SMART Recovery serves as an alternative to traditional Alcoholics Anonymous or Narcotics Anonymous (NA) formats and is rooted in a different philosophy. SMART Recovery works by trying to understand the science of recovery and employs and teaches tools and techniques to help people in their journey towards recovery. SMART Recovery operates in a harm reduction model and teaches that abstinence is neither a requirement for membership nor is it an expectation. The concepts are based on management and recovery training, and its empowering approach-based model is about meeting people where they are at then finding out where they want to go. This is done by utilizing tools to help achieve set goals.
Evidence-Based Practice
SMART Recovery bases its approach on utilizing the best tools from clinical evidence-based practice (EBP) to guide its philosophy regarding successfully reducing addictive behaviors. To be clear, SMART Recovery does not take the place of clinical intervention, but it does draw from clinical techniques to help guide recovery efforts. Some of the techniques may be concepts you are familiar with, as they are widely used:
• Motivational Enhancement, which closely follows clinical Motivational Interviewing techniques
• Rational Emotive Behavioral Therapy (REBT)
• Cognitive-Behavioral Therapy (CBT)
In its most basic form (similar to the AA 12 step format), SMART Recovery has a 4-point program. The four-point program serves as a set of building blocks to help a person build motivation for change. 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®
These four points are the catalyst for which all of the tools within the evidence-based practices can be laid out. While learning about SMART Recovery and attending the meetings, it is hoped that group discussion meetings participants learn and utilize 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)
It is vital to understand this background because when in meetings, the facilitator will be utilizing these techniques to help people with their goals.
Group Facilitator
SMART Recovery meetings will look different from an AA format. In AA, a leader or a chairperson will decide what the topic will be, but the topic itself will be in line with AA philosophy, such as thoughts about information in the Big Book or 12-step work.
SMART Recovery hosts meetings in an entirely different format. Groups operate with a trained facilitator. To be clear, this person is not a treatment professional, and they do not have clinical training; unless that is a coincidence, in which case it would be unethical to use those skills in the SMART Recovery group setting. Facilitators are volunteers who have gone through the SMART Recovery facilitator training. They have a firm grasp on the techniques and tools SMART Recovery uses to help people recognize there are problematic patterns and reduce addictive behaviors.
Addictive Behaviors
SMART Recovery welcomes all people who suffer from problematic addictive behaviors. This philosophy, which is somewhat different from conventional approaches focused specifically on drugs or alcohol use, operates with the understanding that addictive behaviors, whether from alcohol, substance abuse, or process addiction, all affect the same area of the brain. As a result, treatment of the problematic behavior, regardless of what caused it, should ultimately lead to a successful outcome.
Materials
Because SMART Recovery’s entire philosophy is founded and rooted in evidence-based practice, it is important to understand the concept and the materials that will be presented in the meetings. The materials are easy enough to find, and if going to a face to face meetings, oftentimes the facilitator will have a welcome kit containing basic information about the concepts and the tools utilized to make them work. Beyond that, the rest of the workbooks and materials can be found on the SMART Recovery website. There is a small cost affiliated with getting these materials; however, they are purposely kept at a low price so everyone can purchase them.
Group Format
Now that there is an understanding of the background and direction on where to get the materials, what happens next? SMART Recovery meetings can be either in person or done virtually. SMART Recovery meetings are free group discussion meetings, with no cost to attend, open to anyone, and usually lasting between 60 and 90 minutes. Because of the different format and philosophy, SMART Recovery offers, the structure of the meetings will look different from the more conventional meetings most people are used to.
Members of the group are asked to check-in and talk about what they bring to the meeting—what they would like to work on. Once everyone had an opportunity to go around the room, the facilitator then creates an agenda based on the material brought into the meeting. This is where the “work” begins. Discussion between participants is encouraged in these meetings, as the belief is that brainstorming and working together can help people accomplish their goals far faster than one person trying to go at it alone. That is not to say that a person does not need to do their own work, but that help is encouraged and appreciated. The facilitator helps guide the discussion to ensure it stays on topic and works within the SMART Recovery EBP structure.
In-Person
If choosing to do an in-person meeting, it is best to get there a little early, so you can meet your group facilitator, and they can help explain what to expect in your first meeting. Facilitators are usually very open, welcoming, and are happy to discuss any questions you may have.
Online Community
If planning on attending a meeting online, it is also best to get there early, as the meeting rooms cap out at 35 participants. The idea behind limiting the number of attendees is to make sure everybody has an opportunity to at least check-in. The actual how-to process of the meeting will be the same, whether in person or online.
