SMART Recovery

SMART Recovery is an international non-profit organization that provides assistance to individuals seeking abstinence from addiction. SMART stands for Self-Management and Recovery Training. The SMART approach is secular and science-based, using cognitive behavioral therapy (CBT) and non-confrontational motivational methods.[1]

SMART Recovery
Formation1994 (1994)
Headquarters7304 Mentor Avenue
Suite F
Mentor, Ohio 44060
WebsiteSMARTRecovery.org

SMART Recovery is an alternative to Alcoholics Anonymous (AA) and other twelve-step programs. SMART differs from AA by not encouraging individuals to admit powerlessness over addictions, not using the concept of a "Higher Power", and not endorsing the disease theory of alcoholism. Addiction is viewed by the organization as a dysfunctional habit, rather than a disease, while allowing that it is possible that certain people have a predisposition toward addictive behavior.[2]

History

After Jack Trimpey, founder of Rational Recovery (RR), decided to turn RR into a for-profit organization, the organization's board of directors left and formed SMART Recovery. Incorporated in 1992 as the Alcohol and Drug Abuse Self-Help Network (ADASHN), the organization began operating under the SMART Recovery name in 1994.[3][4]

General operations are overseen by a volunteer board of directors, which initially included Dr. Marc Kern. Local groups are run by volunteers known as "facilitators" with the assistance of volunteer recovery professionals called "volunteer advisors". A central office is currently maintained in Mentor, Ohio.[5]

SMART Recovery offers its services for free. Donations are encouraged, and its publications are sold.[6]

Methodology

SMART Recovery is based on scientific knowledge and is intended to evolve as scientific knowledge evolves.[7] The program uses principles of motivational interviewing found in motivational enhancement therapy (MET)[8] and techniques taken from cognitive-behavioral therapy (CBT), particularly in the version called rational emotive behavior therapy (REBT), as well as scientifically validated research on treatment.[9] The SMART Recovery Program and meetings are congenial to participants who choose to use appropriately-prescribed medications, including opioid-agonist medications, as part of their recovery programs.[10]

The organization's program emphasizes four areas, called the 4-Point Program, in the process of recovery: Building Motivation, Coping with Urges, Problem Solving, and Lifestyle Balance.[11] The "SMART Toolbox" is a collection of various MET, CBT and REBT methods, or "tools", which address the 4 Points.[12]

SMART Recovery can be used as a stand-alone primary recovery support program for those seeking help recovering from addictions but does not insist on being exclusive.[13] The program does not use the twelve steps that make up the basis of the various "Anonymous" self-help groups (e.g., Alcoholics Anonymous (AA), Narcotics Anonymous (NA), etc.) and is generally listed as an "Alternative to AA" or an "Alternative to the Twelve Steps."[14][15][16] SMART Recovery believes that each individual finds his and her own path to recovery. Though listed as an "alternative", it is also suggested as a possible "supplement" to twelve-step programs in SMART Recovery's main program publication, The SMART Recovery Handbook.[17]

Stages of change

SMART Recovery recognizes that participants may be in one or more of various stages of change and that different exercises may be helpful at different stages.[18]

  1. Precontemplation – At this stage, the participant may not realize that they have a problem.[18]
  2. Contemplation – The participant evaluates the advantages and disadvantages of the addiction by performing a cost/benefit analysis.[18]
  3. Determination/Preparation – The participant decides to pursue personal change, and may complete a Change Plan Worksheet.[18]
  4. Action – The participant seeks out new ways of handling their addiction behavior. This can include self-help, the support of addiction help group or professional guidance.[18]
  5. Maintenance – After a few months, the participant's behavior has been changed and now seeks to maintain their gains.[18]
  6. Graduation/Exit – Once a participant has sustained a long period of change, they may choose to move on with their lives and "graduate" from SMART Recovery.[18]

Side event: Relapse – Although not inevitable, relapses are a normal part of the change cycle and if handled well, can serve as a learning experience in overcoming an addiction.[18]

Meetings

The meetings are free for all wishing to attend and are intended to be informational as well as supportive.[19] Over 1500 weekly group meetings led by volunteer facilitators are held worldwide.[20] In addition, the organization provides online resources and support to the volunteers and those attending the groups and one or more daily online meetings.[21]

Meetings are also held in correctional facilities in many states including: Arizona, California, Florida, Indiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, Vermont, Virginia, Washington, and Wisconsin.

