SMART Recovery

Last updated
SMART Recovery
Formation1994;29 years ago (1994)
Headquarters7304 Mentor Avenue
Suite F
Mentor, Ohio 44060
Website www.smartrecovery.org OOjs UI icon edit-ltr-progressive.svg

SMART Recovery is an international community of peer support groups that help people recover from addictive and problematic behaviors, using a self-empowering and evidence-informed program. SMART stands for Self-Management and Recovery Training. The SMART approach is secular and research-based. SMART has a global reach, with a presence established in more than 30 countries. [1] SMART Recovery is effective with a range of addictive and problematic behaviors (alcohol, drugs, gambling, overeating, internet use etc.) [2]

Contents

Meetings of SMART participants are held throughout the week, both in person and online. [3] These meetings, which tend to run from 60 to 90 minutes each, are confidential, free, and guided by trained facilitators. Facilitators can be volunteers or professionals. Participants in various stages of recovery, or simply curious about pursuing recovery, share lessons and challenges from their own journeys, while exploring, through discussion, a suite of scientifically grounded psychology tools and techniques.

The SMART approach is built on the belief that freedom from substance use disorders and behavioral addictions fundamentally requires the exercise of personal choice. The SMART model is built on psychological tools of cognitive behavioral therapy and motivational interviewing. SMART was initially developed by medical professionals seeking more effective methods to treat patients. At the same time, SMART acknowledges that certain individuals can benefit from a blend of approaches, and does not discourage people from using other methods whilst attending SMART meetings. SMART endeavors to be inclusive for all participants.

The organization’s methods and meetings are congenial to participants who choose treatment with appropriately prescribed medications. SMART recognizes some participants may be seeking to regulate behaviors whilst others may choose abstinence. Throughout its global network of affiliates can be found both large scale SMART Recovery meetings and specific meetings tailored to prison inmates, military personnel, the LBGTQIA+ communities, young adults and family & friends of people engaged in or trying to achieve independence from addictive and problematic behaviors.

Methodology

SMART Recovery is based on scientific knowledge and is intended to evolve as scientific knowledge evolves. [4] The program uses principles of motivational interviewing, found in motivational enhancement therapy (MET), [5] and techniques taken from rational emotive behavior therapy (REBT), and cognitive-behavioral therapy (CBT), as well as scientifically validated research on treatment. [6] 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. [7]

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. [8] The "SMART Toolbox" is a collection of various MET, CBT and REBT methods, or "tools", which address the 4 Points. [9]

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. [10] The program does not use the 12 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 12 Steps." [11] [12] [13] SMART Recovery believes that each individual finds their own path to recovery. Though listed as an "alternative", it is also suggested as a possible "supplement" to 12-step programs in SMART Recovery's main program publication, The SMART Recovery Handbook. [14]

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. [15]

  1. Precontemplation – At this stage, the participant may not realize that they have a problem. [15]
  2. Contemplation – The participant evaluates the advantages and disadvantages of the addiction by performing a cost/benefit analysis. [15]
  3. Determination/Preparation – The participant decides to pursue personal change, and may complete a Change Plan Worksheet. [15]
  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. [15]
  5. Maintenance – After a few months, the participant's behavior has been changed and now seeks to maintain their gains. [15]
  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. [15]

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. [15]

Meetings

SMART Recovery meetings are free for all wishing to attend and are intended to be informational as well as supportive. [8] Over 1500 weekly group meetings led by volunteer facilitators are held worldwide. [16] In addition, the organization provides online resources and support to the volunteers and those attending the groups and one or more daily online meetings. [17]

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. [18]

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, there was no significant difference in the success rate. [19]

History

The first SMART Recovery meeting was held in the United States in 1994, and the organization established its original headquarters in Mentor, Ohio. As interest grew SMART meetings spread into Canada, the United Kingdom and Australia. Thirty years later the expansion is ongoing, with SMART meetings now held in 36 countries and 16 languages. [20]

In 2017 SMART Recovery International (SRI) was established. SRI is the governing body for the global SMART Recovery community. [21] SRI is overseen by a Board of international Directors mostly drawn from national SMART Recovery organizations. It receives advice from the SMART Recovery Global Research Committee. SMART affiliates in individual countries maintain their own governance structures as independent entities that are licensed to use the SMART Recovery intellectual property by SMART Recovery International. Specific program offerings can differ among these entities. SMART Recovery relies on funding from voluntary donations, philanthropy and grants. [22]

SMART Recovery also offers for sale a Participant Handbook and other related publications. [23]

Recognition

The following organizations recognize SMART Recovery.

