What Is Smart Recovery?
In short, SMART Recovery is a global community of people and families working together to resolve addictive problems. SMART Recovery began in 1994 as an offshoot of Rational Recovery. Looking for an option beyond Alcoholics Anonymous (AA) and finding little, SMART Recovery began to offer an alternative to the traditional 12-step model.
Evidenced-Based Practice
uses evidence-based practice (EBP) techniques to guide the format and philosophy of recovery. Clinical EBP is used in treatment facilities to treat addiction, so this format works well for people who have experience in the treatment community. SMART Recovery is not treatment, and its group facilitators are not treatment professionals; however, concepts utilized while working in recovery using the SMART model method will use modified versions of clinical EBP’s such as:
- Motivational Enhancement, which closely follows clinical Motivational Interviewing techniques
- Rational Emotive Behavioral Therapy
- Cognitive-Behavioral Therapy
SMART Recovery also has a trademark registered 4-point program®. These points are:
- Building and Maintaining Motivation®
- Coping with Urges®
- Managing Thoughts, Feelings, and Behaviors®
- Living a Balanced Life. The methods used in SMART Recovery evolve as scientific knowledge®
While working through the four-point program, SMART Recovery hopes to have its members utilize management and recovery training by learning the following:
- Stages of Change
- Change Plan Worksheet
- Cost/Benefit Analysis (Decision Making Worksheet)
- ABCs of Rational Emotive Behavioral Therapy (REBT) for Urge Coping
- ABCs of REBT for Emotional Upsets
- DISARM (Destructive Images and Self-talk Awareness & Refusal Method)
- Hierarchy of Values
- Brainstorming
- Role-playing and Rehearsing
- USA (Unconditional Self-Acceptance)
This list is by no means exhaustive but gives a preview of some of the things a person will be working through, either via the materials offered online, in print, or in groups that could be held online or in person.
All Addiction
SMART Recovery has another defining characteristic in that it does not discriminate against different types of addiction. Alcoholics Anonymous (AA) is specific for people with alcohol concerns, while Narcotics Anonymous (NA) is specific for people with substance abuse concerns. Conversely, SMART Recovery is for people with addictive behavior concerns, no matter what form addiction may take. SMART Recovery recognizes that biologically speaking, how the brain reacts to addiction is no different, whether it be an addiction to substances or addictive behaviors revolving around process addictions. For reference, process addictions are defined as addictions that are behavioral in nature rather than induced with substances or alcohol. A good example of a process addiction could be overeating, overworking, shopping, or excessive internet usage.
Empowerment
SMART Recovery operates in a model that is somewhat different from AA or NA in that SMART Recovery wants to build self-efficacy and self-reliance. Under SMART Recovery’s empowering approach-based model, skills are taught that can help people have a better understanding of their addictive tendencies and behaviors, and learn what they can do to try and combat them rather than be powerless to do anything about their addictive issues.
This approach is a different concept than the traditional AA/NA philosophy. AA seeks to empower members by admitting helplessness over alcohol or substance abuse and asking a higher power to help. AA, and, by extension, NA operates under the assumption that nobody can control alcohol or substance abuse by themselves. Rather, the only way to combat this disease is to turn it over to a higher power. Historically, this was the gold standard, and this philosophy worked not only in the support groups, but also weaved its way through treatment centers, as often AA or NA attendance is required while in a treatment setting. With AA or NA often being the only option available, not everyone was successful in their recovery with this format.
To be clear, AA and START Recovery are both wonderful support groups, and one approach is not necessarily objectively better than the other. The key difference is that the two groups provide members with different methods which may fit some individual situations better. This is important because applying a one-size-fits-all approach to addiction treatment may set people up for disappointment, as not everyone learns, thinks, understands, or feels the same. Because each person has their unique circumstances, background, and beliefs, different options help people recover successfully. SMART Recovery provides another option.
Group Format
Group formats look a little different in SMART Recovery as well. Traditional groups operate in a format where people are invited to share their experiences, but there is no opportunity for discussion until after the group session is over. It is meant to allow the people speaking to share their stories, and for the people listening to gain perspective, or to be moved in a way that can help them in recovery. SMART Recovery works more in a way that would model a group format in a traditional treatment setting, where discussion meetings participants learn from one another.
SMART Recovery hosts free group discussion meetings. Each group is between 60 and 90 minutes in length, and the meetings are free and open to anyone. Groups are offered in both an in-person and online format. If held in person, groups usually consist of between 3 and 12 attendees. The online format caps at 35 participants. If doing an online meeting, SMART Recovery offers options for either video or text chat.
A group starts with the facilitator completing a check-in by asking what is going on in people’s lives. During the group discussion meetings, participants go around the room and share. Once this gets completed, the facilitator will develop a meeting agenda based on what was shared in the check-in. This agenda will utilize the tools that SMART Recovery bases its philosophy on.
Materials
Whether in person or online, SMART Recovery offers an opportunity to get materials that highlight both the four-point program and the other EBPs. If you are attending an in-person meeting, in your first meeting you will usually be given beginner materials that are needed to understand the concepts that will be utilized both in meetings and practiced outside of meetings to help you better build the skills needed to help with the addictive behaviors.
