Scott Douglas Jacobsen: What’s your own story? How did you get into the recovery business?
To be honest, in 1994, it started out as simply a part-time job. I had a full-time job, but my former boss was hired by SMART Recovery as SMART’s Executive Director, and I would work about 4-6 hours/week trying to help get the organisation off the ground. It wasn’t long before we learned there weren’t ample funds to pay his salary, so he departed. I thought SMART was a great organisation, so I stayed on. I transitioned to full-time and accepted the role of Executive Director in 2005. And here I am 22+ years later.
SMART Recovery (Self-Management and Recovery Training), is based on self-empowerment and science-based processes to assist with addiction coping and recovery. What are the main steps to this system of recovery?
As you correctly note, SMART is a self-empowering, science-based program. As opposed to steps, SMART Recovery uses a 4-Point Program®:
Point 1: Building and Maintaining Motivation
Point 2: Coping with Urges
Point 3: Managing Thoughts, Feelings, and Behaviours
Point 4: Living a Balanced Life
Each of the 4-Points has tools and techniques that our participants use to overcome their addictive behaviour(s). The tools are terrific – they’re great for recovery, but many of them are truly life skills that can be used time and again through life even once someone has overcome their addiction.
As well, it caters to believers and non-believers alike, and does not require belief in a higher power. How does this differ from some other programs?
You’re exactly right – SMART Recovery doesn’t require a belief in a higher power. That’s not to say people who are believers can’t combine their faith with the SMART program – we have people who have success with SMART and do just that. But our meetings and program don’t have a spiritual component. I think everyone reading this interview is familiar with AA and other 12-step programs, which rely on a belief in a higher power. Such programs work for them, and the same can be said for people using SMART Recovery, LifeRing, Women for Sobriety and others that have been offered for many years. We all offer proven programs, but they won’t all appeal to every individual seeking recovery. There are many pathways to recovery, SMART being a great choice for many. We believe that it’s important for people seeking a recovery program to learn about all of the available pathways, and one (or, in some cases, a combination) that works for them.
What is the main line of evidence in support of the SMART Recovery program?
SMART is based on six principles that underlie proven and effective treatment programs:
Self-empowerment – people take control of their recovery and assume responsibility for its success.
Mutual support – recovery works best when the challenges and successes are shared with others, typically at meetings. People learn that recovery is possible by observing and following the example of others in the group.
Motivation – building and maintaining motivation is the first point in SMART’s 4-Point Program®. The program uses methods from Motivational Interviewing, a standard practice in more than 90 percent of addiction treatment programs today.
Coping with urges – the second point in the program helps people identify all the triggers to use and how to resist them. Over a short time, they learn that urges grow less intense and occur less often.
Managing thoughts, feelings and behaviours – point three teaches how to calm extreme anxiety and avoid relapses by growing aware of the beliefs that control feelings and acts. This concept is drawn from Cognitive Behavioural Therapy, also used by more than 90 percent of treatment programs.
Leading a balanced life – the fourth point helps secure recovery through the creation of a new lifestyle to replace the one associated with addiction.
The truest measure of effectiveness is its widespread and growing use since the program was founded in 1994. SMART currently hosts 2,200 weekly meetings in 19 countries, including 30 online gatherings that people anywhere in the world with an internet link can attend.
In addition, numerous recovery professionals are incorporating SMART into their practices and launching meetings. In 2016, professionals comprised 61 percent of the 2,500 people who signed up for SMART’s facilitator training course.
Leading medical and government authorities worldwide endorse SMART for recovery support in best practice and quality care guidelines for people seeking to overcome addictions.
How does the program differ in the outcomes for its treated recovering addict sub-population from the general untreated recovering addict (control) sub-population?
As much as this question is debated, the honest answer is that it is difficult to scientifically measure outcomes for people using mutual support models such as SMART Recovery and 12-step programs. Addiction scientists have tried but meta-analyses of the research on both programs have been inconclusive. These are not treatment programs in which attendance can be easily measured and tracked. Attendance is anonymous. Large numbers of participants are coerced to attend meetings, especially 12-step programs. As a result, it is extremely difficult to conduct randomised controlled trials measuring the effectiveness of such programs.
How is this more effective than other forms of recovery? Also, what are the other kinds of—ineffective—addiction recovery programs/systems?
