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246 S.H. Kellogg / Journal of Substance Abuse Treatment 25 (2003) 241–247 able to improve on its record of success. Second, by creating a continuum of care, a therapeutic ‘‘safety net’’ can be created (see also Marlatt, 1998b). The goal would be that the life and health of relapsing patients would be preserved through the work of the harm-reduction organizations, and, using the momentum of a gradualist approach, they would be able to return more rapidly to a drug- and alcohol-free life. 6. Conclusion We are currently living in a time of rich therapeutic possibilities for working substance-using and substancedependent patients. This creativity is taking place both within the harm-reduction and abstinence-oriented spheres. To optimize care for those who are addicted, it would be ideal to connect harm reduction and abstinence treatment into a continuum that has the cessation of drug and alcohol use and the healing of mind and body as the desired end point. Gradualism has been put forward as an organizing principle to facilitate this development. Acknowledgments This paper is adapted from a presentation that was given on April 6th, 2001, at a conference entitled, ‘‘The Great Debate: Abstinence vs. Harm Reduction in Addiction Treatment’’ that was held at The New School University. This conference was conceptualized and sponsored by the New York State Psychological Association Division on Addictions Executive Committee, whose members include: Julie Barnes, F. Michler Bishop, Lisa Director, Scott Kellogg, Robert Lichtman, A. Jonathan Porteus, Marlene Reil, Debra Rothschild, Suzanne Spross, Andrew Tatarsky, and Alexandra Woods. It was co-sponsored by the Masters Program in Mental Health and Substance Abuse Counseling at The New School University. Support for this work was received from the Division on Addictions of the New York State Psychological Association and from NIH-NIDA Grant P60-DA05130. 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