United States

American Academy of Family Physicians [24]

National Institute on Alcohol Abuse and Alcoholism (NIAAA). [25] NIAA is an agency of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.

National Institute on Drug Abuse (NIDA) [26]

Substance Abuse and Mental Health Services Administration (SAMHSA) [27]

United Kingdom

Public Health England [28]
National Institute of Health and Care Excellence (NICE) [28]

Recovery Orientated Drug Treatment Expert Group (RODT) [28]

Advisory Council on the Misuse of Drugs (ACMD) [28]

Australia
Lifeline (crisis support service) [29]
Turning Point Alcohol and Drug Centre [30]

See also

Related Research Articles

<span class="mw-page-title-main">Alcoholics Anonymous</span> Sobriety-focused mutual help fellowship

Alcoholics Anonymous (AA) is a global peer-led mutual aid fellowship begun in the U.S. and dedicated to abstinence-based recovery from alcoholism through their spiritually inclined twelve-step program. Besides stressing anonymity, AA's twelve traditions establish it as non-professional, non-denominational, apolitical and unaffiliated. In 2020 AA estimated its worldwide membership to be over two million with 75% of those in the U.S. and Canada.

Twelve-step programs are international mutual aid programs supporting recovery from substance addictions, behavioral addictions and compulsions. Developed in the 1930s, the first twelve-step program, Alcoholics Anonymous (AA), founded by Bill Wilson and Bob Smith, aided its membership to overcome alcoholism. Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating. All twelve-step programs utilize a version of AA's suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.

Rational Recovery was a commercial vendor of material related to counseling, guidance, and direct instruction for addiction designed as a direct counterpoint to Alcoholics Anonymous (AA) and twelve-step programs.

Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin or amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and stop substance misuse to avoid the psychological, legal, financial, social, and physical consequences that can be caused.

<span class="mw-page-title-main">Alcohol dependence</span> Medical condition

Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol.

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

Dry drunk is an expression that describes an alcoholic who no longer drinks but otherwise maintains the same behavior patterns of an alcoholic. The objective of groups such as Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) is not just to help their members stop abusing drugs and alcohol. It is asserted in these programs that addiction is more systemic than a "bad habit" and is fundamentally caused by self-centeredness. Long term membership in Alcoholics Anonymous has been found to reform pathological narcissism, and those who are sober but retain characteristics associated with addiction are known in AA as dry drunks. The term is used by AA in relation to feelings of anger, depression and resentment.

The term Oxford House refers to any house operating under the "Oxford House Model", a community-based approach to addiction recovery, which provides an independent, supportive, and sober living environment. Today there are nearly 3,000 Oxford Houses in the United States and other countries.

Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programs may advocate a reduction in the use of drugs rather than outright abstention. One survey of members who found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorder. The survey found group participation increased when the individual members' beliefs matched those of their primary support group. Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for the twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organizations for Sobriety.

<span class="mw-page-title-main">LifeRing Secular Recovery</span> Addiction and recovery organization

LifeRing Secular Recovery is a secular, non-profit organization providing peer-run addiction recovery groups. The organization provides support and assistance to people seeking to recover from alcohol and drug addiction, and also assists partners, family members and friends of addicts or alcoholics. It is an abstinence-based recovery program with three fundamental principles: sobriety, secularity and self-empowerment. The motto of LifeRing is "empower your sober self."

Moderation Management (MM) is a secular non-profit organization providing peer-run support groups for anyone who would like to reduce their alcohol consumption. MM was founded in 1994 to create an alternative to Alcoholics Anonymous and similar addiction recovery groups for non-dependent problem drinkers who do not necessarily want to stop drinking, but moderate their amount of alcohol consumed to reduce its detrimental consequences.

