Training in Harm Reduction Therapy
Training Focus
As a principal developer of integrated treatment for multi-diagnosed clients, HRTC is one of the best-known training entities in the U.S. for dual diagnosis, harm reduction, and motivational interviewing. For over two decades, HRTC has trained thousands of social services providers in individual workshops, courses, and large multi-year training projects.
All available research on “implementation science” stresses that trainings by themselves – even excellent participatory ones – are ineffective in leading to practice change. To be effective, training must combine workshops or courses with ongoing coaching, supervision and case consultation. Over the years, we have been able to experience the validity of the above-mentioned research. It takes years to develop the professional identity, knowledge, skills, and tolerance to work with the extremely complex individuals that inevitably use the most resources in our service systems. Many, if not most, staff are mostly trained by their own experience, wisdom, and dedication to work in social service systems. While such motivation represents the heart of the work, it does not give staff the many other resources needed to manage the most complex individuals in our society.
We have found that if we maintain a relationship with an agency or a group of providers from different agencies for at least one, preferably two years, we can facilitate a process that combines learning new concepts, discovering resistance to the new concepts, discovering disagreements among staff, finding consensus, and eventually integrating the new concepts and skills.
Using this data, HRTC has developed an innovative, effective, and engaging training model that mirrors how HRTC works with clients – collaborative, responsive, and relevant to consumers’ needs – and has trained thousands of mental health, drug treatment and medical professionals and paraprofessional case managers, housing counselors, and peer counselors across the United States.
In HRTC’s training model, information is delivered in workshops that are composed of typically no more than 50 people (preferably 30) called “immersion trainings.” In those workshops, there is an equal mix of didactic presentation, discussion of general concepts, role-play, and case consultation. This combined experiential, didactic, and discussion model is essential for adult learners. All of HRTC’s workshops are followed by months or years of ongoing coaching and case consultation. It is only this coaching component that ensures the integration of new information and leads to practice change.
HRTC has the experience and capacity to train professional, paraprofessional and peer staff by utilizing both in-house trainers and sub-contractors who, between them, have trained staff in virtually every position in San Francisco.
HRTC’s training expertise includes, but is not limited todual diagnosis, motivational interviewing, trauma and substance use, managing complex clients, harm reduction for families, harm reduction groups, client-driven assessment and treatment planning, harm reduction case management,andself-care/burnout prevention.
All trainings are consumer inclusive and driven and based on needs assessments that customize trainings for each audience. Trainings include ongoing consultation and coaching 100% of the time, immediate feedback during trainings to meet the changing questions and needs of each audience, and support for supervisors of training participants.
Ongoing small coaching groups create a culture of cross-training where resources are shared between trainees. In its training projects, HRTC develops “peer consultation networks” to develop practice leaders within work communities who will ensure sustainability of knowledge and good practice. HRTC trainers facilitate almost 30 ongoing weekly or monthly case consultation groups (6-12 members) for agencies or groups of providers from different agencies. Once training has been completed, monthly groups are ideal for busy staff to maintain learning.
Management and supervision trainings are essential to staff development, because it is supervisors who support and model growth to their employees and hold them accountable to agency policies and best standards of practice. HRTC has a well-developed supervisory training curriculum, and it provides coaching to supervisors in most of its training projects. On-going supervisory support, either in small groups or in 1:1 consultation. is incorporated into all technical assistance offered to participating agencies. We also provide organization consultation to assist managers and staff align written policies and procedures with their new harm reduction practice.
DEVELOPMENT of a TRAINING PLAN
- Prospective trainer meets with agency or county principals to understand the motivation for training and to answer the following questions:
- What are the unmet needs of the target population?
- What are the skills that staff need to meet the target population needs?
- What are the system barriers to meeting the needs of the target population and how can the training assist with system change?
- Prospective trainer discusses with the agency or county principals the “menu of training options” to ascertain if the principals have any previously-determined wishes for particular topics
- Prospective trainer then prepares a custom-designed training proposal and a fee estimate. (HRTC charges either by the hour or by the half-day or day for each item, so components can be adjusted to fit budgetary constraints.) The recommended model would likely include several sessions, structured like a course, or an intensive 1- or 2-day workshop.
Tainings are spaced according to staff time availability, budget considerations, and are never spaced so close together that participants are overwhelmed by too much information at once.
The training sequence is followed by biweekly or monthly 1.5 or two hour consultation groups where participants are expected to present challenging situations and learn to use new skills to handle them and where participants can ask challenging questions of the trainer about difficulties in applying the training material to real-life situations. Any disagreements between staff about applying new learning are addressed in these groups. Management of self, of feelings, and burnout prevention are also integrated into these groups.
- The trainer meets regularly with the management/supervisory staff during the training and consultation series to work on staff development issues, to respond to any requests for changing the training content or style, and to work on system barriers. These meetings are also used to rewrite policies and procedures.
- A final session is held with training/consultation participants to summarize what has been learned and well-integrated and to identify further development needs.
- A final session is held with management/supervisory staff to discuss strengths and weaknesses of the training and to discuss future learning needs.
To see examples of trainings we have done in the past using this model, open our Training Resume.
Continuing Education Credit.
HRTC provides CEUs for MCEP (psychologists), the BBS (for MFTs and LCSWs), the Board of Nursing, and CADAAC. MHASF can provide CEUs for LPPC's and LEP's.
To discuss your training needs, call Dr. Patt Denning at 415-252-0669 or email her at pattdenning@gmail.com. We look forward to working with you.
HRTC custom designs training for each agency or individual. As follow-up to workshops, we offer ongoing case consultation to assist participants in integrating their learning into practice, in accordance with best practice recommendations indentified by research.
Training Workshops
Introduction to Harm Reduction Psychotherapy
In this workshop you will learn the theory, goals, principles and practice of this new therapeutic method, including a focus on:
- History of harm reduction in public health
- Principles of Harm Reduction Psychotherapy
- The Stage Model of Change
- Drug, Set, Setting
- Motivational Interviewing
- Transference and Countertransference
About Alcohol and Other Drugs
An overview of how drugs work in the brain, both what we should know and what we should teach our clients, including:
- Pharmacology of drugs and alcohol
- Basic brain functioning
- Why certain people might use specific drugs
- Substance Use Managment
Dual Diagnosis
Dual diagnosis of substance use and emotional/mental disorders is the rule rather than the exception. In this workshop we review:
- Major mental disorders
- Neurobiological impact of trauma
- Interactions between mental illness and trauma with drugs and alcohol
- Differential diagnosis
- Recommendations for integrated treatment
Harm Reduction Groups
This workshop integrates the principles and practice of Harm Reduction Psychotherapy with those of psychodynamic group psychotherapy. This training will focus on both drop-in support groups and ongoing therapy groups. Particular issues are:
- Homogenous vs. heterogeneous groups
- Focusing on other therapeutic issues
- Challenges for the leader
Other Training Topics
- Working with Trauma
- Harm Reduction with Familes
- Substance Use Management
- Harm Reduction in Housing
- Harm Reduction Case Management
Contact Dr. Patt Denning, HRTC's Training Director, to discuss your training needs: 415-252-0669 or email her at: pattdenning@gmail.com
To download our training brochure as a pdf., click here.