There are numerous potential pathways to recovery, including ones that use no treatment or recovery support program at all. I don’t feel comfortable suggesting that SMART is more effective than other forms. That’s why part of SMART’s mission statement reads “To support the availability of choices in recovery”.
I’ve had the privilege of witnessing many people’s lives change when using the SMART program. I also know that it won’t appeal to all people seeking a recovery support group. The same is true for AA, Women for Sobriety, LifeRing, etc. We are all going to attract and help people, but we’ll have the most success when people know their options and select the one that best meets their beliefs and needs. Some people will benefit by combining SMART Recovery and inpatient or outpatient therapy. Others find combining mutual-support meetings helpful. Some find becoming involved with art or yoga/meditation helpful. Recovery can take on many forms and we feel individuals should determine a program that will be most helpful to them.
Now, you are the executive director of the SMART Recovery. What tasks and responsibilities come with being the executive director?
That’s an interesting question. I have a heart for people – I love to see people succeed, and I love being in communication with our volunteers and the people who come to SMART Recovery for help. I’ll admit that, as the organisation has grown, there are duties and responsibilities that now require more of my time – fiscal responsibilities, organisational development responsibilities, helping to ensure the organisation stays vibrant and continues to grow and keep up with technology, etc. We have a small staff because we rely so much on volunteers, so it’s challenging to keep all of the plates spinning. But we have amazing volunteers and staff, which makes my job both challenging and rewarding!
If I were a recovery addict, and if I came to SMART Recovery, how would I be introduced to SMART Recovery?
Our 2016 survey concludes that nearly 50% of our participants find SMART Recovery via an online search. Over 20% were introduced to SMART while in a treatment program, and nearly 20% were referred by a counsellor or therapist. Interestingly, more than 10% found SMART when it was recommended by a friend or family member. Once they find us, we encourage them to attend a face-to-face meeting (if there’s one in their area) or to become involved in our online community, which has 30 online meetings per week, highly active message board forums and a 24/7 chat room.
What would be my typical struggles on the path to recovery? What would be the chances of recovery?
I believe that the typical struggles encountered by anyone in recovery are covered within our 4-Point Program®:
- Building and Maintaining Motivation – Nobody will change based on someone else wanting them to change. Each individual needs to identify motivating factors that will help see them through their recovery process. (SMART tool examples include: Cost/Benefit Analysis and Hierarchy of Values.)
- Coping with urges – You won’t give up an addictive behaviour without experiencing urges, so having coping mechanisms in place is key to one’s recovery. (Tool examples include: Urge log and ABCs of Rational Emotive Behaviour Therapy.)
- Managing thoughts, feelings and behaviours – As someone is going through recovery, there are all sorts of opportunities to reflect on one’s thoughts, feelings and behaviours, and to assess which are helpful, unhelpful and need to be changed. (Tool examples include: ABCs of REBT for emotional upsets and Role-playing.)
- Leading a balanced life – So often the drug or behaviour has really taken over an individual’s life. Everything had revolved around time spent planning for or involved in the addictive behaviour. Returning to a balanced life can be a challenge. (Tool examples include: Lifestyle Balance Pie Chart and Vital Absorbing Creative Interests – finding helpful activities to replace the former unhealthy/unhelpful activities.)
As far as chances of recovery, I’m sure that there are statistics out there somewhere regarding the number of people who succeed in recovery. From my perspective, if people are truly motivated, and are able to achieve the 4-point program noted above, the likelihood of success is great. And a reminder that people’s personal recovery journeys vary, so for some, combining SMART Recovery and other groups or activities may increase the chances of achieving recovery for that individual.
Are there appropriate supports for the recovering addicts as they transition back into normal life and as they have entered into a new non-addicted lifestyle?
We choose not to use the term “addict” or apply labels to participants. We help people who are struggling with addictive behaviours. We offer meetings and online support for as long as the individual deems them to be useful. As far as other supports, i.e., job-skills, transitional housing, etc., we leave that to other organisations and agencies. Our goal and mission is to provide mutual support meetings that encourage cross-talk, allow people to learn the SMART tools and techniques, and allow participants to learn from one another’s experiences – both success and failures.
What are some of the main social and communal services of the SMART Recovery, if any?
