In April 2025, I joined a harm reduction psychotherapy clinic in Madison, Wisconsin.
CAYA Clinic — an acronym for “Come As You Are” — has earned a reputation for its nonjudgmental approach to mental health and addiction services. The clinical team at CAYA is composed of some of the most compassionate individuals dedicated to supporting those struggling with substance use disorders.
This commitment to meeting clients where they are, without judgment, immediately distinguished CAYA from other organizations in the field.
Letting People Define Their Own Recovery
One aspect of CAYA that immediately resonated with me, especially as I transitioned from a strict abstinence-based model, was the empowerment of individuals to define their own recovery.
Rather than focusing solely on cessation, the peers I support are encouraged to establish goals that address both their immediate needs and long-term aspirations.
This collaborative approach to goal-setting encourages engagement because clients become the primary architects of their own success.
While these objectives can remain challenging, they are pursued with a sense of purpose and hope that can sometimes be absent in more restrictive programs.
Why Lived Experience Matters
Another facet of working in harm reduction that resonates with me is the opportunity to leverage my lived experience to empathize with and support others in moments of need.
Drawing from my firsthand knowledge of withdrawal, cravings and euphoric recall, I can more effectively support others navigating similar challenges.
Ultimately, the practice of pairing peers — those with established recovery and improved outcomes — with individuals in the early stages of their journey makes sense to me.
Just as you wouldn’t expect someone who has never driven to teach a driving lesson, it follows that support for addiction or mental health recovery can be especially meaningful when it comes from people who have walked a similar path themselves.
Recovery Is Personal — and Fluid
Through my service as a peer support specialist, I have continued to learn a great deal about myself and the nature of my own recovery.
I have discovered that recovery is a deeply personal and fluid process that looks different for everyone who embraces it. It is far more nuanced than many traditional definitions allow.
While providing a framework rooted in evidence-based therapy is beneficial, truly understanding a client and their immediate needs shapes the core of the work we do together.
Meeting clients where they are requires significant patience. It takes time to build rapport and recognize their specific needs rather than simply defining success as total abstinence.
The Criticism of Harm Reduction
Some argue that harm reduction acts as a crutch or normalizes illicit drug use. I believe that assumption is fundamentally flawed.
When implemented with integrity and intentionality, harm reduction leverages both logic and empathy to provide a high standard of care.
Empowering individuals to take ownership of their unique recovery journeys creates pathways toward immediate stability while building a stronger foundation for their long-term aspirations.
I can attest that meeting someone exactly where they are isn’t always easy. In fact, it can be incredibly taxing.
Yet walking alongside someone as they forge new relationships and achieve goals they’ve pursued for years makes every ounce of effort worthwhile.
#QUITLIT BOOK REVIEW: My Life with Karma by Travis Sackett
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What is harm reduction in addiction recovery?
Harm reduction is an approach that focuses on reducing the negative consequences associated with substance use while meeting people where they are. Rather than requiring total abstinence as the only measure of success, individuals may work toward goals based on their immediate needs, circumstances and long-term recovery aspirations.
Does harm reduction require abstinence?
Not necessarily. In the model Travis describes, people are empowered to define their own recovery goals rather than being required to make complete cessation their immediate objective. Abstinence may still be a goal for some people, but it is not presented as the only possible measure of progress.
Why is lived experience important in peer recovery support?
People with lived experience may understand challenges such as withdrawal, cravings and euphoric recall in ways that allow them to connect with and support others navigating similar experiences. Travis compares it to learning to drive from someone who has actually driven before.
What does “meeting people where they are” mean in recovery?
It means understanding an individual’s current circumstances, needs and goals rather than imposing a single definition of successful recovery. Travis emphasizes that this approach requires patience, rapport and an understanding that recovery can look different for different people.
Can harm reduction support long-term recovery?
From Travis’ perspective, yes. He argues that helping people take ownership of their recovery can create immediate stability while also building a foundation for longer-term goals and improved outcomes.
