Counseling Blog

Harm reduction is an evidence-based treatment for SUD that acknowledges each individual’s right to self-determination and offers safer alternatives without judgment to those who choose to continue using substances. Evidence shows that harm reduction reduces risks associated with substance use such as injury, disease, and death. 

“Harm reduction refers to policies, programmes and practices that aim to minimize negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights – it focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that they stop using drugs as a precondition of support” (Harm Reduction International, n.d.). 

As a public health strategy, harm reduction was developed in response to numerous historical events and movements that occurred between the 1960s and 1980s. The harm reduction model is often associated with the AIDS crisis and needle-exchange programs or safe injection sites which aimed to reduce the risk of acquiring blood-borne viruses like HIV.

While harm reduction was originally and most frequently associated with substance use disorder, it is increasingly being applied to a multitude of other behavioral disorders

Harm reduction has shown to be effective for:

• Alcohol Use Disorders
• Cannabis Use Disorder
• Opioid-Related Disorders
• Stimulant-Related Disorders
• Tobacco-Related Disorders

We have providers here at Charmed Counseling who are trained in Substance use disorders and can be a support in your recovery process. Email us at info@charmedcounseling.com to find out how we can be a support. 

Harm Reduction International (n.d.). What is harm reduction? https://www.hri.global/what-is-harm-reduction

A common problem people have when they have identified an issue in their lives is striving for an unattainable or difficult to attain solution. For instance, you might identify that you need to lose weight. Your health is not the greatest, you aren’t fitting into your clothes, and you don’t feel confident in your appearance. The solution you might identify is that you need to lose 80 pounds. Why 80? Because losing 80 pounds would put you back at what you identify as your “ideal weight,” never mind that the last time you were that weight, you were in seventh grade! 

You then set your goal to lose 80 pounds. However, if you set your goal so high, anything less than meeting that goal might cause you to feel like you have “failed.” You could work really hard, change your whole life, become much healthier but have only lost 70 pounds and still feel like you did not meet your goal. 

When we set our own bar so high, we don’t allow for anything less than perfection. And I’m going to tell it to you straight: You can’t achieve perfection. If you can achieve it, you will need to take steps towards that goal. You’ll need to take bites out of that apple, not just swallow the entire apple whole! 

The answer to this issue is to strive for progress, not perfection. Going back to our original example. You identify the problem of wanting to lose weight. Then you identify a goal that is working towards progress. Maybe you set your goal at losing 10 pounds. What things can you do in the next week or month towards your goal? In this example, you might identify choosing healthier foods, starting an exercise routine, and talking to a friend who has a similar goal so you can support each other. 

Notice what happens when you achieve your goal. You succeeded! You praise yourself for your effort. Perhaps you add another goal with new objectives. You feel good about yourself, and you recognize that progress has been made. You are no longer holding yourself to a standard that you will feel negatively about for not achieving. 

Let’s work on another example. Let’s say you are working on being more patient with your kids. The solution through a perfection lens would be that you never, ever yell at them and you always respond calmly and patiently. First of all, notice the “all or nothing” thinking there! Nobody “always or nevers” anything. By having a perfection mindset, you set up for yourself that any moments of irritability, any time you raise your voice, anytime you respond with something that is less than calm, you have failed your goal. 

Instead, what if the goal was set to reduce the number of times you yell. Let’s say right now you find yourself yelling every day. What if you set a goal to not yell for one day? The progress towards that goal might include using skills that you learn in counseling. You might try noticing you are feeling angry before you take action, taking three deep breaths, giving yourself a timeout in your bedroom to calm down, and focusing on your own self-care when you are not in a moment of upset. Then, when you make it one day without yelling, you have accomplished your goal and you set another goal. 

This also brings us to the black and white thinking you might have noticed me using in these examples. You are either a success or a failure. Is that true? What defines a success? What defines a failure? Is it possible to be successful at everything all of the time? Is it possible to always be a failure? 

In focusing on progress, not perfection, we can also redefine how we feel successful. Even if you made a goal not to yell for one day but you did yell that day, could you still see your success? What if during that day, you took four breaks. You identified that you were getting angry, and you wanted to yell FOUR TIMES, but you didn’t do it. Does yelling one time negate the success you have already achieved? No, it does not! 

Part of the idea of progress not perfection is giving ourselves praise for the progress we’ve made, rather than focusing on the perceived failures. Perfection mindset tells us that anything less than perfect is failure. Progress mindset tells us that any movement towards achievable goals is just that, PROGRESS. Keep striving for progress! 

Last week in the blog, I provided a brief intro to Play Therapy so parents can understand the methods and approach utilized when working with their children. Oftentimes after I explain to parents about Play Therapy, I’m met with the question “can’t I just play on my own with my kids?”. To this, I say.. Yes! As a parent one of the most nourishing activities with your child is to engage with play which they lead and direct. This provides parents a lens into their child’s interests and strengths, which will be discussed more in next week’s blog! That said, the play between a parent and child is a relationship building activity and considered regular play, which is vastly different from therapeutic play.