Social activities vary from meeting to meeting. Some meetings allow for a half-hour social gathering at the end of the meeting. Others have some planned activities – a bowling night, a recovery walk during Recovery Month, etc. I’ve always found it interesting how much of a community spirit there is within our online activities. We have people participating from all over the world, and most have never met the others with whom they’re in online meetings, posting on the message boards, or chatting within the chat room. But they really are a cohesive group that find inspiration and help from one another.
What is the scope and scale of the SMART Recovery? Who are some of its most unexpected allies?
Growth and awareness of SMART Recovery continues to increase with more than 1,000 new meetings launched in the past three years. (I’ll share a growth chart which makes it easier to grasp, if you’d like to include it.) And our international expansion is also continuing, even to the point of us creating a new SMART Recovery International organisation, with what was known as Alcohol & Drug Abuse Self-Help Network, Inc., d.b.a. SMART Recovery, soon to become SMART Recovery USA. And, of course, online activities know no boundaries and our online registrations continue to grow each year.
SMART Meeting Growth Since Its Founding
I, of course, believe everyone should be an ally of SMART, with none being unexpected (laughs). We have volunteers who are peers, professionals, and a growing number of non-peer/non-professionals. Mums and Dads who have children who have struggled with an addiction and they feel a need to provide choice in mutual support meetings, so they train and start meetings. We have a nice partnership with other non-12-step groups including Women for Sobriety (WFS) and LifeRing. We have a growing number of treatment centres that are ensuring that SMART Recovery meetings are available to their clients. SMART was recognised by President Obama and Michael Botticelli during our 20th anniversary celebration and conference in 2014. I think even some of the “hard core” 12-step people are beginning to realise that there truly are multiple pathways to recovery, and the importance of people having choice. This isn’t a competition – there are plenty of people in need with different backgrounds and beliefs and they need choices like AA, WFS, LifeRing and SMART Recovery.
With the current Trump Administration, do you see new threats to the practice of science-based and self-empowering recovery programs?
It’s not yet clear to me if or how the new administration will impact addiction in the US. SMART Recovery will carry on with our message and program regardless of the level of support from the administration.
What have been the largest activist and educational initiatives provided by SMART Recovery?
All of SMART’s activism and education has been devoted to creating the best possible recovery support program, including meetings and educational materials, for the millions of people worldwide who need help overcoming additions. We have focused intensely on educating the volunteers who facilitate our meetings, developing a rigorous 30-plus hour training program. We are now training 2,500 people a year. Our facilitators are hosting well over than 100,000 meetings a year in countries from Australia to Canada to the UK and Uzbekistan, including more than 1,200 in the US alone.
SMART hosts meetings in correctional institutions and Veterans Administration medical centres. Since 2010, we’ve held meetings for the family members and friends of people with loved ones suffering from addiction. Our Family & Friends program is based on the highly effective model known as Community Reinforcement and Family Training or CRAFT.
As much as we’d like to engage in activism in the conventional sense of term, our time and energy is best spent focusing on our mission.
How can people get involved with the SMART Recovery, even donate to them?
I’d suggest a wander through our extensive website at www.smartrecovery.org. (Our new site will debut soon!) If you’d benefit from using the program, there’s lots of information about the program and tools, as well as a meeting list, access to our online activities, etc. If you want to serve your community by starting a SMART meeting, you can visit our training page. If you’d like to donate to SMART, you can visit https://secure.processdonation.org/smartrecovery/. (Note, that link will likely change with our new site, but a visit to www.smartrecovery.org will connect you to a donation button.)
Any closing thoughts or feelings based on the discussion today?
We’re always so grateful for the opportunity to help acquaint people with our 4-Point Program and tools, and I want to thank you for providing us with this opportunity to do so. I want to encourage anyone who is struggling with an addiction to visit www.smartrecovery.org and see what SMART can offer you. If you have a loved one struggling, our Family & Friends program is an amazing resource. If you’re involved in serving people with addictions in a treatment setting, or court, or government agency, I encourage you to become familiar with SMART Recovery to recommend it to your clients and constituents.
Thank you for your time, Shari.
Thank you again for this opportunity!
Scott Douglas Jacobsen is the Founder of In-Sight: Independent Interview-Based Journal and In-Sight Publishing. Jacobsen works for science and human rights, especially women’s and children’s rights. He considers the modern scientific and technological world the foundation for the provision of the basics of human life throughout the world and advancement of human rights as the universal movement among peoples everywhere.