Provider views of harm reduction versus abstinence policies within homeless services for dually diagnosed adults

Benjamin F. Henwood, Deborah K. Padgett, Emmy Tiderington

Research output: Contribution to journalArticle

Abstract

Harm reduction is considered by many to be a legitimate alternative to abstinence-based services for dually diagnosed individuals, yet there is limited understanding of how varying approaches affect front-line practice within services for homeless adults. This paper examines how front-line providers working with individuals who have experienced homelessness, serious mental illness, and addiction view policies of harm reduction versus abstinence within two different approaches to homeless services: the traditional or "treatment first" approach that requires abstinence, and the more recent housing first approach that incorporates harm reduction. As part of a federally funded qualitative study, 129 in-depth interviews conducted with 41 providers were thematically analyzed to understand how providers view harm reduction versus abstinence approaches. Themes included the following: (a) harm reduction as a welcomed alternative, (b) working with ambiguity, and (c) accommodating abstinence. Drawing on recovery principles, the authors consider the broader implications of the findings for behavioral health care with this population.

Original languageEnglish (US)
Pages (from-to)80-89
Number of pages10
JournalJournal of Behavioral Health Services and Research
Volume41
Issue number1
DOIs
StatePublished - Jan 2014

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Harm Reduction
homelessness
addiction
mental illness
Homeless Persons
housing
health care
interview
Interviews
Delivery of Health Care
Population

ASJC Scopus subject areas

  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

Provider views of harm reduction versus abstinence policies within homeless services for dually diagnosed adults. / Henwood, Benjamin F.; Padgett, Deborah K.; Tiderington, Emmy.

In: Journal of Behavioral Health Services and Research, Vol. 41, No. 1, 01.2014, p. 80-89.

Research output: Contribution to journalArticle

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