The SMART Recovery program is the leading alternative to Alcoholics Anonymous and other 12-Step programs. SMART stands for “Self-Management for Addiction Recovery Training.” Although it is about 100 times smaller than AA, there are over 1,000 groups available across the United States.
How SMART Recovery Works
SMART uses a 4-Point Program, loosely similar to the 12-Step program. These four points are:
- Heighten and maintain members’ motivation to refrain from problematic substances and behaviors
- Deal with urges to indulge in problem behaviors
- Manage thoughts, feelings, and actions
- Balance momentary and enduring satisfactions in life
This nonprofit organization was founded by Joe Gerstein and other psychologists in 1994, to eliminate the spiritual component of 12-Step programs and the idea of being in lifelong recovery. SMART Recovery focuses on evidence-based steps, using the latest medical research on addiction and substance abuse to help members overcome their compulsive behaviors by changing their thoughts and practicing those actions. Meetings are free, primarily focused on abstinence, and focus on helping members develop tools to change patterns in their lives leading to addiction. Using these psychological tools, the program aims to help members lead meaningful and satisfying lives.
The SMART Recovery program does not just focus on alcohol and drugs, although these meetings primarily feature members who have difficulty with these addictive substances. 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 becomes more popular, 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.
Although SMART uses terms like addiction and abuse, meetings never require those attending to refer to themselves as addicts or substance abusers. According to research, many people in the early stages of recovery may not wish to refer to themselves using these terms, even though they know they engage in problematic behaviors and need help overcoming those issues. AA and 12-Step programs require, as one of the steps, that members refer to themselves as addicts, because this is viewed as accepting personal responsibility for the problem. However, this drives some people away from attending 12-Step programs or other, similar support groups that might otherwise help them.
SMART also focuses on the idea that recovery can have an end date. Although it takes a long time for people struggling with substance abuse to overcome compulsive behaviors around their addiction, including relapse, SMART meetings focus on the idea that each person can be recovered, not just recovering. There will be a time when SMART meetings are no longer useful to a person because that individual has overcome their addiction through conscious effort and self-exploration.
The program uses a specific set of tools based in Cognitive Behavioral Therapy and Rational Emotive Behavioral Therapy (REBT). These tools are:
- Noticing and focusing on the stages of change
- Using the change plan worksheets
- Conducting a cost-benefit analysis of substance use versus abstinence
- Reviewing the ABCs:
- Activating event: something happens
- Beliefs, thoughts, and attitudes triggered by A
- Consequences of B: both thoughts and behaviors used to cope with B
- Disputes: finding arguments against original behaviors and thoughts, developing different, rational methods of handling B
- Effects of the disputes: new emotions and behaviors based on a better understanding of self
- Maintaining a hierarchy of values
- Using DISARM (Destructive Irrational Self-Talk Awareness & Refusal Method) strategies
- Role-playing and rehearsing to ingrain new behaviors
- Practicing USA (Unconditional Self-Acceptance)
- Finding VACI (Vital Absorbing Creating Interests)
SMART meetings typically focus on one or two of these tools, applying them to the problems the group has noticed that came up 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.
Although SMART Recovery is not currently as popular as 12-Step programs like AA, this type of support group is recognized by several medical organizations, including the American Academy of Family Physicians, the Center for Health Care Evaluation, the National Institute on Drug Abuse, and the American Society of Addiction Medicine.
Who Benefits from SMART and Who Doesn’t?
The SMART Recovery website states specifically that, due to the nature of the meetings, there are no studies that directly address whether the program is effective or not. However, there are studies that indirectly show this form of supportive therapy can be very helpful for people working to overcome an addiction.
In terms of scientific psychological research, there are essentially two types of people: those who have an external locus of control and those who have an internal locus of control. The locus of control involves who is in charge of the individual’s future: whether it is something external to individuals, which is the approach of the religious-based 12-Step program, or if individuals are in control of themselves, which is the SMART program’s focus.
There are people who are better suited to this form of supportive therapy than others. People who will likely benefit from SMART meetings 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, although each individual will find more or less benefit from the in-person and online options for support groups. 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, and instead prefer to focus on proactive change based on understanding oneself, are likely to prefer SMART. As mentioned before, AA meetings require members to label themselves as “addicts,” which can drive some people away who might want help. SMART meetings do not require 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 who need these therapies might find SMART meetings more useful.
People who might not work well with SMART therapy are:
- People who wish for religious or spiritual guidance as the primary mode of 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.)
SMART is a style of recovery that is growing in popularity, so more people are receiving the benefit of a type of supportive group therapy that offers different methods, terminology, and goals. This can help more people enter a recovery program or maintain their recovery progress. Regardless of the type of support group a person chooses, finding regular meetings after going through detox and a rehabilitation program will help the person stay on track in recovery.