SMART Recovery

{{Short description|Secular organization for recovery from addiction}}

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| headquarters = 7304 Mentor Avenue
Suite F
Mentor, Ohio 44060

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SMART Recovery is an international community of peer support groups that aims to help people recover from addictive and problematic behaviors. SMART stands for Self-Management and Recovery Training. The SMART approach is secular and research-based.

The SMART model is built on psychological tools of cognitive behavioral therapy and motivational interviewing, and was initially developed by medical professionals seeking more effective methods to treat patients. SMART Recovery is used with a range of addictive and problematic behaviors (alcohol, drugs, gambling, overeating, internet use, etc).{{cite web |title=FAQs- SMART Recovery |url=https://www.smartrecovery.org/about-us/frequently-asked-questions/ |archive-url=https://web.archive.org/web/20180417062013/https://www.smartrecovery.org/about-us/frequently-asked-questions/ |url-status=usurped |archive-date=April 17, 2018 |website=SMART Recovery |access-date=20 May 2023}}{{independent source needed|date=June 2025}}

SMART is established in more than 20 countries.{{cite web |title=GROWTH |url=https://www.smartrecovery.org/wp-content/uploads/2020/04/SMART-Growth-Global-Research-for-Media-Page.pdf |archive-url=https://web.archive.org/web/20200926173603/https://www.smartrecovery.org/wp-content/uploads/2020/04/SMART-Growth-Global-Research-for-Media-Page.pdf |url-status=usurped |archive-date=September 26, 2020 |website=SMART Recovery |access-date=10 May 2023}} Meetings of SMART participants are held throughout the week, both in person and online.{{cite news |last1=Savage |first1=Melanie |title=AHM's SMART Recovery program provides support during trying times |url=https://www.courant.com/2022/01/17/ahms-smart-recovery-program-provides-support-during-trying-times/ |access-date=19 May 2023 |work=Hartford Courant |date=17 January 2022}}

These meetings, which tend to run from 60 to 90 minutes each, are confidential, free, and guided by trained volunteer or professional facilitators. Participants in various stages of recovery, or simply curious about pursuing recovery, share lessons and challenges from their own journeys, while exploring, through discussion, a suite of scientifically grounded psychology tools and techniques.

Methodology

SMART Recovery is based on scientific knowledge and is intended to evolve as scientific knowledge evolves.{{cite book | last = Steinberger | first = H. | title = SMART Recovery Handbook | publisher = Alcohol & Drug Abuse Self-Help Network, Inc.| year = 2004 | location = Mentor, Ohio | pages = Section 1/Page 5 | isbn = 0-615-13135-2 }} The program uses principles of motivational interviewing, found in motivational enhancement therapy (MET),{{Cite book| first=W.R. | last=Miller| contribution=Motivational Enhancement Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals With Alcohol Abuse and Dependence.| title=Project MATCH Monograph Series| url=https://archive.org/details/match04 | publisher=National Institute of Health | year=1995|display-authors=etal}} and techniques taken from rational emotive behavior therapy (REBT), and cognitive-behavioral therapy (CBT), as well as scientifically validated research on treatment.{{cite book | last = Hester & Miller | title = Handbook of Alcoholism Treatment Approaches: Effective Alternatives | publisher = Allyn and Bacon | year = 2002 | location = University of Michigan | isbn = 0-205-36064-5 | url-access = registration | url = https://archive.org/details/handbookofalcoho0000unse }} The SMART Recovery Program and meetings are congenial to participants who choose to use appropriately-prescribed medications, including opioid-agonist medications, as part of their recovery programs.{{cite web|url=https://www.smartrecovery.org/mat/|archive-url=https://web.archive.org/web/20190417084702/https://www.smartrecovery.org/mat/|url-status=usurped|archive-date=April 17, 2019|title=SMART Recovery MAT/OAT Behavioral Care Support Program|publisher=SMART Recovery|quote=since its beginning in 1994, SMART has always welcomed participants using appropriately prescribed, FDA-approved medications for treatment of an addiction and/or its underlying mental health problems.}}

