Date of Award

Summer 2010

Document Type


Degree Name

Doctor of Philosophy (PhD)


Counseling & Human Services


Counselor Education and Supervision

Committee Director

Theodore P. Remley, Jr.

Committee Member

John Nunnery

Committee Member

Timothy Grothaus


In the United States, the preferred method for treating alcohol and drug addictions is the abstinence based approach. While most American mental health professionals use this approach, studies over time have demonstrated that relapse rates remain high. In Europe, the harm reduction approach, in which the primary goal is to decrease the harms associated with substance use, is beginning to be implemented as an additional approach to abstinence. Although the outcomes of the harm reduction approach are not yet clear, countries that utilize harm reduction have seen a decrease in crime, wages lost, and hospitalizations due to alcohol and drug addictions.

This study examined counselors' attitudes toward harm reduction and explored whether their attitudes toward harm reduction were associated with their personal characteristics. Goddard's (2003) Harm Reduction Assessment Scale, Howden's (1992) Spirituality Assessment Scale, and a brief personal information form were utilized to measure the variables. The population for this study was professional members of the American Counseling Association who held a master's degree or higher in counseling. A multiple regression was conducted to analyze the data. Results showed that counselors had a slightly positive attitude toward the concept of using a harm reduction approach to treating substance abuse issues. This was a significant finding because treatment for substance abuse in the United States is primarily abstinence based. Data analyses determined that counselors' attitudes toward harm reduction were predicted by three variables (living in an urban setting, having a close relationship with someone with a substance abuse problem, and years of substance abuse counseling experience). It was determined that counselors who lived in urban areas are more favorable to harm reduction as a treatment method than those who lived in rural or suburban areas, that those who had a close relationship with individuals with substance abuse problems had favorable attitudes toward harm reduction, and that the more years of substance abuse counseling experience counselors had, the more favorable were their attitudes toward harm reduction. Implications of the results of this study for counselors, counselor educators, and future researchers are discussed.


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