Abstract
Traditionally, therapeutic communities (TCs) have focused on providing abstinence-based treatment. However, with the emergence of HIV among injecting drug users, some TCs have evolved to include risk management or harm reduction strategies into their previously abstinence-based programs. We Help Ourselves (WHOS), a group of TCs in Australia, integrated harm reduction into their services in the 1980s. WHOS passed through a series of stages as it moved from a goal of “abstinence only” to one of “abstinence eventually.” Following these changes, client retention and length of stay increased and HIV risk behaviors decreased. The process by which WHOS integrated harm reduction into their services while maintaining a commitment to abstinence is outlined and a guide for TCs interested in adopting harm reduction is provided.
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