The organization's program emphasizes four areas, called the 4-Point Program, in the process of recovery: Building Motivation, Coping with Urges, Problem Solving, and Lifestyle Balance.{{cite book | last = Shaw | first = BR | title = Addiction & Recovery for Dummies | publisher = Wiley Publishing | year = 2005 | pages = [https://archive.org/details/addictionrecover00shaw/page/176 176–177] | isbn = 0-7645-7625-9 | display-authors = etal | url = https://archive.org/details/addictionrecover00shaw/page/176 }} The "SMART Toolbox" is a collection of various MET, CBT, and REBT methods, or "tools", which address the 4 Points.{{cite journal |title=Comparing treatments for dual diagnosis: Twelve-Step and Self Management and Recovery Training |journal=American Journal of Drug and Alcohol Abuse |year=2003 |first=A.J. |last=Brooks |author2=Penn, P. E. |volume=29 |issue=2 |pages=359–383 |doi=10.1081/ADA-120020519 |pmid=12765211|s2cid=9257240 }}

SMART Recovery can be used as a stand-alone primary recovery support program for those seeking help recovering from addictions, but does not insist on being exclusive.{{cite book | last = Hardin| first = Rosemary| title = SMART Recovery Handbook | publisher = Alcohol & Drug Abuse Self-Help Network, Inc.| year = 2013 | location = Mentor, Ohio | pages = Chapter 1: Welcome to SMART, Section: How is SMART different from other recovery programs? | isbn= 978-0-615-85267-6 }} The program does not use the 12 steps that make up the basis of the various "Anonymous" self-help groups (e.g., Alcoholics Anonymous (AA), Narcotics Anonymous (NA), etc.) and is generally listed as an "Alternative to AA" or an "Alternative to the 12 Steps."{{cite journal|title=Models of alcoholism used in treatment: Contrasting A.A. and other perspectives with which it is often confused |journal=Journal of Studies on Alcohol |year=1994 |first=W. R. |last=Miller |author2=Kurtz, E. |volume=55 |pages=159–166|pmid=8189736|issue=2 |doi=10.15288/jsa.1994.55.159 }}{{cite book | last = Volpicelli | first = Joseph |author2=Maia Szalavitz | title = Recovery Options: The Complete Guide | publisher = Wiley Publishing | year = 2000 | pages = 149–151 | isbn = 0-471-34575-X }}{{cite news | title=SMART Alternative Self-Help Groups Tackle Substance Abuse | publisher=Robert Wood Johnson Foundation | url=http://www.rwjf.org/reports/grr/027460s.htm | access-date=2007-12-12 | archive-date=2012-09-11 | archive-url=https://archive.today/20120911030138/http://www.rwjf.org/reports/grr/027460s.htm | url-status=dead }} SMART Recovery believes that each individual finds their own path to recovery. Though listed as an "alternative", it is also suggested as a possible "supplement" to 12-step programs in SMART Recovery's main program publication, The SMART Recovery Handbook.{{cite book | last = Steinberger | first = H. | title = SMART Recovery Handbook | publisher = Alcohol & Drug Abuse Self-Help Network, Inc.| year = 2004 | location = Mentor, Ohio | pages = Section 1/Page 4 | isbn = 0-615-13135-2 }}

= Stages of change =

SMART Recovery recognizes that participants may be in one or more of various stages of change and that different exercises may be helpful at different stages.{{cite book | last = Steinberger | first = H. | title = SMART Recovery Handbook | publisher = Alcohol & Drug Abuse Self-Help Network, Inc.| year = 2004 | location = Mentor, Ohio | pages = Section 2/Page 8 | isbn = 0-615-13135-2 }}

Precontemplation – At this stage, the participant may not realize that they have a problem.
Contemplation – The participant evaluates the advantages and disadvantages of the addiction by performing a cost/benefit analysis.
Determination/Preparation – The participant decides to pursue personal change, and may complete a Change Plan Worksheet.
Action – The participant seeks out new ways of handling their addiction behavior. This can include self-help, the support of addiction help group or professional guidance.
Maintenance – After a few months, the participant's behavior has been changed and now seeks to maintain their gains.
Graduation/Exit – Once a participant has sustained a long period of change, they may choose to move on with their lives and "graduate" from SMART Recovery.