<span class="mw-page-title-main">Secular Organizations for Sobriety</span> Non-profit network of autonomous addiction recovery groups

Secular Organizations for Sobriety (SOS), also known as Save Our Selves, is a non-profit network of autonomous addiction recovery groups. The program stresses the need to place the highest priority on sobriety and uses mutual support to assist members in achieving this goal. The Suggested Guidelines for Sobriety emphasize rational decision-making and are not religious or spiritual in nature. SOS represents an alternative to the spiritually based addiction recovery programs such as Alcoholics Anonymous (AA). SOS members may also attend AA meetings, but SOS does not view spirituality or surrendering to a Higher Power as being necessary to maintain abstinence.

Women for Sobriety (WFS) is a non-profit secular addiction recovery group for women with addiction problems. WFS was created by sociologist Jean Kirkpatrick in 1976 as an alternative to twelve-step addiction recovery groups like Alcoholics Anonymous (AA). As of 1998 there were more than 200 WFS groups worldwide. Only women are allowed to attend the organization's meetings as the groups focus specifically on women's issues. WFS is not a radical feminist, anti-male, or anti-AA organization.

<span class="mw-page-title-main">Addiction</span> Disorder resulting in compulsive behaviours

Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behaviour that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use often alters brain function in ways that perpetuate craving, and weakens self-control. This phenomenon – drugs reshaping brain function – has led to an understanding of addiction as a brain disorder with a complex variety of psychosocial as well as neurobiological factors that are implicated in addiction's development. Classic signs of addiction include compulsive engagement in rewarding stimuli, preoccupation with substances or behavior, and continued use despite negative consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification, coupled with delayed deleterious effects.

Recovery coaching is a form of strengths-based support for people with addictions or in recovery from alcohol, other drugs, codependency, or other addictive behaviors. There are multiple models, with some programs using self-identified peers who draw from their own lived experience with substance use and recovery and some utilizing people who have no lived experience but some training in support, depending on local standards and availability. They help clients find ways to stop addiction (abstinence) or reduce harm associated with addictive behaviors. These coaches can help a client find resources for harm reduction, detox, treatment, family support and education, local or online support groups; or help a client create a change plan to recover on their own.

About 1 in 7 Americans suffer from active addiction to a particular substance. Addiction can cause physical, psychological, and emotional harm to those who are affected by it. The American Society of Addiction Medicine defines addiction as "a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences." In the world of psychology and medicine, there are two models that are commonly used in understanding the psychology behind addiction itself. One model is referred to as the disease model of addiction. The disease model suggests that addiction is a diagnosable disease similar to cancer or diabetes. This model attributes addiction to a chemical imbalance in an individual's brain that could be caused by genetics or environmental factors. The second model is the choice model of addiction, which holds that addiction is a result of voluntary actions rather than some dysfunction of the brain. Through this model, addiction is viewed as a choice and is studied through components of the brain such as reward, stress, and memory. Substance addictions relate to drugs, alcohol, and smoking. Process addictions relate to non-substance-related behaviors such as gambling, spending money, sexual activity, gaming, spending time on the internet, and eating.

Community reinforcement approach and family training (CRAFT) is a behavior therapy approach in psychotherapy for treating addiction developed by Robert J. Meyers in the late 1970s. Meyers worked with Nathan Azrin in the early 1970s whilst he was developing his own community reinforcement approach (CRA) which uses operant conditioning techniques to help people learn to reduce the power of their addictions and enjoy healthy living. Meyers adapted CRA to create CRAFT, which he described as CRA that "works through family members." CRAFT combines CRA with family training to equip concerned significant others (CSOs) of addicts with supportive techniques to encourage their loved ones to begin and continue treatment and provides them with defences against addiction's damaging effects on themselves.

Linda Carter Sobell, Ph.D., ABPP, is the President's Distinguished Professor at Nova Southeastern University (NSU) in Fort Lauderdale, Florida. She is a professor of clinical psychology, addiction specialist, co-director of NSU's Guided Self-Change clinic, a Motivational Interviewing Trainer, and is board-certified in cognitive and behavioral psychology.

