Preparing Students for Real Clinical Work

For more than half a century, substance use has been taught primarily through disease-based and abstinence-only models shaped by criminalization rather than clinical reality. As a result, one of the most common issues in modern practice remains siloed as a “specialty” instead of treated as part of ordinary psychotherapy. Students enter the field unprepared for how substance use actually appears in therapy: quietly, relationally, often hidden, and bound up with shame and ambivalence.

This course offers a necessary counterpoint—grounded in contemporary psychological understanding and real-world clinical conditions. Students learn how to address one of the most dangerous clinical problems—clients hiding their use—by creating conditions where honesty is possible and treatment can actually work.

Who this is for

• Social work, psychology, counseling, and MFT programs

• Graduate students preparing for real-world clinical practice

• Faculty seeking to modernize substance-use education

What students gain

• Skills for handling risk and ambiguous clinical situations

• A continuum-based understanding that moves beyond abstinence mandates

• Tools for working with ambivalence, mixed goals, and gradual change

• Integration of substance-use work into ordinary therapeutic relationships

A Harm-Reduction Framework for Modern Clinical Practice

Most clinics encounter substance use not as a discrete specialty problem, but as part of ongoing psychotherapy—often unspoken, ambivalent, and clinically risky. This training provides a clear, harm-reduction framework designed for contemporary clinical settings, where engagement, honesty, and flexibility are essential.

The program is taught by Dr. Andrew Tatarsky and includes testing and an official Harm Reduction Psychotherapy for Addiction & Compulsions certification. It is appropriate both for clinics new to harm reduction and for those already practicing harm-reduction interventions who want parallel techniques that deepen psychotherapeutic work.

Clinics that clearly communicate a goals-based, harm-reduction approach keep patients engaged and willing to speak honestly about their substance use—and consistently attract a broader pool of prospective clients, including many who would never contact an abstinence-only program.