When it comes to recovery from substance use disorders or other behavioral addictions, 12-step programs are usually the norm for those who aren’t “normies,” as some people in the rooms of these programs refer to people “outside” the rooms. Whether it’s Alcoholics Anonymous, Gamblers Anonymous, or any of the many other programs that use the 12-steps as their foundation, this tends to be the first treatment option offered by everyone from judges in court rooms across the country to counselors in treatment facilities.
There are a number of issues, however, that can arise when such recommendations are made. For example, what do you as a therapist when —
A client finds identification as an “addict” or “alcoholic” offensive.
A client doesn’t believe, and what’s more, doesn’t want to believe in a Higher Power.
A client has had bad experiences in the past that make him or her resistant to the 12-Steps.
The good news is that other options now exist. A perfect example has been the rise of SMART Recovery meetings nationwide. Although smaller in comparison to the 12-Step options available, SMART Recovery has been continuing to grow over the past decade.
SMART Recovery stands for Self Management and Recovery Training. This program has many benefits for clients who may not connect with the stance and methodology of 12-step programs and their resulting meetings.
There are some key differences between SMART Recovery and 12-step groups. As a therapist, I aim to provide my clients with options that fit most closely with what they want, and often need. In SMART Recovery, the name of the game is choice. By offering its participants a different approach, SMART Recovery can be a worthwhile option to offer clients that need to find a path to sustainable recovery from substance use disorders and behavioral addictions.
It’s important to point out that SMART Recovery is not better than 12-Step. Rather, it’s a viable alternative that can help save lives by providing a fit for that “round peg” client who refuses to be forced into a square hole. Indeed, SMART Recovery can work for clients in search of something different; the road less traveled, if you will. It offers methods and tools that are taken specifically from two well-known theoretical practices, Rational Emotive Behavior Therapy and Motivational Interviewing.
The following are three key differences between SMART Recovery and 12-Step:
1) SMART Recovery does not use labels
There is no identification as an “addict” or “alcoholic” as a mandatory tenet of SMART Recovery. As a therapist, by offering an alternative to what is sometimes seen as demeaning terminology, I can help empathize with the client and take the problem outside of the person. Furthermore, the addiction becomes the problem, not the person. Clients find this self-empowering and non-pathologizing. Indeed, it is often a welcome breath of fresh air for those struggling with the shame of having to identify as an addict.
2) SMART Recovery provides a choice in terms of spirituality
You don’t have to believe in or surrender to a Higher Power in order to benefit from SMART Recovery. Many people grapple with the spiritual aspect of 12-step programs. This one tenet often turns them off to the 12-step program itself and sometimes leads to a frustrating rejection of recovery altogether. With SMART Recovery, the client has a choice; spirituality is not an inherent part of the program.
3) SMART Recovery meetings promote an open discussion format with cross-talk encouraged.
At a SMART Recovery meeting, there is a facilitator who may have personal experience with recovery or who may not, such as a therapist or other professional. At 12-step meetings, commenting on what another member shares is discouraged. In contrast, in SMART Recovery, direct responses to another participant’s comments are supported. Meeting members comment and give feedback on other participant’s issues. Unlike 12-Step programs, however, there are no sponsors in SMART Recovery. As a result, a lot of the support that may take place outside of 12-step meetings seems to take place in the context of the actual meetings.
From a therapeutic perspective, SMART Recovery provides another option to those suffering from substance use disorders or behavioral addictions who are less than sure about the methodology and approach of the 12-step programs. As a therapist, when I offer an alternative to what is foremost in our society, it allows me to acknowledge that there is no one “right” way to live. The goal is to further empower my clients by helping them navigate on their path to finding a preferred way of living—and their preferred way of getting there.
"This article was previously published in Voices, the Los Angeles Chapter of CAMFT, LA-CAMFT’s, monthly newsletter.”
Matianna Baldassari, MA LMFT, is a Licensed Marriage and Family Therapist and certified SMART Recovery meeting facilitator at Pacific MFT Network in Santa Monica and Manhattan Beach. Matti specializes in private practice at helping clients struggling with addiction, anxiety, mindful living, and stress relief. She can be reached at by email or phone/text at (424) 254-9611.
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