Guided self-change (GSC) treatment has been accepted by American Psychological Association Division 12, Society of Clinical Psychology, as an empirically supported treatment.

References

  1. ↑ "GROWTH" (PDF). SMART Recovery. Retrieved 10 May 2023.
  2. ↑ "FAQs- SMART Recovery". SMART Recovery. Retrieved 20 May 2023.
  3. ↑ Savage, Melanie (17 January 2022). "AHM's SMART Recovery program provides support during trying times". Hartford Courant. Retrieved 19 May 2023.
  4. ↑ Steinberger, H. (2004). SMART Recovery Handbook. Mentor, Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Section 1/Page 5. ISBN   0-615-13135-2.
  5. ↑ 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.
  6. ↑ Hester & Miller (2002). Handbook of Alcoholism Treatment Approaches: Effective Alternatives . University of Michigan: Allyn and Bacon. ISBN   0-205-36064-5.
  7. ↑ "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.
  8. 1 2 Shaw, BR; et al. (2005). Addiction & Recovery for Dummies. Wiley Publishing. pp.  176–177. ISBN   0-7645-7625-9.
  9. ↑ 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. S2CID   9257240.
  10. ↑ 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.
  11. ↑ 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. doi:10.15288/jsa.1994.55.159. PMID   8189736.
  12. ↑ Volpicelli, Joseph; Maia Szalavitz (2000). Recovery Options: The Complete Guide. Wiley Publishing. pp. 149–151. ISBN   0-471-34575-X.
  13. ↑ "SMART Alternative Self-Help Groups Tackle Substance Abuse". Robert Wood Johnson Foundation. Archived from the original on 2012-09-11. Retrieved 2007-12-12.
  14. ↑ Steinberger, H. (2004). SMART Recovery Handbook. Mentor, Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Section 1/Page 4. ISBN   0-615-13135-2.
  15. 1 2 3 4 5 6 7 8 Steinberger, H. (2004). SMART Recovery Handbook. Mentor, Ohio: Alcohol & Drug Abuse Self-Help Network, Inc. pp. Section 2/Page 8. ISBN   0-615-13135-2.
  16. ↑ "1500 SMART Recovery Meetings – SMART Recovery". 30 June 2015.
  17. ↑ "Online Meeting Schedule" . Retrieved 2009-05-29.
  18. ↑ "SMART Recovery". SMART Recovery. Retrieved 2022-11-05.
  19. ↑ 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.
  20. ↑ "SMART Recovery Online Meetings". SMART Recovery. Retrieved 20 May 2023.
  21. ↑ "SMART Recovery International". SMART Recovery. Retrieved 20 May 2023.
  22. ↑ "Strategic Plan 2021-22: Leading the Future of SMART Recovery". SMART Recovery. Retrieved 20 May 2023.
  23. ↑ "SMART Recovery Bookstore". SMART Recovery Bookstore. Retrieved 20 May 2023.
  24. ↑ "Substance Abuse--How To Recognize It". American Family Physician. 67 (7). 2003-04-01.
  25. ↑ "Recommend Evidence-Based Treatment: Know the Options". National Institute on Alcohol Abuse and Alcoholism (NIAA.org). Retrieved 20 May 2023.
  26. ↑ "National Institute on Drug Abuse director to speak on addiction recovery". The News-Herald. 6 April 2022. Retrieved 20 May 2023.
  27. ↑ "Staying Connected is Important: Virtual Recovery Resources" (PDF). SAMHSA Substance Abuse and Mental Health Services Administration. Retrieved 20 May 2023.
  28. 1 2 3 4 "A briefing on the evidence-based drug and alcohol treatment guidance recommendations on mutual aid". GOV.CO.UK. Public Health England. 10 April 2018. Retrieved 21 May 2023.
  29. ↑ "SMART Recovery Australia". Lifeline Support Toolkit. Lifeline. Retrieved 21 May 2023.
  30. ↑ "Patient Pathways Study". Turning Point. Turning Point. Retrieved 21 May 2023.

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