Advocacy strategies and resources

Harm Reduction is any strategy that reduces the harm of risky behaviors, without necessarily quitting those behaviors completely. Harm Reduction focuses on SAFETY FIRST. It does not judge people’s choice to engage in risky behaviors.

It is common for young people to take risks. Young people involved in the dependency system who have experienced trauma can be especially vulnerable to risky behaviors and situations such as:

• leaving an approved placement

• Substance use or substance misuse

• CSEC/DMST

• Inappropriate social media use

• Unsafe sex

• Peer recruitment in congregate care for substance use, CSEC, & leaving a placement.

• Self harm

• Truancy

A Harm Reduction approach recognizes that young people have valid reasons for the choices they make. It supports them in thinking through their feelings and options with a focus on safety (not moral evaluation). Harm Reduction embraces the paradox of change: When a person feels accepted for who they are and what they do—no matter how unhealthy—it allows them the freedom to consider change rather than needing to defend against it.

The foundational principles of Harm Reduction are:

1. Self-determination for the young person

2. Relationship building

It is crucial to recognize that real and lasting change comes from within, and that motivation and steps towards change are usually incremental.

Asking questions that help a young person see the discrepancy between their actions and their desired goals, known as Motivational Interviewing (MI), is a technique than can support a young person towards positive change. For guidance on practicing MI, please see the APPROPRIATE LANGUAGE section below.

The Stages Model of Change provides a research based understanding of how people make behavioral change - in stages. It helps us assess a young person's readiness for change, and informs how we talk about the behavior with them.

It is common for youth to be in the Pre-Contemplation phase of change, meaning that they do not see their behavior as a problem and have no intention to change. In this stage they will not perceive advice or suggestions about changing their behavior as relevant. The role of the CASA in this case is to listen calmly and empathetically, and to reflect what you are hearing back to the young person.

Behind the Scenes:

• check-in with your Case Supervisor to strategize about how to talk with your young person about the risky behavior.

• advocate for therapeutic support services for the young person.

• consider what services/resources/strategies might be helpful.

• educate yourself about the risky behavior (Advocacy Strategies is a great resource).

• consider how trauma and/or racism, sexism, and systems of power may impact why a youth engages in a risky behavior.

• become familiar with Motivational Interviewing. (see below)

With your youth:

• respond calmly and empathetically when your youth shares about risky behavior.

• know that how you think about safety, and how the young person thinks about safety are likely different.

• appreciate your young person for trusting you enough to share.

• be curious about what safety means to them.

• be curious about the reasons they engage in the risky behavior.

• ask a question or two related to safety, but be careful to not interrogate your youth.

• reflect what you are hearing ("you are saying...", "you feel...").

• listen so you can recognize readiness for change.

• roll with any resistance to change that they express.

• remember that they have dreams for the future and strengths they can build on.

• trust that they are doing their best, and will change when they can.

Real and lasting changes usually happen in steps. Talk with your Case Supervisor to plan on how to support a young person. Encourage engagement with therapeutic or supportive services. Learn about specific behavior and how trauma and stress may play a role. When you work directly with a youth, respond calmly and with empathy when they share about their experiences. Learn what “safety” means to them. Ask open questions and reflect on what you hear back so they feel heard and understood. Recognize readiness for change and trust that small steps are meaningful. 

Use language that shows care for the person’s health and safety. Respect their choices and offer confidence in their ability to make positive changes. One effective method is:

Motivational Interviewing, which helps people think about pros and cons of a behavior without feeling judged. Ask questions like: 

• What do you like about this behavior? 

• How does it affect other parts of your life? 

• What might help you if you decide to change? 

Encourage them to identify goals that matter to them and build on their strengths.  

A safety conversation can begin when the youth is willing to talk about what keeps them safe. You might start with: “I care about your safety and want to talk about how you can stay safe.” Examples of safety questions include: 

• What has helped you stay safe in the past? 

• What does safety look like to you? 

• Who can you contact if you feel unsafe? 

Help them think about practical steps they can take to stay safe and remind them that you are there to support them consistently. 

Harm Reduction Vignettes from Real-Life SFCASA Cases

The Stages of Change

The Harm Reduction Therapy Center

• SAMHSA Harm Reduction Overview – U.S. federal public health information on harm reduction principles and practices that apply to substance use and safety. SAMHSA 

• National Harm Reduction Coalition – Practical tools and guidance for harm reduction approaches to substance use and safety. 

Motivational Interviewing Network of Trainers (MINT) – Resources and explanations to learn about motivational interviews. 

• Center for Young Adult Health and Development – Health information for adolescents and young adults, including harm reduction approaches. 

• Substance Abuse and Mental Health Services Administration (SAMHSA) Find Treatment – Search tool for local supportive services.