SMART Family & Friends

SMART Family & Friends is an online or face-to-face support group for Concerned Significant Others (CSOs) of people struggling with addictions. The group was started in September 2010. Its purpose is to address specific issues encountered when a family member or friend tries to reach out and help a loved one[22] and it draws from the work of Robert Meyers' community reinforcement approach and family training (CRAFT) program, which differs significantly from Al-Anon in that it is a behavioral program which advocates that the CSO can have a positive impact on the substance abuser. The CRAFT program has been demonstrated in Meyers' research to be more effective than the Vernon Johnson-type intervention or Al-Anon, with less negative side-effects and better outcomes, whether or not the substance abuser enters treatment.[23][24]

Effectiveness

A 2018 longitudinal study compared the self-reported success of SMART Recovery, LifeRing Secular Recovery, Women for Sobriety, and Alcoholics Anonymous. After normalizing for income and other demographic factors, the study saw that SMART Recovery fared worse across the outcomes of alcohol abstinence, alcohol drinking problems, and total abstinence, compared to Alcoholics Anonymous. However, after normalizing for treatment goal, SMART Recovery members who pursued abstinence did as well across all three factors as members of AA. In other words, among AA members and members of SMART Recovery who wanted to abstain, both programs had the same success rate.[25]

Recognition

SMART is recognized by the American Academy of Family Physicians,[26] as well as the National Institute on Drug Abuse (NIDA)[27] and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).[28] NIDA and NIAAA are agencies of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.

See also

References
  1. "Religiosity and Participation in Self-Help Groups". The Walsh Group. 2007-10-17. Retrieved 2007-12-11.
  2. Horvath, AT (October 2000). "Smart Recovery: Addiction Recovery Support from a Cognitive-Behavioral Perspective". Journal of Rational-Emotive & Cognitive-Behavior Therapy. 18 (3): 181–191. doi:10.1023/A:1007831005098.
  3. Lemanski, Michael J. (2000). "Addiction Alternatives for Recovery". The Humanist. University of Michigan Health System. Retrieved 2007-12-12.
  4. Humphreys, Keith (2003). Circles of Recovery: Self-help Organizations for Addictions. Cambridge University Press. pp. 82–86. ISBN 0-521-79277-0.
  5. "Archived copy" (PDF). Archived from the original (PDF) on 2016-10-10. Retrieved 2016-12-10.CS1 maint: archived copy as title (link)
  6. Hovarth, A. Thomas (2004). SMART Recovery Handbook. Mentor Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Section 1/Page5. ISBN 0-615-13135-2.
  7. Steinberger, H. (2004). SMART Recovery Handbook. Mentor Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Section 1/Page5. ISBN 0-615-13135-2.
  8. Miller, W.R.; et al. (1995). "Motivational Enhancement Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals With Alcohol Abuse and Dependence.". Project MATCH Monograph Series. National Institute of Health.
  9. Hester & Miller (2002). Handbook of Alcoholism Treatment Approaches: Effective Alternatives. University of Michigan: Allyn and Bacon. ISBN 0-205-36064-5.
  10. "SMART Recovery MAT/OAT Behavioral Care Support Program". SMART Recovery. since its beginning in 1994, SMART has always welcomed participants using appropriately prescribed, FDA-approved medications for treatment of an addiction and/or its underlying mental health problems.
  11. Shaw, BR; et al. (2005). Addiction & Recovery for Dummies. Wiley Publishing. pp. 176–177. ISBN 0-7645-7625-9.
  12. Brooks, A.J.; Penn, P. E. (2003). "Comparing treatments for dual diagnosis: Twelve-Step and Self Management and Recovery Training". American Journal of Drug and Alcohol Abuse. 29 (2): 359–383. doi:10.1081/ADA-120020519. PMID 12765211.
  13. Hardin, Rosemary (2013). SMART Recovery Handbook. Mentor Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Chapter 1: Welcome to SMART, Section: How is SMART different from other recovery programs?. ISBN 978-0-615-85267-6.
  14. Miller, W. R.; Kurtz, E. (1994). "Models of alcoholism used in treatment: Contrasting A.A. and other perspectives with which it is often confused". Journal of Studies on Alcohol. 55 (2): 159–166. PMID 8189736.
  15. Volpicelli, Joseph; Maia Szalavitz (2000). Recovery Options: The Complete Guide. Wiley Publishing. pp. 149–151. ISBN 0-471-34575-X.
  16. "SMART Alternative Self-Help Groups Tackle Substance Abuse". Robert Wood Johnson Foundation. Retrieved 2007-12-12.
  17. Steinberger, H. (2004). SMART Recovery Handbook. Mentor Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Section 1/Page4. ISBN 0-615-13135-2.
  18. Steinberger, H. (2004). SMART Recovery Handbook. Mentor Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Section 2/Page8. ISBN 0-615-13135-2.
  19. Shaw, BR; et al. (2005). Addiction & Recovery for Dummies. Wiley Publishing. pp. 176–177. ISBN 0-7645-7625-9.
  20. "1500 SMART Recovery Meetings – SMART Recovery". 30 June 2015.
  21. "Online Meeting Schedule". Retrieved 2009-05-29.
  22. For Family & Friends SMART Recovery website. Retrieved 2010-10-18.
  23. Smith, J.E. & Meyers, R.J. (2004)Motivating Substance Abusers to Enter Treatment: Working with Family Members; Guilford Press
  24. Meyers, RJ & Wolfe, B. (2004) Get Your Loved One Sober: Alternative to Nagging, Pleading and Threatening by Meyers, Hazelden Press
  25. Zemore, Sarah E; Lui, Camillia; Mericle, Amy; Hemberg, Jordana; Kaskutas, Lee Ann (2018). "A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with AUD". Journal of Substance Abuse Treatment. 88: 18–26. doi:10.1016/j.jsat.2018.02.004. PMC 5884451. PMID 29606223. Lay summary.
  26. "Substance Abuse--How To Recognize It". American Family Physician. 67 (7). 2003-04-01. Retrieved 2007-12-12.
  27. "Principles of Drug Addiction Treatment: A Research Based Guide". National Institute on Drug Abuse. Archived from the original on 2007-09-10. Retrieved 2007-12-12.
  28. "Alcohol and Drug Information". US Dept of Health and Human Services. Archived from the original on 2007-12-15. Retrieved 2007-12-12.

