Shari from SMART Recovery Here...

[Shari]

Maggie, that's not at all a stupid question!  While there may be some health-related issues with some individuals who are obese, food can be an addictive behavior as well. (I can relate, as when I'm stressed, it's so easy to head to the fridge!)  We have an eating disorders forum on our message boards, and we have people who participate in the program in order to gain control over their eating behaviors.  (Mind you, in this case, abstinence isn't an option, but moderating the behavior and changing the things that are causing one to overeat are addressed.)  The same question, on the other side of the equation, is binging/purging.  That can be an addictive behavior, as well. So if an over eater or someone who purges attends the program, they use the tools for behavioral change. 

[Shari]

I'll be away from the computer for a while, but will look forward to continuing the communications, so feel free to post questions.  At the risk of putting you all to sleep, I'm going to share an overview of the SMART Recovery program as I provided it for a newsletter for a treatment facility.  I tried to be concise (no easy task for me with words!), and I think it might be helpful to you to gain a little more insight into the SMART Recovery program.

Are you familiar with SMART Recovery??
by Shari Allwood, Executive Director, SMART Recovery

SMART Recovery? supports individuals who desire to abstain or are considering abstinence from any substance or activity addiction. (The SMART acronym stands for Self-Management And Recovery Training.) Our program utilizes a collection of scientifically-proven techniques from Cognitive Behavioral Therapy, Rational Emotive Behavior Therapy, as well as some Motivational Enhancement techniques. 

SMART Recovery?s mission is to offer donation-requested, self-empowering, science-based, face-to-face and online support groups for abstaining from any substance or activity addiction.  There are currently over 650 meetings worldwide, daily online meetings, and a 24/7 chat room. 

SMART Recovery provides a 4-Point Program? which includes the following components:

Point #1: Enhancing and maintaining motivation to abstain
Point #2: Coping with urges
Point #3: Managing thoughts, feelings and behavior (problem-solving)
Point #4: Balancing momentary and enduring satisfactions (lifestyle balance)

A variety of tools and techniques are employed for each of the above-noted points.

Our program is abstinence-based.  That being said, quite often, there are times when a person who is new to SMART Recovery may be considering abstinence, but is not yet committed to such a plan.  (This is where Point #1 and its tools can be helpful?an example being a Cost/Benefit Analysis, which can often help individuals determine why they desire to choose an abstinence recovery path.)  These newcomers are invited to attend several SMART Recovery meetings, to gain an understanding of the program and tools, and to enhance their motivation to determine if they choose to pursue abstinence.

In addition to the Cost/Benefit Analysis, program tools include the Change Plan Worksheet, Hierarchy of Values, ABCs of Rational Emotive Behavior Therapy (for both urge coping and emotional upsets); DISARM (Destructive Images Self-talk Awareness and Refusal Method); Brainstorming; and Role-playing/Rehearsing.

Meetings typically last either 60 or 90 minutes and are designed to be highly interactive.  It?s often been said by facilitators that the meetings which they feel have been most advantageous to the participants are those meetings in which the facilitator seldom had the need to speak.  Participants are encouraged to share their personal experiences during meetings and discuss the tools that (1) help them personally on an ongoing basis and (2) allow them to help a fellow participant who is seeking assistance.
 
SMART Recovery meetings follow an outline, which includes:
?   A welcome to attendees and an opening statement
?   Check-in (personal update)
?   Agenda setting
?   Working Time (focused on the 4-Point Program)
?   Hat passing (financially, SMART Recovery relies primarily on sale of publications and personal donations to survive)
?   Check-out (meeting review and personal plans for the week)
?   Socializing (announcements, publications purchase, Q&A, meeting verification forms, general socializing)

SMART Recovery is almost entirely operated by volunteers, whose primary activities are facilitating face-to-face and online meetings, and providing additional recovery support via the SMART Recovery website message boards and chat room. 

I could go on and on!  But let me conclude by simply saying that I?ve had the honor of working for SMART Recovery for 17 years, and I?ve had the privilege of witnessing so many changed lives! But rather than continue extolling the many virtues of SMART, I?ll instead direct you to the wealth of information available on our website, www.smartrecovery.org.  At the Central Office, both Jodi (our Manager of Network Services) and I will be pleased to assist if you have any questions.

The last sentence in our Mission is:  To support the availability of choices in recovery.  We are grateful for the opportunity to acquaint you with our organization, and we invite you to participate in our online services, face-to-face meetings ? or to volunteer to start a meeting in your community!  We are confident that you will find participation in SMART Recovery to be a most worthwhile and rewarding experience.

Contact information:  SMART Recovery, 7537 Mentor Avenue, Suite 306, Mentor, OH 44060; Phone: 440/951-5357; Toll-free: 866/951-5357; Email: information@smartrecovery.org; Website: www.smartrecovery.org.
***********
I'll be back later! Am thoroughly enjoying these discussions.  Again, don't hesitate to post questions if you have any.

