Chances are you have heard of Alcoholics Anonymous (AA). Since its inception in 1935, it has helped millions of people through both its Big Book, which has currently been translated into 70 different languages, and its self-help meetings. AA membership is currently estimated at around 2.1 million members.
AA is big, and for good reason, as it helped millions of people achieve and maintain sobriety. There is however another support group that has begun to make a name for itself. SMART Recovery is an alternative to the traditional AA support groups and offers a different model than what many in the recovery community are used to. Not to take away from the traditional options, but this is something to be celebrated, as it offers a new way and new support groups for people who might be looking for options outside of AA.
What Is AA Really?
AA builds off a framework that expects a person must take ownership and responsibility of their actions if they are to be successful in their recovery process. The famous 12-step program, which is the basic road map people will follow while working in AA, highlights these responsibilities. The steps are found on page 59 of the Big Book, and are listed below for reference:
1. We admitted we were powerless over alcohol — that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
Most people who are engaged in an AA group are learning about its principles and working through the steps. As individuals work through the process, they may find themselves in a position to offer help or mentorship to newer members. This is what is commonly referred to as being a sponsor, or a mentor to newer members who are in the earlier stage of recovery.
What Is SMART Recovery?
SMART Recovery is newer. Founded in 1994, SMART Recovery offers an alternative to the conventional self-help model. Multiple studies have shown that there is value in attending AA, but there is often a public perception that a portion of its philosophies may be somewhat outdated. With the decline of people identifying as religious within the United States, the second step, which relies on belief in a higher power and is a foundation for multiple subsequent steps, can be controversial and may lead to push back from some prospective members. SMART Recovery eliminates these concerns, as they operate using evidence-based practices that are similar to psychotherapy techniques used by clinicians within a treatment setting. SMART Recovery also does not operate in a way that requires a person to believe in a higher power and has no religious or spiritual component. Further, SMART Recovery has been recognized by several national institutes, and some programs received grants from the United States government.
AA Philosophy
The only requirement to become a member of the AA is the desire to stop drinking. There are no educational, age, or formal application requirements. Working an AA program, or, as people refer to it, working the program, requires a fair amount of responsibility and dedication to the required philosophy that surrounds AA. Much of the philosophy can be found in the Big Book. There is a term in the recovery community which states it works, if you work it. Meaning that to be successful in recovery with AA you need to constantly be utilizing the tools given to you within AA — working the program.
One core thing required for AA membership is that a person understands they are unable to control their drinking, they have a drinking problem, and they are an alcoholic. Next, a person in AA needs to understand that their life is out of control and they need to turn over control to a higher power. The idea is that by working the 12 steps, understanding the principles, and using those around you for support, you can stop your drinking. With that in mind, even a person who is no longer actively drinking will always remain an alcoholic under AA’s definition. AA prefers that you label yourself as an alcoholic even if you no longer partake in the substance; the philosophy behind this is so you will never forget where you came from, how far you have come, and that your drinking is problematic. The AA philosophy understands that some people may relapse and pick up drinking again, but expect that it may lead to serious negative consequences.
When going to an AA meeting, you can expect it to consist of people coming together, sitting down, and one by one sharing any experiences they might have had or are currently having. It gives program participants a place to collect their thoughts, share their stories, and learn from one another. During the meetings, AA members do not talk with one another while the stories are being shared. People are welcome to talk to each other after the meeting is over.
SMART Recovery Philosophy
SMART Recovery works a little differently. One of the big draws to the SMART Recovery program is its explicitly secular message that there does not need to be a belief in a higher power for recovery to be successful. SMART Recovery operates using an evidence-based practice approach. Evidence-based practice is a certain philosophy that considers peer-reviewed and scientific evidence as the best way to develop treatments that help treat addiction. To be clear, SMART Recovery is not a treatment program, but they have adopted a 4-point program® that looks somewhat similar to some of the techniques that clinical staff may use in a treatment setting. These points are:
1. Building and Maintaining Motivation®
2. Coping with Urges®
3. Managing Thoughts, Feelings, and Behaviors®
4. Living a Balanced Life. The methods used in SMART Recovery evolve as scientific knowledge®
Currently, SMART Recovery uses techniques from cognitive-behavioral therapy (CBT), Rational Emotive Behavior Therapy (REBT), and Motivational Enhancement (ME), a method that very closely mirrors Motivational Interviewing (MI) also used in a clinical setting.
