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Client Centered Behavior Change: Using a Harm Reduction Approach

Client Centered Behavior Change: Using a Harm Reduction Approach 

Have you ever struggled to support a client in changing their behavior? Do you ever feel like your clients want to change, but do not follow through with their intentions? Do you ever feel like you want change for your clients more than they want to change themselves?

During this five-week course geared for providers working directly with individuals experiencing homelessness, substance use, or other instability, participants will learn and understand theories of behavior change and harm-reduction approaches to better support clients to make and sustain changes in behaviors. Guided by Motivational Interviewing and Trauma-Informed Care approaches, topics will include (but not limited to):

- Behavior Change Theory
- History and Philosophy of Harm Reduction
- Behavior Change and Substance Use
- Behavior Change and Sexual Risk
- Conducting Risk Assessments

Harm Reduction can be applied on a wide range of topics with a wide range of populations. This course is focused more specifically for individuals and agencies working with marginalized populations who are at high risk for STIs, overdose, and other negative health outcomes.

Meet the Instructors

Ayala LivnyAyala Livny has worked in homeless services since 1995, working with men, families, children, and young adults to improve health outcomes and navigate systems. She most recently spent 11 years as the Program Manager at Youth On Fire, a drop-in center for youth and young adults ages 14-24 who are experiencing homelessness, based in Cambridge, MA. Her focus has been creating safe and welcoming spaces that incorporate harm reduction, HIV prevention, trauma-informed services, and positive youth development practices. Ayala also has an extensive background in organizational culture, substance use and addiction services, policy advocacy, positive youth development, performance measurement, facilitative leadership, community collaboration, and working with non-clinical staff to provide trauma-informed services. She participates in the Massachusetts Special Commission on Unaccompanied Homeless Youth, and is on the Advisory Board for the Y2Y Initiative to create a new student-run overnight shelter for young adults experiencing homelessness. 


Lonnie_NoName.pngLonnie McAdoo is an Associate and Trainer for The Center for Social Innovation. He began training while in high school, serving as the Coordinator for the Boston Student Service Center. In 2000, Lonnie helped design and implement a Harm Reduction-based HIV prevention program, which utilized Motivational Interviewing, called Peer Action.  Peer Action worked with Intravenous Drug Users (IDU), Men who have Sex with Men (MSM), High Risk Sex Partners (also called High Risk Heterosexuals) and High Risk Youth, who were mostly homeless, using hard drugs (many addicted), had diagnosed mental illness (often not in care) and formally or informally doing sex work.  He later became the Associate Director of Community Programs, overseeing the AIDS Action Committee’s (AAC) Harm Reduction services and staffing the program’s out-posting at the Cambridge Needle Exchange. Prior to joining C4, he served as the Director of Child and Youth Violence Prevention for the Massachusetts Department of Public Health. Lonnie has also been a core trainer for the Community Health Education Centers in Boston and Lowell for the past 18 years.



  • Week 1: Course Introduction and Overview of Behavior Change Theory:  Discusses the history and philosophy of Harm Reduction, as well as its criticism and evidence. Also introduces Stages of Change and Motivational Interviewing approaches. 
  • Week 2: Harm Reduction and Substance Use: Discusses the risks associated with substance use, the basics of substance use and the brain, and how to reduce substance use risk and elicit change. 
  • Week 3: Harm Reduction and Sexual Risk: Discusses the risks associated with sexual behaviors, the challenges of discussing sex with the people served by programs, and how to reduce sexual risk and elicit change. 
  • Week 4: Implementing Harm Reduction Models: Participants will have the opportunity to look concretely at how to implement Harm Reduction programming and important considerations for how to operationalize Harm Reduction with be discussed. 
  • Week 5: Application of Harm Reduction and Self-Care Strategies: Participants will have the opportunity to apply Harm Reduction approaches to scenarios. Additionally, self-care strategies will be discussed. 

Certificates of Completion are awarded to participants who have attended the all five, live webcasts (or watched the webcast recording in their entirety), completed all required learning activities, scored higher than 80% on each weekly quiz, completed the course evaluation form, and the certificate request form. 10 hours of continuing education credit will be awarded upon completion of this course through ASWB and NAADAC. 6 hours of continuing education credit will be awarded upon completion of this course through NBCC. Certificates will be emailed directly to participants roughly two weeks after the completion of the final webcast.

If you need accommodations for disability, please contact t3’s Managing Director, Rachel Ehly,

If you would like to report a complaint, please email Ken Kraybill, t3 Director of Training,; or t3 Managing Director, Rachel Ehly,


Center for Social Innovation, Provider #1457, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB), through the Approved Continuing Education ACE) program. The Center for Social Innovation maintains responsibility for the program. ASWB Approval Period: 10/17/2016 to 10/17/2020. Social workers should contact their regulatory board to determine course approval. Social workers participating in this course will receive 10 continuing education clock hours.

Center for Social Innovation has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6576. Programs that do not qualify for NBCC credit are clearly identified. The Center for Social Innovation is solely responsible for all aspects of the programs.

This course has been approved by the Center for Social Innovation, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #100990, The Center for Social Innovation is responsible for all aspects of their programing.