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What Is SMART Recovery?

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SMART Recovery (Self-Management and Recovery Training) is a recovery group for those who want an alternative to 12-step support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). SMART’s mission is to offer self-empowering, face-to-face, and online support groups that are rooted in the latest scientific research surrounding addiction and treatment. The basis of the support group is the 4-Point Program, which offers tools to help people get and stay motivated, cope with cravings and urges, manage the connection between thoughts, feelings, and behaviors, and live a balanced life.2

In 2009, an estimated 23.5 million people aged 12 or older needed treatment for an illicit drug or alcohol abuse problem.1 Many people go without the support of a community due to many different factors. Some people may be unwilling to admit they have a problem, while others may be worried about being stigmatized for their addiction. Other people may not be interested in the 12-step philosophy and are unaware of the alternative groups that are available. Luckily, SMART Recovery offers face-to-face meetings in 49 states in the U.S. and across 21 countries in the world. It also offers an interactive web application called Overcoming Addictions (OA), which doesn’t consist of online meetings but rather, it integrates a 4-Point Program, cognitive-behavioral methods, and relapse prevention tactics to promote abstinence. OA may be beneficial for those who prefer a self-directed approach or those who struggle with finding the time to attend groups in between work, home, or school responsibilities.2.,3

The 4-Point Program

The SMART Recovery program helps people recover from all types of addictive behaviors, including drug addiction, alcohol addiction, gambling addiction, sexual addiction, and other behavioral addictions. As a SMART participant, you have access to face-to-face meetings, daily online meetings, and a 24/7 chat room where you can find the support you need.

Overcoming Addictions (OA), the app, helps people work the 4-Point Program. The program offers tools and techniques for each of the program points listed below:2,3

  • Gaining and maintaining motivation to abstain from addictive behaviors.
  • Dealing with cravings and urges to engage in addictive behaviors.
  • Controlling thoughts, feelings, and behaviors associated with drug use or behavioral addictions.
  • Balancing short- and long-term rewards to avoid relapse.

SMART Recovery believes that recovery is a process that must be done with intention. It is a process that, when combined with scientifically backed strategies, can be successful in helping you abstain from your addiction and make conscious, informed decisions.

SMART Recovery is different from many other recovery programs because it will help you to focus on the action stage of change.2 It incorporates the interactive group component of 12-step programs with the use of evidence-based strategies, such as motivational interviewing and cognitive-behavioral interventions, notably leaving out the spiritual component that is typically employed by 12-step groups. SMART can be used alone or as an adjunct to another recovery program. SMART avoids labels, such as “alcoholic” or “addict,” due to the stigma that is often associated with such labels. Feeling stigmatized can interfere with recovery efforts.3 It also does not classify addiction as a disease, as 12-step programs do, because the disease model asserts that you are powerless over your addiction, and SMART Recovery aims to empower individuals.3 Because of these unique elements, SMART Recovery appeals to a large variety of people struggling with addiction.

Effectiveness for Recovery

The best way to establish the effectiveness of any recovery program is through research or ongoing study. One study tested the effectiveness of 3 different ways of using the SMART Recovery and OA programs over a 3-month period for heavy problem drinkers.2 189 study participants were randomly placed into 1 of the following 3 study groups:2

  • SMART Recovery alone
  • SMART Recovery with OA
  • OA alone

 In order to participate in the study, the participants had to meet the following criteria:2

  • 18 years of age or older
  • If male, drank 5 or more alcoholic drinks on at least one occasion, in the last 90 days
  • If female, drank 4 of more alcoholic drinks on at least one occasion, in the last 90 days
  • Alcohol User Disorders Identification Test (AUDIT) score of 8 or higher
  • New to SMART Recovery (joined within the past 4 weeks)
  • Had a computer at home with Internet access
  • Possessed a primary treatment goal to quit drinking

Interested study participants with any of the following were excluded from participation:2

  • Court-mandated Driving While Intoxicated (DWI) offenders
  • Current diagnosis of drug dependence or consideration of themselves to be drug-dependent
  • History of uncontrolled psychosis or bipolar disorder
  • Significant cognitive impairment due to brain dysfunction
  • English reading level below 8th grade
  • Unwilling or unable to follow up with study staff at 3 and 6 months after enrollment
  • Unwilling or unable to provide one significant other who could verify the participants self-reported drinking

The SMART Recovery group was used as the control group, or the group with standard treatment.2 Participants in this group had access to face-to-face and/or online support group meetings.2 The SMART Recovery with OA group had access to both online and/or face-to-face meetings and unlimited use of the 4-Point Program, including all strategies for behavior change.2 The OA group did not have access to the online or face-to-face meetings; however, they had unlimited access to OA and the tools of OA.2

The study measured the participant’s intention to treat the addiction or addictive behaviors.2 The results indicate that participation in any of the 3 treatment groups assisted in the recovery process.2 The following results were found for all 3 groups:2

  • 28% increase in the number of days without alcohol
  • Decrease in the average number of drinks consumed from 8 to 4.6 drinks on drinking days
  • Decrease in alcohol/drug-related problems

The study also found that the more the participants attended online or face-to-face meetings, the more likely they were to not participate in addictive behaviors.2 This supports the idea that consistent positive relationships and support may sustain the recovery process over time.

In recent years, online recovery programs in general have received increased support as an effective delivery mechanism for recovery services, and the number of people who use them has also increased.2 Some individuals may not seek standard recovery services due to illness, lack of access to a local group, or lack of financial means to pay for participation in support services.2 Online recovery services increase access in ways never seen before the implementation and acceptance of these online programs.2

SMART Recovery has taken these services one step further than other online programs by increasing the access to recovery groups and using scientifically proven tools.2 This type of recovery program is commonly used in clinical settings and college dorms.2

The SMART Recovery program was created to address all addictive behaviors.2 The program uses addiction-specific modules for alcohol, marijuana, opioids, stimulants, and compulsive gambling.2 All of the SMART Recovery tools utilize cognitive-behavioral and motivational strategies that have proven effective as addiction treatment methods.2 These methods make SMART Recovery a universal treatment for addictions of all kinds. As it is specifically a science-based program that does not incorporate spirituality or religion, it is a good option for people who are atheist, agnostic, or who otherwise do not feel comfortable with the ideas of a Higher Power or a spiritual awakening that Anonymous groups follow.

Sources

  1. National Institute on Drug Abuse. (2011). Treatment Statistics.
  2. Hester, R., Lenberg, K., Campbell, W., Delaney, H. (2013). Overcoming Addictions, a Web-Based Application, and SMART Recovery, an Online and In-Person Mutual Help Group for Problem Drinkers, Part1: Three-Month Outcomes of a Randomized Controlled Trial. Journal of Medical Internet Research.
  3. SMART Recovery. (2017). Five-Year Strategic Plan: Freedom from Addiction.

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