Little is known about the ethical experiences of psychologists who work with high-risk youth using a harm reduction approach. We used interpretative phenomenological analysis (IPA) to explicitly explore this phenomenon. In this small exploratory study three participants were interviewed to glean their experiences of ethical tension. Data analysis revealed three superordinate themes (questioning, acting, and holding) within which eight subthemes are subsumed (questioning beneficence, questions from others, self-care, social change, negotiation, consultation and supervision, acceptance, and sitting with tension). The results of this research suggest that context-specific ethical tensions may arise for psychologists who work with high-risk youth using a harm reduction approach, which in turn lead to and necessitate a tailored ethical response. The results also suggest that harm reduction promoters may benefit from increased dialogue with licencing and professional bodies to foster awareness and develop guidelines on promoting ethical practice when using a harm reduction approach with high-risk youth. Future research can profitably be directed towards an increased experiential understanding of some of the central themes of this research, such as “sitting with tension” and “holding.