Building Motivation
What are some of the tools that you might actually see in a meeting? Building motivation is one of the prime indicators for successful and lasting changes. Motivational Enhancement is a tool that can be used when trying to build motivation. During a meeting, conversations will be held about the pros and cons of either deciding for or against the change or the goal that a person is contemplating. The idea is to build internal motivation for change. This can take time and needs to be done with the goal focused on what a person wants to do, not on a goal that someone else thinks they should achieve. For example, perhaps a person’s goal is to establish a safe level of drinking at this time instead of seeking an instant stop to alcohol use.
External Motivation
Why does a person not have the sense to stop drinking? Someone telling others to stop doing something because that is bad or starting another activity because it is good for them does not work. If it were that easy, problematic addictive behaviors would have never developed to begin with. This is an example of external motivation. This is often seen when people find themselves in the justice system. They may be forced to do things to meet the conditions of their probation or parole. Failure to do so will end up with punitive consequences. Because a person usually does not want to face those consequences, they will do what they were told not because they want to or expect any lasting change from doing it, but because they do not want the consequences of what happens if they do not do so it. Unfortunately, external motivation may be made ineffective by alcohol or another type of addiction as the person may be more focused on avoiding punishment while satisfying addiction than on dealing with addiction itself.
Internal Motivation
Internal motivation is what needs to be developed for lasting changes to occur. Internal motivation can be defined as the desire to make a change, regardless of whether it is expected, popular, or not. It is the internal desire of a person fueling the fire of change. This usually requires a significant and introspective look at an individual’s ethics, morals, virtues, and belief system. When a person can make lasting changes from a place of internal motivation, the chances for that change to be lasting, authentic, and permanent are much higher.
Identifying Thought and Feelings
During a SMART Recovery meeting, when a person is trying to figure out how to accomplish a goal they want to set for themselves, they might be asked to start journaling their thoughts and feelings. This utilizes both CBT techniques and REBT techniques.
CBT and REBT are psychotherapies often used to help a person untangle thoughts from feelings. Feelings and thoughts are two separate things, but often they get combined into one, leaving a person sometimes feeling helpless to their feelings when in reality, it is a thought that is keeping them stuck. For example, let’s say someone says they feel like they are not good enough. This is not generally a feeling, it is a thought. The thought is they are not good enough. There is a feeling behind that statement. Do they feel sad, or perhaps ashamed? Is there actual evidence to support they are not good enough? Evidence to not support that thought? Once this is looked at logically, the person might realize that statement is not actually true and might start feeling better about themselves. SMART Recovery’s ABCs of working with urges tool, provided for its members, outlines this concept well.
Stages of Change
SMART Recovery also uses the stages of change model to teach its members about the cycle of addiction. This is a tool that is clinically used to help guide treatment decisions when a client enters treatment, so it is also an evidence-based tool. The stages of change comprise of five different stages, and each stage builds on the stage before it:
• In the pre-contemplation stage a person might not even realize they have an issue with addictive behaviors.
• In the contemplation stage a person starts to wonder if there is a problem.
• In the preparation stage a person has acknowledged, there is a problem and is weighing their options trying to decide what is the best course of action to take. This course of action could lean either way, meaning a person could continue with the addictive behavior or decide to make a change. This is called ambivalence.
• In the action stage a person has decided to make the change needed and begins the reduction or cessation of the addictive behavior.
• In the maintenance phase a person has found what successful recovery looks like for them.
There is an optional sixth stage called relapse. It is understood that relapse is a part of recovery. If a person falls into the sixth stage, the cycle starts all over again with pre-contemplation, although that does not necessarily mean a person will have to go through all the steps linearly.
DISARM
Another tool used in SMART Recovery is called DISARM. This is a tool that is used to help people fight cravings and urges. The idea here is to remember that a craving or an urge is nothing but a passing thought. You are not considered an addict; rather, you have thoughts about doing something impulsive. DISARM tries to externalize these thoughts because a person can be more successful and not engage in the addictive behavior if they can separate the behavior from themselves. The technique they suggest is to give the urge a name. Group discussion meeting participants have come up with different names throughout the years; the names do not necessarily matter as long as they have meaning for the person being affected. When a person can externalize the urges, it becomes a lot easier to not act on the urge when it comes up.
If Help is Needed Beyond SMART Recovery
SMART Recovery is a fantastic program and has helped countless people reduce or cease their addictive behaviors. There are, however, times when professional intervention is appropriate and necessary. If you or a loved one are concerned about out-of-control addictive behaviors, reaching out for an evaluation by a mental health professional is a good idea. This will help guide you towards the best level of care for you to be successful in your recovery. A support group can help, contact us today.
