17 May 2012

SMART Recovery - addictive behaviour support and training

I have recently been doing some online training for an organisation called SMART Recovery. I came across them by accident, when a local facilitator and representative of SMART Recovery found my blog on REBT versus CBT and called to ask about that. We got chatting and I found out what he does - facilitates meetings for people with addictive behaviour issues. 

The chap in question had some good things to say about the system, so I looked into it further as I have an interest in the field of addictions. As some of you know, I did a voluntary placement with Chandos House Treatment Centre in Bristol last year (blog posts here and here).

I read up on SMART Recovery, attended a couple of meetings (they are open to interested professionals - just ask beforehand) and have just completed the online meeting facilitator training. I am fortunate enough to be able to attend Devon Drugs and Alcohol Action Team's Exploring Recovery Event day this Monday 21st May, as a professional interested in substance misuse, sharing what I have seen of how SMART Recovery works. This will be an opportunity for people from different agencies dealing with addiction to come together and share ideas. SMART stands for Self Management and Recovery Training, by the way.

I would sum up what I know of SMART Recovery thus:

1) It is a meetings based system for self-help to educate, inspire and support those committed to dealing with their addictive behaviour. This can involve any form of addictive behaviour - drugs, alcohol, gambling, compulsive shopping etc.

2) It draws heavily from Albert Ellis' Rational Emotive Behaviour Therapy which, as some of you may know, I am a huge fan of, in contrast to CBT which I think is more feeble (blog post on REBT versus CBT here). The sessions involve teaching the ABC system - A is the activating event, C is the emotional consequence. Initially clients will have a tendency to say that A causes C, For example, if I fail my exam then I will feel awful. We teach the client to see that there is a B - their beliefs about A, and this is what is causing the problem. D is to dispute the belief - the irrational outlook and E is the new, effective, rational outlook. So in this example, the belief might be, if I fail my exam it will ruin my life and I will be a failure. Well, the client might really be believing that but through Socratic questioning we can help the client to challenge their sedimented belief and see that it is their own irrational beliefs that are leading them to feel so anxious. So the anxiety will reduce. Of course, this is to be delivered in an understanding and empathic way. I have seen it work very well with the SMART Recovery meetings. Eg Somebody feels terrible because they've had a relapse. Then feeling awful about the relapse then makes them more likely to stay lapsed, because they feel so terrible about themselves. By ABC'ing them - which they do in groups at the meetings, and are given a handbook to do it at home, they can feel less bad about lapsing, and therefore not likely to relapse. The B for them might be "if I lapse then that proves I'm a failure so I might as well carry on being the failure I so obviously am". The D - disputing, would be that nowhere is it said or written that lapsing makes you a failure. The person can feel regret at their action but not shame, for they are human! It's the fundamentally humanistic quality of REBT that I like so much, but also that the client can take away a system of help which they can apply to other irrational thoughts in the future.

3) There is no affiliation with any religion, which makes it a good alternative to those that are uncomfortable with that aspect of Alcoholics Anonymous.

4) The belief behind the Smart Recovery system is that nobody is an addict; they have problems with addictive behaviour.  The use of words such as "addict" and "alcoholic" are banned at meetings to ensure that there is a clear distinction between the person and their behaviour. I think that this fundamentally humanistic stance helps attendees to stop judging themselves (and others) - judging oneself leads to more bad feelings - so why do it? REBT fosters unconditional self-acceptance (USA). Unconditional other acceptance is a natural by-product of USA.

5) In contrast to Alcoholics Anonymous, people who attend meetings are invited to attend for as long as they wish to. When they feel they no longer need to attend there is no pressure to do so. The belief is that a person can choose to make changes to their addictive behaviour and can get the support when they feel that they need it. When they no longer feel they need it they can stop. People with addictive behaviours are not believed to be addicts all their lives - they can make choices. SMART Recovery believes that calling people addicts or the like promotes a sense of helplessness at their situation.

6) The system involves many tried and tested tools to help people make changes, such as the Motivational Matrix, and the Hierarchy of Values. I have tried these on friends and family, and the odd client, and they are valuable and effective.

I think that SMART Recovery will continue to go from strength to strength. The meetings I attended had a very warm and sharing atmosphere. There is really good work going on here, and sometimes attendees go on to become facilitators - using what they learned to transform their lives to help transform the lives of others. I found the attendees and facilitators inspirational and it is certainly a privilege to be able to be part of their sharing.  I look forward to learning more at the Exploring Recovery Event on Monday and no doubt will have something to impart next week.


Anonymous said...

Really very interesting insights into a 'technique' I'd never heard of before.

Anonymous said...

Dear Amanda,
I really enjoyed reading your article on Smart Recovery. If you are in Torquay any time you are very welcome to come over and attend one of our groups. I am Facillitating here and would welcome your input. My e-mail is : andersondouglas795@gmail.com Best wishes,Douglas Anderson.

Amanda Williamson (She/her) said...

Thank you Douglas, that's very kind of you. Glad you enjoyed the post. Will contact you if I'm ever in Torquay - keep up the wonderful work that you are doing! Amanda

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