In “Working the floor: the role of the counsellor at the Sydney Medically Supervised Injecting Centre” ^{Footnote 5} this approach is described as follows:

(T)o contextualise the role of the MSIC as a ‘gateway’ for injecting drug users into drug treatment programs, it needs to be appreciated that the MSIC occupies the chaotic endpoint of the harm reduction continuum, serving a notoriously challenging and marginalised client population, considered ‘too hard’ and intransigent for most health services for drug users. The expectation that this population will readily transcend both the complexity of their daily existence and the impoverishment of their histories needs to challenged. Change of this magnitude is typically a slow and fickle struggle. This is not an argument for defeatism but rather a case for strategic pragmatism forged through experience. In the meantime MSIC continues to provide a service where the possibility for long-term change is fostered and its short-term absence is accepted (p. 6).

Sarah’s response: For most people, actively looking for a way to deal with their addiction is a process that takes 10 years. Addiction is a chronic, relapsing condition. Let’s face it: for any of us, change of any magnitude is a slow and fickle process.

Harm Reduction workers therefore need to be patient and non-judgemental. Brown and Gilligan argue that we should be equally patient with organizations trying to work together:

Just as women in the groups were educated to make changes in high–risk behaviours in a slow, incremental manner, so too, the multiple agencies involved in this collaboration learned that working together in an atmosphere of changing staff, different organizational cultures, limited funding resources and high demands, and ever changing time lines, also require a slow and steady approach where communication and a willingness to change are crucial factors.
(L. M. Brown & Gilligan, 1992: 332)

And finally, Erin Graham reminds us that, in this high-burnout profession, a shared political analysis is vital:

I came to believe that working on behalf of, or with “disenfranchised” populations, has the potential to be burn-out work unless a at least two conditions are met: 1) A strong theoretical political analysis fuels the work, and other workers share this analysis, and 2) there is a commitment to provide support, empathy, mutual aid and political solidarity rather than ‘service’.
(Graham, 2007: 15)