Side event: Relapse – Although not inevitable, relapses are a normal part of the change cycle and if handled well, can serve as a learning experience in overcoming an addiction.

Meetings

SMART Recovery meetings are free for all wishing to attend and are intended to be informational as well as supportive. Over 1500 weekly group meetings led by volunteer facilitators are held worldwide.{{cite web|url=http://blog.smartrecovery.org/2015/06/30/1500-smart-recovery-meetings/|archive-url=https://web.archive.org/web/20150703022544/http://blog.smartrecovery.org/2015/06/30/1500-smart-recovery-meetings/|url-status=usurped|archive-date=July 3, 2015|title=1500 SMART Recovery Meetings – SMART Recovery|date=30 June 2015}} In addition, the organization provides online resources and support to the volunteers and those attending the groups and one or more daily online meetings.{{cite web |url=http://www.smartrecovery.org/meetings/olschedule.htm |archive-url=https://web.archive.org/web/20060111061824/http://www.smartrecovery.org/meetings/olschedule.htm |url-status=usurped |archive-date=January 11, 2006 |title=Online Meeting Schedule |access-date=2009-05-29}}

Meetings are also held in correctional facilities in many states, including: Arizona, California, Florida, Indiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, Vermont, Virginia, Washington, and Wisconsin.{{Cite web |title=SMART Recovery |url=https://www.smartrecovery.org/ |archive-url=https://web.archive.org/web/19981201220726/http://www.smartrecovery.org/ |url-status=usurped |archive-date=December 1, 1998 |access-date=2022-11-05 |website=SMART Recovery |language=en-US}}

SMART hosts both large scale meetings and specific meetings tailored to prison inmates, military personnel, the LBGTQIA+ communities, young adults and family and friends of people engaged in or trying to achieve independence from addictive and problematic behaviors.

Effectiveness

A 2018 longitudinal study compared the self-reported success of SMART Recovery, LifeRing Secular Recovery, Women for Sobriety, and Alcoholics Anonymous. After normalizing for income and other demographic factors, the study saw that SMART Recovery fared worse across the outcomes of alcohol abstinence, alcohol drinking problems, and total abstinence, compared to Alcoholics Anonymous. However, after normalizing for treatment goal, SMART Recovery members who pursued abstinence did as well across all three factors as members of AA. In other words, among AA members and members of SMART Recovery who wanted to abstain, there was no significant difference in the success rate.{{cite journal|title=A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with AUD|journal=Journal of Substance Abuse Treatment|volume=88|pages=18–26|doi=10.1016/j.jsat.2018.02.004|pmid=29606223|pmc=5884451|year=2018|last1=Zemore|first1=Sarah E|last2=Lui|first2=Camillia|last3=Mericle|first3=Amy|last4=Hemberg|first4=Jordana|last5=Kaskutas|first5=Lee Ann}}

{{cite news |author=German Lopez |date=March 5, 2018 |title=Alcoholics Anonymous works for some people. A new study suggests the alternatives do too |work=Vox |url=https://www.vox.com/science-and-health/2018/3/5/17071690/alcoholics-anonymous-aa-smart-lifering-study}}

History

The first SMART Recovery meeting was held in the United States in 1994, and the organization established its original headquarters in Mentor, Ohio. As interest grew, SMART meetings spread into Canada, the United Kingdom and Australia. Thirty years later, the expansion is ongoing, with SMART meetings now held in 36 countries and 16 languages.{{cite web |title=SMART Recovery Online Meetings |url=https://www.smartrecoveryinternational.org/covid-19response |website=SMART Recovery |access-date=20 May 2023}}

In 2017, SMART Recovery International (SRI) was established. SRI is the governing body for the global SMART Recovery community.{{cite web |title=SMART Recovery International |url=https://www.smartrecoveryinternational.org/ |website=SMART Recovery|access-date=20 May 2023}} SRI is overseen by a Board of international Directors mostly drawn from national SMART Recovery organizations. It receives advice from the SMART Recovery Global Research Committee.