SMART Recovery has a different philosophy than AA in that rather than accepting your lack of agency and giving control to a higher power, SMART Recovery believes taking ownership to build self-efficacy and promote self-reliance. SMART Recovery does not require the use of labels, and program participants are free to attend the group no matter what the addictive behavior. This could be alcohol or substance abuse or process addictions such as gambling, gaming, or shopping.
SMART Recovery meetings will look different as well. SMART Recovery meetings will have a group facilitator. This is a person trained within the SMART Recovery programs. They will operate the meeting in a way similar to a treatment group in that people are encouraged to talk to each other rather than at each other. The idea is that it helps people talk through any issues they may be currently facing, and helps them form connections with others within the program.
Abstinence and Harm Reduction
What is the difference between abstinence and harm reduction? Sometimes these two terms can be confusing when speaking with people about recovery. To put it simply, abstinence can be defined as removing oneself completely from the substance or alcohol usage or not using any substances at all. Working and recovering under an abstinence model means a person would completely remove themselves and not engage in any usage of the previous drug or substance of choice. Some in recovery take this a step further and use an abstinence-based model as a way of life, not using any substance or alcohol ever as it can be perceived as a gateway to relapse. for example, if a person is recovering from opiate addiction, not only would they not use opiates, but they would also not drink alcohol, as alcohol can be viewed as a stumbling block leading to relapse. The above is an extreme example of an abstinence-based model in recovery.
On the opposite end of the spectrum is a harm reduction model. This model recognizes that every person’s recovery journey looks different. The idea here is that reducing usage is better than nothing at all, and can be part of a gradual model to reduce dependence. For example, if you are a heavy drinker, reducing the usage to be a moderate drinker is better than doing nothing at all. Even from a physiological perspective, while still not ideal compared to avoiding substance use altogether, to use reducing usage is better for your body than doing nothing.
AA operates under an abstinence-only philosophy. One of its guiding philosophies is that a person is powerless over their drinking. Under AA’s tenets, to try limiting the amount of alcohol being used is to fool yourself into thinking you can control your consumption when, in reality, you cannot.
SMART Recovery has harm reduction built into its model. The idea behind their philosophy is that there is more than one way to get sober. Some people need different approaches to be successful. The idea is that by using some of the EBP techniques taught both in literature and in meetings, you will get resources to build internal motivation to stop using substances or alcohol.
What Is Right for You?
There is no single right or wrong answer regarding recovery, as it looks different for everyone. The things that work for you may not be appropriate for someone else. Simply put, AA approaches recovery one way and SMART Recovery approaches it in another way. There is no magical solution when it comes to being successful in recovery. If you are thinking about entering one of these support groups, the key is to consider which philosophy makes the most sense to you. There is no judgment one way or the other — it is just an understanding that different approaches are needed as not every person is the same, and everyone comes with their own history and set of considerations. One thing that AA and SMART Recovery both agree on is that being part of a group that provides mutual support to one another is incredibly valuable.
Mental Health Concerns
One thing that also needs to be addressed is mental health disorders. There is a significant crossover between mental health disorders and addiction — in other words, there is a large population of people who have substance abuse or alcohol use disorder and also have a co-occurring mental health disorder. Both AA and SMART Recovery are geared towards helping addiction. The former focuses solely on alcohol, while the latter covers addictive behaviors in general. These groups are not meant to help diagnose or treat mental health disorders. If you have been diagnosed with a mental health disorder, or suspect that you may have a mental health concern, it is a good idea to be seen by a professional to get a clinical evaluation. Getting the proper professional care is necessary when working towards or while in recovery.
It is helpful to know that in many cases, people who enter into professional treatment find that they have been using substances to help medicate their underlying mental health diagnoses. These diagnoses can be addressed in much healthier ways, including different psychotherapies, and if necessary, medical intervention through medication.
When to Find Help Beyond Support Groups
AA and SMART Recovery certainly have their place in the world of recovery, but how do you know if help is needed beyond what support groups have to offer? Some things to look for when asking these questions include:
• Difficulty remaining sober, or unable to meet harm reduction goals
• Previous treatment with continued relapse
• Untreated mental health concerns
If you or a loved one has decided that now is the time to look into support groups, look at our website today.
