction. With increased rates of opioid use, overdoses, and advancements in medications for SUDs, harm reduction treatment approaches are becoming more important to improve lives of people who use drugs. Little is known about how counselors who have been educated, trained, and deliver abstinence-based SUD treatment reconcile use of harm reduction into their practice. To address this gap in literature, a generic qualitative study was conducted using the social constructivism theory. A purposive sample of 10 certified SUD counselors in the Pacific Northwest participated in semi-structured interviews which were analyzed using thematic coding. Counselors socially construct their understanding of abstinence-only treatment through professional standards, client safety, and personal recovery experiences, while harm reduction knowledge is shaped by cultural, community, and peer influences. Counselors apply harm reduction pragmatically and flexibly, prioritizing continuous learning and professional growth. Findings can be used to inform SUD counselors about harm reduction and improve schools, educators, and clinical supervisors about harm reduction. Findings are also relevant for advocates and policymakers aiming to promote adoption of harm reduction practices. More acceptance of harm reduction in the SUD field can increase overall knowledge and lead to shifts in social knowledge and acceptance of multiple treatment approaches.
Recommended Citation
Ashton-Williams, Amy Rose, "Reconciling Harm Reduction Philosophy and Approaches Among Abstinence-Only Substance Abuse Treatment Professionals" (2025). Walden Dissertations and Doctoral Studies. 18287.
https://scholarworks.waldenu.edu/dissertations/18287