SMART affiliates in individual countries maintain their own governance structures as independent entities that are licensed to use the SMART Recovery intellectual property by SMART Recovery International. Specific program offerings can differ among these entities.

SMART Recovery relies on funding from voluntary donations, philanthropy and grants.{{cite web |title=Strategic Plan 2021-22: Leading the Future of SMART Recovery |url=https://www.smartrecovery.org/leading-the-future-of-smart-recovery/ |archive-url=https://web.archive.org/web/20210423231211/https://www.smartrecovery.org/leading-the-future-of-smart-recovery/ |url-status=usurped |archive-date=April 23, 2021 |website=SMART Recovery|access-date=20 May 2023}}

SMART Recovery also offers for sale a Participant Handbook and other related publications.{{cite web |title=SMART Recovery Bookstore |url=https://shop.smartrecovery.org/ |archive-url=https://web.archive.org/web/20190328042623/https://shop.smartrecovery.org/ |url-status=usurped |archive-date=March 28, 2019 |website=SMART Recovery Bookstore |access-date=20 May 2023}}

Recognition

The following organizations recognize SMART Recovery.

United States

American Academy of Family Physicians{{cite journal |title=Substance Abuse--How To Recognize It |journal=American Family Physician |date=2003-04-01 |volume=67 |issue=7 }}
National Institute on Alcohol Abuse and Alcoholism (NIAAA){{cite web |title=Recommend Evidence-Based Treatment: Know the Options |url=https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/recommend-evidence-based-treatment-know-options |website=National Institute on Alcohol Abuse and Alcoholism (NIAA.org) |access-date=20 May 2023}} – NIAAA is an agency of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.
National Institute on Drug Abuse (NIDA){{cite news |title=National Institute on Drug Abuse director to speak on addiction recovery |url=https://www.news-herald.com/2022/04/05/national-institute-on-drug-abuse-director-to-speak-on-addiction-recovery-april-6/ |access-date=20 May 2023 |work=The News-Herald |date=6 April 2022}}
Substance Abuse and Mental Health Services Administration (SAMHSA){{cite web |title=Staying Connected is Important: Virtual Recovery Resources |url=https://www.samhsa.gov/sites/default/files/virtual-recovery-resources.pdf |website=SAMHSA Substance Abuse and Mental Health Services Administration |access-date=20 May 2023}}

United Kingdom

Public Health England{{cite web |title=A briefing on the evidence-based drug and alcohol treatment guidance recommendations on mutual aid |url=https://www.gov.uk/government/publications/mutual-aid-toolkit-for-alcohol-and-drug-misuse-treatment |website=GOV.CO.UK |date=10 April 2018 |publisher=Public Health England |access-date=21 May 2023}}
National Institute of Health and Care Excellence (NICE)
Recovery Orientated Drug Treatment Expert Group (RODT)
Advisory Council on the Misuse of Drugs (ACMD)

Australia

Lifeline{{cite web |title=SMART Recovery Australia |url=https://toolkit.lifeline.org.au/articles/support/smart-recovery-australia |website=Lifeline Support Toolkit |publisher=Lifeline |access-date=21 May 2023}}
Turning Point Alcohol and Drug Centre{{cite web |title=Patient Pathways Study |url=https://www.turningpoint.org.au/research/impact/patient-pathways |website=Turning Point |access-date=21 May 2023}}