Despite this "nontherapeutic" approach that characterized early harm reduction efforts in the US, there have developed a number of other more clinically and therapeutically focused approaches that can clearly be subsumed under the rubric of harm reduction. These approaches have often focused on high-risk populations who may or may not have experienced harmful consequences of risky behaviors (i.e. use of alcohol, drugs, or engaging in behaviors such as gambling or unprotected sex), but whose behavior is such that the risk of harm is greatly increased if their behavior is not changed in some fashion (Marlatt, 1998). Often these sorts of interventions have fallen under the rubric of "secondary prevention" (Coie et al., 1993), that is interventions that have as their target, not the cessation of the risky behavior itself, but an alteration of the individual's approach to that behavior in order to make it less risky. (...) The three papers that follow all address preventive, but "therapeutic" interventions with specific target populations. The target behaviors focused on by the three programs range from alcohol use by college students (Fromme and Orrick, 2004), substance use broadly among homeless adolescents (Baer et al., 2004), and gambling (Dickson et al., 2004). Each of these papers describes a theoretically based harm reduction program targeting these specific behaviors in individuals who may or may not have personally experienced harmful consequences of the target behavior. Each presents a view of how the approach is made acceptable to the individuals upon whose behavior it focuses. It is clear from these papers that harm reduction is now in the mainstream of the thinking of researchers and clinicians who work with at risk populations. This represents a major conceptual shift from work on so-called "addictive" behaviors of only a few years ago. As it has become increasingly clear that, for example, prolonged abstinence from a risky behavior is not always a necessary or likely outcome for harm to be reduced (Klingemann et al., 2001), researchers and clinicians have begun to address the problem of how harm can be reduced long before it occurs or poses a serious risk to the individual. (Extract of the publication)