Biological-Psychological-Social-Spiritual: Which Support Group Covers Them All?

Science has revealed that addiction is far more complex than we formerly thought. As a result, professionals and individuals in recovery have changed their language about addiction and recovery. Addiction is now described as a complex problem, and recovery is described as having biological, psychological, social and spiritual aspects.  This “bio-psycho-social-spiritual” model includes: physiology and genetics; behavior, beliefs and emotions; family, community and culture; and values, morality and ultimate beliefs.

If we accept that addiction and recovery are bio-psycho-social-spiritual in nature, which addiction support groups support this broad and complex approach? Which groups include all four aspects in their program (based on a review of the primary publications)? Fortunately, the two leading support groups describe their programs clearly and briefly, allowing for a useful comparison.
The 4-Point Program of SMART Recovery (Self-Management And Recovery Training):
  1. Maintaining Motivation [accomplished by completing and reminding oneself of a cost-benefit analysis, which looks at the bio-psycho-social-spiritual costs and benefits, both short-term and long-term, of the substances or activities the individual is aiming to abstain from]
  2. Coping with Cravings [accomplished by understanding the bio-psycho-social aspects of cravings, and recognizing that spirituals beliefs or ultimate values can help one not act on them; also accomplished by supporting the use of anti-craving medications]
  3. Managing Emotions [accomplished by understanding how our beliefs affect our thoughts, feelings and behaviors and learning more realistic and functional beliefs; also accomplished by supporting the use of psychiatric medications if the individual wishes to take them]
  4. Building Balance [by discovering one’s values and goals and from them creating a lifestyle with a balance of short- and long-term satisfactions; this balance makes life more rewarding without harmful addictions; balance can also include choosing or becoming more deeply involved in a mindful meditative, spiritual or religious path, although such a path is not central nor essential to the SMART Recovery program]
The 12-Step Program of Alcoholics Anonymous:
1. We admitted we were powerless over alcohol – that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
Of course, each person will make a comparison of these programs in his or her own way. However, several questions seem pertinent. Which program appears to offer practical ideas for recovery? Which one addresses each of the biological-psychological-social-spiritual aspects of addiction?
As to similarities, both groups offer friendship, fellowship, mutual support and human connection. These factors have proven helpful in recovery, especially for those who have few connections in their lives. Both groups are free of charge (and request donations), and support abstinence.
Which support group might you prefer to attend?  Which group would your loved one prefer, attend and actively participate in?  Would it make sense to attend both, perhaps deriving different benefits from each one?
Fortunately, it is not necessary to choose between these groups (or any others available to you). Attendance in any support group, before, during, after, or without alcohol treatment or addiction treatment, can be helpful in supporting recovery. Therefore, if you think a support group might be of benefit to you, find individual meetings you like, and attend them as long as you find them helpful.