If you are the kind of person who likes printed materials, SMART Recovery’s website has you covered. They offer print material for all of the concepts you would learn when engaged in the program and things you would incorporate into your daily life to help reduce or cease addictive behaviors. There is a small cost affiliated with these materials, but they really are valuable as they help break down what the program philosophy and concepts are all about.
If you are utilizing an online format, there are also multiple ways to get information. SMART Recovery has a website that helps guide you to many different resources and materials. They also have SMART Recovery online (SMOL) site, which can be a useful resource for program participants. This online community is a place to search for online meetings, utilize message boards, and access journals. They also have an online app that lets you research SMART Recovery tools, view YouTube videos, listen to podcasts, and receive daily motivational exercises to help keep you focused.
Lastly, SMART Recovery has launched a service called Checkup and Choices. This is an EBP based alcohol reduction/cessation digital program that teaches mindfulness exercises, has daily tracking tools, and teaches techniques to help a person stay sober. It starts with a digital 30-minute online check-up in which you answer questions about yourself to tailor the app to be specific to your needs. Once this is completed, you begin to track alcohol consumption, log urges, moods and triggers to help establish patterns. Once the patterns are established, the app can help you make specific and measurable goals to reduce consumption.
Addiction: A Disease or a Choice?
History
A question that often gets asked by family members and those suffering from addiction is if addiction is a disease or a choice? This question can be a bit difficult to answer, but it is important to discuss. Clinically speaking, the Diagnostic and Statistical Manual of Mental Health Disorders 5th edition (DSM-5), which is the manual used to diagnose mental health and substance use disorders, classifies any problematic substance use or alcohol use as a substance use disorder (SUD) or alcohol use disorder (AUD). Certain criteria must be met for this diagnosis to be appropriately assigned to an individual. Specifiers are then used to note the severity of the disorder.
This criterion is new, as previous versions used to have distinct differences between alcohol use and alcohol abuse. As it is written now, clinicians use their clinical judgment when deciding whether a person is in the use or abuse stage of the addiction. It is important to discuss this because there needs to be an understanding of the science of recovery before it is possible to answer the question as to whether or not addiction is a disease.
Choices and Biology
Everyone has choices every day because free will and the ability to choose make people individuals. Biologically speaking, genetics also help make us distinct individuals. Choices and genetics play a big part in the role of addiction. The first time a substance is ingested, unless done so maliciously, is a choice. This is where genetics take over. If a person has a predisposition genetically towards addictive behaviors, the brain will react accordingly.
If an addictive behavior is completed enough times, whether it be substances, alcohol, overeating, or shopping, the brain begins to rewire itself in a way where it becomes dependent upon the behavior. If specifically using substances or alcohol, not only is the brain dependent, but the body also becomes dependent due to the ingredients in the substances which is what leads to withdrawal when you try to stop using.
In light of this background, and to loop back to answering the question of whether addiction is a choice or a disease, at the beginning of a substance or alcohol use disorder, there is still time to stop, as the body and brain have not yet become physically dependent. Once the usage has crossed the threshold of abuse, it becomes a disease, as the body and brain have now become physically dependent upon it. Even in successful recovery, it would be a constant danger for you to relapse from disease because in that situation the body and the brain will pick up right where they had left off.
SMART Recovery Difference
SMART Recovery operates under the philosophy that addiction is a disease rather than a character defect. This philosophy helps people to better understand the science behind the nature of the disease of addiction. It answers the question as to what is happening when others have difficulty understanding or when they may be quick to blame someone for not having the sense to stop drinking. Once a person has become dependent upon alcohol or a substance, recovery becomes a lifelong management tool used to mitigate chronic disease.
SMART Recovery wants to set people up with the tools to help with that lifelong management, understanding that nobody is perfect and there is a reason that relapse is part of the cycle of addiction. Having a grasp on these different behavioral tools can help retrain the brain to better manage the disease.
Mental Health
SMART Recovery is an amazing resource when looking for a self-help community dealing with addiction, but it does not treat mental health disorders. Between 54% and 87% of people with alcohol, substance abuse, or other addictive behaviors also have a diagnosable mental health disorder. When someone has both a substance or alcohol use disorder and another mental health disorder, it is referred to as a co-occurring or dual diagnosis disorder.
Many people using substances might be unaware that they have an undiagnosed mental health disorder, and have been using unhealthy substances to self-medicate. Self-medication through substances is usually done with a lack of understanding of the underlying mental health disorder. Typically, in this situation, a person has symptoms of a mental health disorder, but through the use of substances, the mental health symptoms diminish. This creates a negative feedback loop which leads to addiction. If the underlying mental health disorder can be resolved, oftentimes the reduction of substance use follows, because the need to self-medicate is no longer present.
How to Get Help Beyond SMART Recovery
If you or a loved one are concerned about out-of-control addictive behaviors or are wondering if there is an underlying mental health disorder, it is not only perfectly acceptable to look for help, but it is encouraged. Contact us today!