Solution focused brief therapy (SFBT) and Harm Reduction (HR) have each demonstrated effectiveness with people who use substances, yet they have largely been treated as separate domains, with limited attention paid to their potential integration. This paper argues that the two approaches are philosophically and technically convergent, sharing a commitment to client autonomy, pragmatism, and a strengths-based orientation, and proposes a unified framework, Solution focused harm reduction (SFHR), for working with people who are ambivalent about change or who have not responded to abstinence-oriented treatment. Drawing on the theoretical and empirical literature underpinning both approaches, five areas of convergence are identified: self-autonomy and self-determination, a strengths-based orientation, pragmatism, a shared hierarchy of outcomes, and a common origin in clinical practice rather than theory. Two clinical vignettes illustrate the integrated framework, showing how a not-knowing stance, exception-finding, and HR information offered as a menu of options can support meaningful, client-paced change without requiring abstinence as a precondition of care. SFHR is presented as a clinically coherent, person-centred model that respects the client’s pace and expertise while reducing harm and building on existing strengths. Implications for practice, training, and service development are discussed, along with the need for a fidelity framework to support future empirical evaluation of the integrated approach.