SMART Recovery® at 25: An Overview

SMART Recovery, an alternative to 12-step programsby Tom Horvath, PhD, ABPP

In September, 2019, SMART Recovery celebrated its 25th anniversary, at its annual conference in Chicago, IL. I have been involved with SMART since before it began operating under that name in October, 1994. It was previously the Rational Recovery Self-Help Network. I was president of SMART for 20 years, and have continued to serve on the US board after the development of SMART Recovery International in 2018. I offer the following description of what SMART offers.   

SMART Recovery® (Self Management And Recovery Training) is an international community focused on helping its participants learn about and practice a self-empowering approach for addressing addictive problems. SMART’s primary activity is discussion meetings, face-to-face or online. The ultimate goal, even if never attained, is to gain independence from problematic addictive behavior. Options for how to change are organized under the SMART Recovery 4-Point Program:

1: Building and Maintaining Motivation

2: Coping with Urges

3: Managing Thoughts, Feelings and Behaviors

4: Living a Balanced Life

SMART uses a self-empowering approach. Regardless of how addictive problems arose, participants are supported in creating and implementing solutions that are agreeable to them and realistic in their circumstances. These solutions involve making changes in the participant’s own beliefs and behaviors, although these changes are often in service of modifying the environment. The change methods included under the 4-Point Program lie at the intersection of what is supported in the scientific literature, what is self-empowering, and what can be meaningfully discussed in mutual help meetings led by non-professional volunteers. SMART updates these methods as the scientific literature evolves.

SMART is not just a set of methods for change, but also (and for many participants, primarily) a community of caring individuals intending to have a positive impact on one another. Each meeting is a small community. These meetings exist within larger local, regional, national, international, and online communities. Participants learn about the self-empowering approach together, and demonstrate to one another how to put it into practice. For many participants their sense of community will be more important than specific methods they learn.

In addition to meetings SMART offers a range of additional services, including publications, internet-based activities, training, conferences, social activities, and specialized meetings. The two most prominent specialized meetings are Family & Friends and InsideOut. Family & Friends, which is based on a combination of SMART Recovery and Community Reinforcement and Family Training (CRAFT, developed by Robert J. Meyers, PhD), teaches family members how to take care of themselves better, while not inadvertently reinforcing addictive problems, and instead reinforcing positive changes. InsideOut meetings occur in prisons, jails and other correctional settings, and focus on both addictive problems and the errors associated with criminal thinking.

The SMART Recovery USA Position on Goals is: “SMART Recovery is abstinence oriented. Our meetings and tools are designed to help participants stop problematic addictive behavior.” SMART meetings support individuals who are doing “too much of a good thing.” Discussions focus on how to do less, whether by stopping altogether or reducing. SMART therefore supports individuals who are seeking abstinence, moderation or harm reduction. All three approaches have in common staying within a limit, as chosen by the participant. SMART meetings emphasize this commonality. For instance, in the case of drinking, stopping could occur before the first drink, after the second drink, or after the 10th drink. SMART discussions focus on how to stop, not on how to use. Participants choose where to stop. The discussion focuses on stopping (how to stay within the limit), rather than on how to use up to the limit (which could be the focus of discussion in a moderation approach). A participant might say “I abstain from all alcohol,” or “I abstain after the second drink,” or “I abstain after the 10th drink”. In a future blog I will focus in detail on this Position on Goals.

In practice, most participants are pursuing abstinence, for one or more substances, because those who achieve stable moderation typically do not attend meetings regularly. Participants who wish to meet with others who have similar goals (abstinence, moderation, harm reduction), or who use the same substance(s), or have other similarities (such as demographics), are free (and encouraged) to organize specialized meetings for these purposes. 

Consistent with the flexibility and individualization of SMART’s approach, SMART supports the idea of multiple pathways of recovery. There are even multiple pathways within SMART. Participants make their own decisions about whether to take legally prescribed medications, whether to believe in a god or a higher power, whether to involve a higher power in their change process, whether to attend professional treatment (and what type of treatment), whether to view addiction as a disease, how much to emphasize community or techniques, and other issues. SMART’s slogan is “Discover the Power of Choice.”

The SMART Recovery organization is now an international non-profit. The latest information about the countries in which we operate, the languages our materials are printed in, the number of meetings we hold, and additional organizational information, is on our websites. SMART is a partnership of peers and professionals (including scientists), the large majority of which are volunteers. Professionals update SMART’s methods for change. SMART employs a small number of administrative and supervisory staff.  New meetings may be initiated by professionals, but most established meetings are led by non-professional volunteers (peers). Both peers and professionals serve in leadership roles within the organization.

Meeting leaders have several options for being trained. Training focuses on SMART methods for change, as well as how to conduct meetings.

Meetings are open to anyone who is not disruptive. All are welcome to participate, but no one is required to. Meetings are free (a donation is typically requested) and confidential. Participants are expected to talk not too long or too often, not to give advice, and not to go off topic. Meetings do not debate any of the questions participants are free to decide for themselves (e.g, is addiction a disease?), and do not criticize any other approach to recovery. The primary guideline for a meeting is “do SMART Recovery.”

SMART Recovery offers a new approach for mutual help, based on the underlying idea that problematic addictive behavior is a nearly universal human problem, rather than a problem restricted only to some individuals. Almost all human beings at times are challenged to maintain self-control of food intake, sexual activity, and opportunities for attention from others. SMART participants may have any level of any substance or activity problem, and any goal for reducing these problems (abstinence, moderation, or harm reduction). Participants also have a wide range of beliefs about these problems and their solutions. Despite the seeming diversity of participant situations and plans, SMART focuses on what participants have in common, the need for greater self-control. Self-control can be increased using the methods included in the 4-Point Program, which emphasizes changing oneself (the self-empowering approach).

Individuals considering change can attend SMART confident that they will likely fit in, whatever their substance or activity, level of problem, or plan for change. SMART hopes this broad approach will encourage individuals with addictive problems to seek change early, without being concerned that their problems may not be serious enough, or they may not have the “right” perspective about change

SMART is gaining recognition and acceptance worldwide. We believe we can help make a substantial reduction in the world’s burden from addictive problems.