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Harm reduction is a framework for helping drug and alcohol users who cannot or will not stop completely_the majority of users_reduce the harmful consequences of use. Harm reduction accepts that abstinence may be the best outcome for many but relaxes the emphasis on abstinence as the only acceptable goal and criterion of success. Instead, smaller incremental changes in the direction of reduced harmfulness of drug use are accepted. This book shows how these simple changes in emphasis and expectation have dramatic implications for improving the effectiveness of psychotherapy.