So what is therapeutic play then? There are many different ways to integrate play into therapy but there are two main theoretical approaches: Directive play therapy and non-direct play therapy. In direct play therapy a therapist may plan games, activities, or worksheets which help facilitate skill development, processing different challenges, or increase insight within the child. The therapist trusts the child to heal themselves, but provides guidance and direction to the child. Direct play therapy relies heavily on the therapeutic relationship between child and therapist and communication between therapist and child. For this reason, most often direct child therapy approaches are best for children who are able to communicate well, typically age 5-6+. Non-direct play therapy is just as it sounds, non-direct. The modality trusts that when a child is introduced to a safe environment, which is comfortable and inviting, that they have the natural ability to process and heal through the activities of their choosing. As you will recall from last week’s blog post, Virginia Axiline was instrumental in the development of non-direct play therapy. Axiline felt that through having a space where a child is free of judgement and are capable of harnessing their own strengths, a child can feel empowered to conquer different challenges and obstacles. Non-directive play therapy is typically better for children who are pre-verbal or non-verbal as it allows them to communicate through play, or children who are younger than 6.

Like most approaches, therapists may blend modalities and methods together to provide child centered care which fits the child’s own needs. This may look like some focused sessions surrounding practicing coping skills, and other sessions where children engage in non-directive play to communicate their challenges with the therapist. In utilizing either approach, the therapist is doing much more than simply playing with the child. They are observing different behaviors, assessing how the child responds to barriers when confronted with them, identifying strengths, and most importantly empowering the child to be their true self.

All of this is to say as parents, you should definitely be playing with your kiddos, but your role is not as a therapist. A play therapist offers children time to be their true authentic selves, free of judgement, and allows their bodies and mind process in ways which are natural to them. A parent provides love and nurturing, is an example of the first attachment in a child’s life and shows how relationships and attachments in their lives should be. Play with your child may be recommended by your therapist to engage in outside of your sessions, and they may even provide different activities to try to help strengthen and secure your attachment with your child. Overall play is not only an excellent method for parents to use to communicate with their child, but also is therapeutic to helping your child. So play with your child and learn how they like to play, but don’t mistake it for the same value as therapeutic play.

Kaitlyn Lee, LICSWA
Charmed Counseling PLLC
Phone & Text: 509-606-0708
Fax: 509-232-5552

Rule #2 – Survival

In my first discussion of Brain Rules we talk about Exercise because movement is the key to so much about our existence.

In the second chapter… or better yet the second rule Medina shares some fun facts about evolution of our brains and bodies.

First fun fact: You have three brains. NEAT! The “lizard brain,” very basic (the primal keep-you-alive brain). Then surrounding that is the “mammalian brain” that deals with fear, pleasure, memories… you know those important things! And thirdly, surrounding that is the outside layer the “human brain” which encompases the prefrontal cortext known for giving you your personality and executive functions.

Next fun fact? The evolution of these brain(s) includes the learning and researching of Dual Representation Theory and Symbolic Reasoning.

Judy DeLoache identified Dual Representational theory, in other words, we make up things that aren’t there. We get to fantasize. Take advantage, friends. Imagine yourself on that beach or in a foreign city that isn’t your living room where you’ve felt shackled for months.

Medina also discusses the birth of Symbolic Reasoning… where we can share our experiences so that we learn from each other. Instead of having to learn harsh lessons on our own we can listen to our peers, when they say not to walk in the quicksand so we don’t die.

I don’t know about you but during these COVID times, I am absolutely using the dual representation, often daydreaming about being elsewhere or having a live-in nanny… also, using symbolic reasoning HARD and OFTEN as I learn from others’ what to do and not to do keep myself and family safe!

I really appreciate the beginning of this chapter because Medina gets right to the point about our brain(s) stating: “Our brains are designed to (1) solve problems (2) related to surviving (3) in an unstable environment (4) to do so in nearly constant movement.” After his laying out of evolution in the first chapter on Exercise this is what he can definitively say.

When I process this, part of my take-away is that as stressful as quarantine and pandemic living is, we were built for this… we were built to “solve problems” in order for ourselves and families survive in this “unstable environment.” Now, this is not to say that those who have passed away didn’t solve a hard problem, it’s not up to one person to solve. This is a communal issue hence the symbolic reasoning where we get to share our learnings and come together over shared goals of survival.

What do you think of Survival? How are you surviving? What makes sense to you with this rule?

Also in this survival chapter, Medina asserts that we humans took over the earth by working smarter not harder. We adapted not by sheer strength but by keen understanding and brain development from that primal “lizard brain” to the full “human brain” encompassing all.

So to truly survive (physically, mentally and financially) we need to do so by being in constant motion. Whether that is physically moving or playing mental gymnastics to figure out how to find consistency of food or income.

Written by Lindsey McIntyre LICSW, at Charmed Counseling