Little is known about the ethical experiences of psychologists who work with high-risk youth and implement a harm reduction approach. This study uses an interpretative phenomenological analysis methodology (IPA) to explore the experiences of psychologists who are faced with ethical tensions as a result of their work with high-risk youth and the use of a harm reduction approach. A small, purposefully selected sample consisting of two psychologists-in-training and a registered psychologist were interviewed. Data analysis of the ethical tensions experienced revealed three overarching themes: questioning, acting and holding. An experience of questioning ensued for each participant when that person was initially faced with an ethical tension. The experiences of acting and holding were in reference to how the psychologists managed the tensions. Data analysis also revealed a subtheme of sitting with tension. It was noted that participants had learned to coexist with ethical tensions when working with a harm reduction approach given the prevalence of ethical tensions that arise when working with high-risk youth. Implications for practice, suggestions for further research, and limitations of the research are discussed.