A 2019 Guide to SMART Recovery

A Different Step-Based Recovery Program

Self-management and recovery training (SMART) Recovery is a substance abuse rehabilitation program that serves as an alternative to traditional 12-step programs, such as Alcoholics Anonymous. 1 SMART Recovery is a program designed to help a person overcome self-defeating thinking in order to achieve long-term sobriety. Take an in-depth view into the program and how it has benefited those struggling with addiction.

What Is SMART Recovery?

The SMART Recovery program is built around four major points. These include:

  1. Building and maintaining motivation
  2. Coping with urges
  3. Managing thoughts, feelings, and behaviors
  4. Living a balanced life

A person participating in the SMART Recovery program can attend meetings in-person or online. The SMART Recovery website also offers online message boards as well as chat rooms for members. There are several publications offered in conjunction with the SMART Recovery program, including workbooks and manuals that may assist someone in decision making and finding their personal motivations for sobriety.

In addition to the four major tenets surrounding the program, their approach includes:

  • Teaching participants how to empower themselves and boost self-reliance
  • Encouraging individuals to re-build their lives into satisfying, rewarding opportunities
  • Advocating for the use of medications and psychological counseling when appropriate as combination therapies
  • Allowing participants to attend meetings to discuss their motivations and steps in the recovery process

SMART Recovery Compared to Alcoholics Anonymous

The SMART Recovery program is geared toward those addicted to all different types of substances and habits. The program is not segmented, like Gamblers Anonymous, Alcoholics Anonymous, or Narcotics Anonymous. Instead, people with addictions of all types participate with each other in group meetings and online discussion groups. 2 However, there are segments within the SMART Recovery member network who find they need addiction-specific help.

In addition to benefiting those from a variety of addictions, a person also can participate in the SMART Recovery program if they have a dual diagnosis. This means that a person who struggles with addiction as well as a mental health disorder can benefit from the program too.

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History of SMART Recovery

The SMART Recovery program was officially founded in 1994 .3 However, the program was a transitional one from a previous program called Rational Recovery that Jack and Lois Trimpey founded in 1985. Throughout the 1990s, Rational Recovery meetings started to expand in the United States as a secular alternative to Alcoholics Anonymous and other 12-step meetings. The first in-person Rational Recovery meeting took place in 1990, and ultimately expanded to 14 groups by the end of 1990.

A few years later, researchers started to conduct studies as to how effective Rational Recovery programs were proving in combating substance abuse. These studies concluded that Rational Recovery participation helped to increase the likelihood of abstinence. They also found the longer a person participated, the more likely they were to stay sober.

Rational Recovery Becomes SMART Recovery

In 1994, a meeting of the non-profit board for Rational Recovery Self-Help, Inc. voted to incorporate as the SMART Recovery program. By 1995, there were an estimated 90 SMART Recovery meetings taking place in the United States. In 1998, the first programs outside the United States were formed in the United Kingdom and Scotland.

By the year 2000, an estimated 319 SMART Recovery meetings are held across the United States. Since this time, the programs have continued to expand internationally as well as across the United States. As of 2013, there were an estimated 1,098 total worldwide meetings for the program as well as handbooks, social media accounts, and specialty handbooks, including a teen handbook.

How Does SMART Recovery Help Those Struggling with an Addiction?

The SMART Recovery program is based on researched therapeutic approaches that include motivational interviewing and cognitive behavioral therapy. The focus is on changing addictive behaviors instead of focusing on addiction as a disease. 4

Meetings are typically led by a “coordinator” who facilitates and conducts the meeting. The meeting usually aims to identify problems they’re experiencing, analyze the problems, and find motivation and solutions that can help achieve abstinence goals. A typical meeting is 90 minutes and may go as follows:

  1. Welcome and opening statement
  2. Personal update
  3. Agenda setting
  4. Coping with activating events
  5. Pass the Hat
  6. Meeting review and homework
  7. Socializing

Some people will hold a 60-minute meeting instead of a 90-minute one. This format can vary based on the area where a person attends a meeting.

In addition to these meetings, a participant may often complete “homework,” which may include worksheets regarding decision-making and enacting positive changes in their lives.

Misconceptions About SMART Recovery

Because SMART Recovery programs are often positioned as a non-spiritual alternative to Alcoholics Anonymous and other similar programs, a common misconception is that a person cannot use both program types to successfully stay free from drug and alcohol abuse. According to the SMART Recovery website, administrators encourage the participation in whatever programs a person can find most effective in helping them maintain their abstinence. They also encourage those who do not have a SMART Recovery group in their area to attend Alcoholics Anonymous or other similar meetings.

Also, just because the SMART Recovery program is a non-spiritual one (does not focus on a higher power), people may commonly believe that a spiritual person should not participate. This is not true, as many spiritual people participate in SMART Recovery programs and experience the benefits they offer in keeping a person sober.

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Effectiveness of SMART Recovery

A meta-analysis published in the February 2017 edition of the journal Psychology of Addictive Behaviors examined 12 studies that evaluated the use of the SMART Recovery program for addiction treatment.5 Eight of the studies were published in peer-reviewed journals while the remaining four were unpublished dissertations. The researchers found the largest body of research surrounding SMART Recovery and its effectiveness was related to alcohol treatment.

Results from an estimated 7,655 participants were included in the meta-analysis. When evaluating and comparing the studies, the researchers found those who participated in SMART Recovery were more likely to have had past suicide attempts, suffer from mental health conditions, and experience distressing symptoms associated with their addiction.

The researchers also found evidence that supported SMART Recovery had proved beneficial in helping those suffering from alcohol abuse. They also found the research suggests that participation in SMART Recovery typically proved at least equivalent, but not necessarily superior than, other forms of mutual aid therapy, such as Alcoholics Anonymous. However, they did conclude that current research reveals those participating in programs such as Alcoholics Anonymous experienced longer durations of abstinence than when compared to SMART Recovery. However, they also found that people attended SMART Recovery programs for shorter amounts of time than they tended to go to Alcoholics Anonymous or other 12-step programs.

What Training Is Required to Administer SMART Recovery?

The coordinator in a SMART Recovery program is usually a trained volunteer that does not usually have a medical degree or background. For this reason, the program encourages participants to find psychotherapists or other medical individuals that can help with this element of counseling. However, some coordinators choose to consult professional advisors that do have a medical background for inclusion in the meetings.

Where Can I Find SMART Recovery Programs?

A person does not have to have a SMART Recovery program in their area to participate. Instead anyone can use the workbooks, videos, and online resources if they so desire to enhance their recovery.

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