What Is SMART Recovery?


SMART Recovery is a mutual support group program considered by some to be a more science-based and self-empowered alternative to Alcoholics Anonymous and other 12-step programs. SMART stands for Self-Management for Addiction Recovery Training; the program hosts thousands of meetings throughout the U.S. and several in other countries to help those in recovery from any type of addictive behavior. Although much smaller than AA, as of early 2020, the SMART website lists more than 1,600 meetings available across the United States and Canada.1

How SMART Recovery Works

SMART utilizes a science-based 4-Point Program to help people modify their addictive behaviors. These four points are followed by participants to help them:2

  1. Build and maintain the motivation to change, such as by refraining from problematic substances and behaviors.
  2. Cope with urges to use substances or otherwise indulge in problematic behaviors.
  3. To better manage their thoughts, feelings, and behaviors without engaging in addictive activities.
  4. To live a positive, balanced, positive, and healthy life.

SMART Recovery was founded by Dr. Joe Gerstein and several treatment professional colleagues in 1994.2 The abstinence-oriented, nonprofit organization has continued to serve as a secular alternative to the 12-step programs. Although SMART uses terms like addiction, meetings discourage those attending to refer to themselves as addicts or alcoholics. Also unlike many 12-step programs, participants aren’t primed to embrace the concept of spending the rest of their lives in recovery. SMART encourages people to attend meetings as long as they need them—months to years, in most cases—but not for a lifetime.3

SMART is designed to help people struggling with the negative consequences of all kinds of addictive behavior, and not just alcohol and drug use. SMART meetings also work for people who struggle with addictive behaviors such as gambling or shopping, as well as people who have compulsive eating or exercise problems. As SMART has grown over the years, the program has branched out into online support communities, which offer additional support outside of face-to-face meetings, as well as support programs for teenagers struggling with addiction and family members of people struggling with addiction.4,5

The program has a scientific, rather than a spiritual foundation, and stresses increased self-reliance instead of powerlessness in helping people change their compulsive behaviors. The program draws heavily from cognitive-behavioral therapy (CBT) and, specifically, Rational Emotive Behavior Therapy (REBT) to help people resolve their emotional and behavioral issues. Central to the REBT approach is the idea that our emotions and behaviors—how we feel and act—are influenced by how we think. REBT practitioners may reference the ABC sequence that people may focus on as they work through to change their patterns of thinking. These include:6

  • A—The activating event. Activating events can range from minor annoyances to major personal losses (deaths, illnesses, job loss). Depending on the nature of the occurrence, activating events may either help or hinder your goals.
  • B—Beliefs, thoughts, and attitudes surrounding A. Beliefs may be rational, reality-based, and self-helping; or, they may be irrational, based on wishful thinking, and self-defeating.
  • C—Consequences of A and B. These are the potential behaviors and emotions to arise as a result of activating events and their associated beliefs. Such consequences can include several emotions, including mad, sad, scared, and glad.
  • D—Disputes: finding arguments against irrational beliefs, developing different, rational methods of handling B.
  • E—Effects of the disputes: new emotions and behaviors to arise from replacing irrational with rational beliefs.

SMART meetings may focus on one or two of these items to better examine problems the group participants have noticed in the past week. Then, the group comes up with a plan to focus on better habits and rational ways of thinking for the next week.

Though it’s only sometimes possible to change A (activating events), it is always possible to change the B (beliefs) associated with these events. Through focusing on the ABCs, people may be able to change how they feel and what they do (emotional and behavioral consequences, respectively) by changing their beliefs.6

SMART meetings are free and, using techniques such as these, help members develop tools to change patterns in their lives that lead to or support an ongoing addiction. Using these psychological tools, the program aims to ultimately help members lead more constructive and satisfying lives.

Who Can Benefit from SMART?

The SMART Recovery website mentions that, while from a scientific perspective, the relative effectiveness of different types of support groups on addictive behaviors is unproven, but urges people to attend several different types to see which works best for themselves.3

However, it makes sense that some people may derive more benefit from SMART’s brand of support than others. Such people may include:

  • Those who do not wish to have religion, spirituality, or similar philosophies involved in their recovery. People who want to work in an evidence-based way with a group will benefit from participation in this program, whether through the in-person and online options for support. SMART recognizes that each individual has a different personal history and different preferences for their treatment, which might allow members to derive more benefit from meetings than other types of support groups.
  • People who do not want to label themselves as addicts or alcoholics, and instead prefer to focus on proactive change based on understanding oneself, may prefer SMART. SMART meetings actively discourage this kind of labeling and instead focus on what each individual experienced in the past week and wants to change in the next week. This can include relapse, and there is no judgment—only a focus on getting healthy.
  • SMART also allows for appropriately prescribed and monitored prescription medications, including maintenance therapies like buprenorphine or psychiatric medications. People on pharmacotherapies such as these might find SMART meetings to be supportive of such recovery tools.

People for whom SMART therapy might be less of a fit include:

  • People looking for religious or spiritual guidance as a primary means of support during recovery.
  • Those whose locus of control is external (a higher power like God).
  • People who need to be accountable to others outside of themselves or have specific goals for their future set, as in the 12-step model of counting abstinent days.
  • Those who cannot emotionally handle direct criticism or interruptions of their personal narratives (SMART encourages discussion during meetings, while AA and 12-step meetings give space for each person to speak when they feel moved to do so.)

Get Help

SMART is a style of recovery that is growing in popularity, and more and more people are receiving the benefit of a type of supportive group therapy that offers different methods, terminology, and goals from some of the more widely known mutual support group programs. Providing alternatives like SMART may help more people begin to recover or maintain their recovery progress. Regardless of the type of support group a person chooses, finding regular meetings after going through detox and/or rehabilitation can help the person stay on track in recovery.

References

  1. SMART Recovery. (2020). SMART Recovery Local Meetings—Full Meeting List Download.
  2. SMART Recovery. (2020). About SMART Recovery.
  3. SMART Recovery. (2020). Frequently Asked Questions—How is SMART Recovery different from Twelve Step programs such as AA or NA?
  4. SMART Recovery. (2020). The SMART Recovery Teen & Youth Support Program.
  5. SMART Recovery. (2020). SMART Recovery Family & Friends.
  6. SMART Recovery. (2020). Introduction to REBT.


About The Contributor

Scot Thomas, M.D.
Scot Thomas, M.D.

Senior Medical Editor, American Addiction Centers

Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating... Read More


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