Further reading
  • Brown JM. (1998) Self-Regulation and the Addictive Behaviors. in Treating Addictive Behaviors, 2nd ed. Miller WR & Heather N. eds. Plenum Press, NY. ISBN 0-306-45852-7
  • Ellis A. & Velten E. (1992) Rational Steps To Quitting Alcohol: When AA Doesn't Work For You. Barricade Books, NY. ISBN 0-942637-53-4
  • Gerstein J. (1998) Rational Recovery, SMART Recovery and non-twelve step recovery programs. In Principles Of Addiction Medicine, 2nd ed. American Society of Addiction Medicine, Chevy Chase ISBN 1-880425-08-4
  • Mattson ME. (1998) Finding the Right Approach. in Miller WR & Heather N. Treating Addictive Behaviors. 2nd ed. Plenum Press, NY. ISBN 0-306-45852-7
  • Myers PL. (2002) Beware of the Man of One Book: Processing Ideology in Addictions Education. J of Teaching in the Addictions. pp 1:69-90
  • Vuchinich RE & Tucker JA. (1998) Choice, Behavioral Economics, and Addictive Behavior Patterns. in Treating Addictive Behaviors ISBN 0-306-45852-7
  • Whittinghill D., et al. The benefits of a self-efficacy approach to substance abuse counseling in the era of managed care. J Addictions & Offender Counseling. 2000; 20:64-74
  • Brooks, A. J., & Penn, P. E. (2003). "Comparing treatments for dual diagnosis: Twelve-step and Self-Management and Recovery Training". American Journal of Drug and Alcohol Abuse. 29 (2): 359–383. doi:10.1081/ADA-120020519. PMID 12765211.CS1 maint: multiple names: authors list (link)
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