Alternatives for Addiction Treatment: If AA Isn’t for You, Try SMART

group of individuals sitting in circle at addiction recovery support groupHave you ever had or heard the following complaints about Alcoholics Anonymous (AA) meetings?

  1. All people do is complain about their problems.
  2. I don’t like the religious stuff.
  3. No one says anything back to you after you talk.
  4. I don’t want to say I am powerless.
  5. Sometimes people dominate the meetings.

Don’t think I am bashing AA. The program has helped save the lives of countless people throughout the world. Those who attend regular meetings, work the steps, meet with their sponsors, and utilize the fellowship have some of the strongest recovery programs I know. But I realize AA does not work for everyone.

For those AA doesn’t suit, SMART Recovery can be a good fit. SMART Recovery is a self-empowering addiction-recovery support group. SMART stands for “self-management and recovery training.” It has been around for over 20 years and is a recognized resource for recovery by national institutes. Participants learn to use tools based on the latest scientific research and attend mutual support groups that typically run once a week for 90 minutes.

SMART meetings differ from AA in that they teach self-empowerment and self-reliance, whereas AA’s first step is admitting “we were powerless over alcohol—that our lives had become unmanageable.” Many people struggle with this concept and react with a depressed, hopeless response. SMART views dependence not as a disease but as a dysfunctional habit. Some prefer SMART meetings because they focus on education and support, encouraging open discussions.

SMART offers a four-point program with tools and techniques for each area. These include building and maintaining motivation; coping with urges; managing thoughts, feelings, and behaviors; and living a balanced life. To support these goals, principles of motivational interviewing and cognitive behavioral therapy are sometimes used.

SMART exercises can help you understand the role alcohol, drugs, or unhealthy behaviors were playing in your life. They also provide concrete ways to make lifestyle changes.

While both AA and SMART are free and peer-led, SMART facilitators go through a training process that may last months. Facilitators also participate in a 30-hour education course to learn how to effectively run meetings. They are taught how to educate members on the four-point program, initiate discussions, and when to reach out for professional support.

SMART exercises can help you understand the role alcohol, drugs, or unhealthy behaviors were playing in your life. They also provide concrete ways to make lifestyle changes.

SMART is typically for those wanting to achieve abstinence. However, people who want to try alcohol moderation are still invited to participate.

People who have attended both SMART and AA meetings have said they prefer the empowered approach, education, and support from peers who are struggling with similar issues. They like that it is structured and that they can have discussions in the meeting, but they also like knowing there is someone trained to guide the process.

If you have tried multiple AA meetings and did not feel that particular program was for you, consider giving SMART a try. Some people I have worked with attend both, reporting they get a different type of support from each format.

References:

  1. Hardin, R. (2013). SMART recovery handbook, 3rd edition. SMART Recovery Central Office, Ohio.
  2. Turner, C. (2017). Can I keep drinking? How you can decide when enough is enough. New York, NY: Morgan James Publishing.
  3. Zemore, S. E., Kaskutas, L., Mericle, A., & Hember, J. (2017). Comparison of 12-step groups to mutual help alternatives for AUD in a large, national study: Differences in membership characteristics and group participation, cohesion, and satisfaction. Journal of Substance Abuse Treatment 73, 16-26.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Cynthia Turner, LCSW, LSATP, MAC, therapist in Ashburn, Virginia

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Jayson

    Jayson

    July 18th, 2017 at 11:23 AM

    Nice new and interesting take on treatment
    I rather like the idea that this is a bad habit over a disease, in that a habit is something that can be changed whereas a disease seems so much more final.
    I know that different things work for different people so my advice would be try it all, see what’s the best fit for you

  • Cyndi Turner

    Cyndi Turner

    July 19th, 2017 at 11:48 AM

    Thank you! I like people to know the different options and resources that are available. What works for one, may not help another.

  • bennett

    bennett

    July 19th, 2017 at 10:59 AM

    I suppose that in the end it all depends on what you are looking for in that manner of support. No matter which you choose though, or even if it is something that is different from either of these methods I think that it is a good thing to remember that you can never have too much support when you are fighting any addiction. It is always a welcome site to know that there is someone there who will be there for you if you ever fall.

  • Cyndi Turner

    Cyndi Turner

    July 19th, 2017 at 11:55 AM

    Absolutely–the number of supports is often linked to the levels of success.

  • Jeff C.

    Jeff C.

    July 21st, 2017 at 12:22 PM

    The majority of scientific studies suggest that maintenance programs for addicts are the best option. According to the World Health Organization and many other health organizations, lifelong methadone and suboxone use results in better outcomes than any abstinence therapies (such as 12 step programs and SMART Recovery).

    In light of these facts, why does addiction treatment in the United States promote abstinence over maintenance when nearly every independent medical organization says maintenance is better for opiate addicts?

    Also, the Sinclair Method has proven far more effective than 12 step programs. SMART is essentially cognitive behavioral therapy, which is not as effective as maintenance or the Sinclair Method.

    Why is the addiction treatment community ignoring scientific developments?

  • Cyndi Turner

    Cyndi Turner

    July 21st, 2017 at 4:31 PM

    Jeff– you bring up excellent points. The US is behind the curve in treatment. One of the sad realities is that addiction treatment is big business: $35 billion fact. Facilities are making money off of people who are struggling with addiction and they make more when people stay sick. There are many abuses happening. I have spent the last year and will continue touring the country educating behavioral health care providers on alcohol moderation. I wrote “Can I Keep Drinking? How You Can Decide When Enough is Enough” that challenges the current treatments and teaches people how to have a better relationship with alcohol. Check out my website: canikeepdrinking.com for more information. My goal is to start a movement to get people the right kind of treatment based on where they fall on the spectrum of substance use disorders.

  • Conner

    Conner

    July 24th, 2017 at 5:57 AM

    It’s a sad state if those who need help think that they are limited by options that are available.
    There are so many resources and programs that are now available to them, but the bad thing is that usually only one or two get talked up so that we have a hard time getting the message out that there are all different kinds of opportunities which might could help.

  • Cyndi Turner

    Cyndi Turner

    July 25th, 2017 at 5:52 PM

    Conner– this is sadly so true. I could write another book on the many resources that are out there that people just do not know about. And there are so many different formats: in person meetings, online, podcasts, postings…

  • Kimberly

    Kimberly

    September 7th, 2017 at 3:56 PM

    How do u find SMART meetings

  • Cyndi Turner

    Cyndi Turner

    September 8th, 2017 at 1:15 PM

    Kimberly- log on to smart recovery.org. Click on meetings, then click on Local Meetings and enter your location. I hope they can be of help to you!

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