SMART Recovery Can be Good Alternative or Addition to AA: Researcher

For some people in recovery, SMART Recovery groups are a valuable alternative or addition to traditional 12-step groups, according to a researcher at Penn State University.

SMART Recovery groups are facilitator-led, structured discussion groups that are closely aligned with counseling techniques. Unlike Alcoholics Anonymous and other traditional 12-step groups, SMART Recovery focuses on self-empowerment instead of surrendering to a higher power, says Deirdre O’Sullivan, PhD, Professor in the Department of Educational Psychology, Counseling and Special Education at Penn State.

Dr. O’Sullivan discussed results from a recent study she conducted on SMART Recovery group members and facilitators, at the National Conference on Addiction Disorders annual meeting on September 22.

Of the 3.8 million people who received treatment for substance abuse in the United States in 2011, 2.1 million received treatment exclusively at a peer support group, according to the Substance Abuse and Mental Health Services Administration.

Dr. O’Sullivan said receiving help from a peer support group is more important than which support group a person attends. “Extensive and rigorous research findings indicate peer support group attendance enhances remission rates,” she said.

There are currently about 300 SMART Recovery groups nationwide, Dr. O’Sullivan noted. The sessions are centered on building and maintaining motivation, coping with urges, managing thoughts feelings and behaviors, and teaching members to live a balanced life. Members are invited to stay involved with the group after gaining independence from addiction.

Alcoholics Anonymous (AA) is much more widely accessible, with more than 59,000 groups in the United States. It is led by non-professional members and centers on storytelling. Basic beliefs include that in order to stop drinking, a person must surrender to a higher power.

Dr. O’Sullivan’s study included 81 SMART Recovery members who had been attending an average of one meeting a week for at least three months, as well as 42 facilitators. The facilitators said their top three recovery goals were abstinence, correcting irrational beliefs and behaviors, and learning to cope with urges. Members listed changing thoughts and behaviors, feeling better about themselves and connecting past events to current use and abuse as their goals. Members ranked belief in a higher power last, while facilitators ranked spirituality last.

“It’s important for people attending peer support recovery groups to know what’s being discussed, and explore their comfort level with that,” Dr. O’Sullivan said.

She found 65 percent of SMART members said they had a psychiatric or physical disability, or both. “People with disabilities have an increased risk of substance abuse and dependence,” she said. “It doesn’t tend to be the primary focus of the meeting, but if you have a disability, it may be helpful to know you’re probably not going to be one of the only ones in the room.”

Although AA does not take an official position on medication, Dr. O’Sullivan said some AA members with physical disabilities who take pain medication say they find it is frowned upon at meetings as interfering with recovery.

SMART Recovery members in the study were similar to AA members in race, age and marital status, she noted. Members said they liked that the groups were led by facilitators who had training, and they appreciated that the meetings had a clear structure and format. They also said they liked being self-empowered to manage their addiction, and had difficulties with surrendering to religious affiliations, such as a higher power, and adopting a powerless identity.

She found about one-third of members attended both SMART Recovery and AA meetings. “It’s something to consider—you don’t have to choose one or another,” she observed.

Dr. O’Sullivan advises substance abuse counselors to discuss the format, structure, availability and accessibility of the different peer support groups with clients when considering referrals. They should also take into account recovery goals when making referrals, she recommended.