Application of a Model of Family-Centered Harm Reduction in Community-Based Programming

Coupling high substance use disorder rates with the effects of the COVID-19 pandemic, our nation faces a growing mental health crisis and a shortage of adequately trained mental and behavioral health providers. As occupational therapists work toward recognition as qualified providers in this practice area, we must ensure that future therapists can meet client needs. Traditional mental and behavioral health educational practices in occupational therapy use a model of harm reduction that minimizes negative outcomes for a select subset of the population engaging in specific “high-risk” behaviors, such as individuals engaging in substance use and sexual activity. Expanding our understanding of the harm reduction model and incorporating a more holistic trauma-informed care lens can better ensure beneficence for all clients. To do this, educational institutions must train students to identify harm in all of its contexts, such as the household dysfunction of cohabitating with a family member with substance use disorder, and apply practical treatments for addressing the impacts of dynamic family systems through occupation-based interventions. This paper illustrates a family-centered harm reduction model and offers a community-based educational intervention that allows occupational therapy students to gain valuable trauma-informed care practice skills through hands-on experiences.