[Kiahanie]

+1 to you, Shari, for taking the time to visit with us.

I'm one of IGI's recovering alcoholics. AA helped the first couple years until I moved here. I could never deal honestly with that Higher Power thing, couldn't find a local AA group hospitable to an atheist, and never finished the 12 steps. I wish there had been something like SMART here when I arrived, but I was 5 years too early. (Just checked, there still isn't a Smart program here.) 24 years sober.

I am also a recovering nicotine addict. In both cases, I think it was the peer group support aspect that was most beneficial. (I did use the nicotine patch, though -that really helped.)

No questions yet, just checking in and listening and learning.

[Pastafarian]

Hi Shari. Thank you for coming!

This post might ramble a bit but I'll try to keep it succinct and structured!

I've been sober for abbot 9 weeks now, I can't remember exactly the date I quit.
I wasn't too bad, about a half bottle of whiskey every night before bed.
I think I've been successful so far largely due to Rational Recovery's simple message and the encouraging emails I've swapped with Former Believer (FB).

I can remember spending countless nights sitting on my balcony with a VERY smart friend who is struggling with a marijuana addiction trying to get to the root of our addictive behavior/natures. We'd analyze ourselves and eachother to death, with total freedom and a lack of fear but we never really got anywhere. Why do we drink? Is it genetic? What's lacking in our lives? What are we running away from? On and on it went.

(I have a question about this last point later)

Then I heard about Trimpey's "beast" concept and had some chats with FB and BAM! Suddenly it made sense: I simply drank because I liked to get high. I am happily married, have a beautiful 20 month old daughter, I love my job as a musician/producer and have let go of most of my anger and hopelessness I felt upon reconverting from Christianity 5 years ago.
I just liked the feeling of lying in the bath reading, high on alcohol. I get a little pang thinking about that feeling writing this (haven't thought about that in awhile, it's a little scary).

Trimpey's approach really resonates with me. BUT
Like I say, there's that longing from my "beast" (base-instinct seeking pleasure. Impotent except for persuasion but so insistent at times, and LOUD!)

So I looked at the recent SMART article on stages of change (FB is your unsung missionary, good man!) and did a CBA, which I can see can help, my concern is, and here's the question I mentioned ealier: how to put this...

Do you think that there is a danger of getting stuck in self examination, self absorption, with the SMART method? I know so little of the ins and outs of how much SMART followers think about this stuff but I like Trimpey's message to just quit! It's seems ridiculous, I know, but I really believe that's what it boils down to. I'm starting to think though that maybe finding a way to rewire my brain where alcohol was previously involved is what I might need. I'm just afraid of getting lost in introspection and (forgive me! I dunno) bulls**t philosophy and pop psychology. Make sense at all?

Thanks again for your time!

[Pastafarian]

ps I'm on a phone so forgive the damn autocorrects! (DEconverted, not reconverted from Christianity)

[Shari]

Kiahanie, do keep in mind that if there's not a local SMART Recovery meeting, we have daily online meetings, an active message boards, and the 24/7 chat.  (Keep that in mind for you, not others, as you've got 24 years sober -- good for you!!!)  And, we continue to strive to seek individuals willing to start a meeting in their community, and the number of available meetings continues to increase.  I'm delighted that you found the peer support groups helpful to you!

+1 to you, Shari, for taking the time to visit with us.

I'm one of IGI's recovering alcoholics. AA helped the first couple years until I moved here. I could never deal honestly with that Higher Power thing, couldn't find a local AA group hospitable to an atheist, and never finished the 12 steps. I wish there had been something like SMART here when I arrived, but I was 5 years too early. (Just checked, there still isn't a Smart program here.) 24 years sober.

I am also a recovering nicotine addict. In both cases, I think it was the peer group support aspect that was most beneficial. (I did use the nicotine patch, though -that really helped.)

No questions yet, just checking in and listening and learning.

[Shari]

Pastafarian, excellent news on the 9 weeks sober!  And the focus on JUST QUIT is a solid one! 

You asked: "Do you think that there is a danger of getting stuck in self examination, self absorption, with the SMART method? I know so little of the ins and outs of how much SMART followers think about this stuff but I like Trimpey's message to just quit! It's seems ridiculous, I know, but I really believe that's what it boils down to. I'm starting to think though that maybe finding a way to rewire my brain where alcohol was previously involved is what I might need. I'm just afraid of getting lost in introspection and (forgive me! I dunno) bulls**t philosophy and pop psychology. Make sense at all?"

I hear what you're saying, for sure.  And it's funny, because as I was reading your post, I was thinking Pastafarian would benefit from a Cost/Benefit Analysis, so I'm delighted that FB has been communicating and making some recommendations, as well!  We've been reviewing the fact that often times there are issues underlying the behavior (or issues that surfaced because of the behavior).  One of the benefits of the SMART Recovery tools is that in addition to helping with recovery-related issues, they're excellent life tools. So, I think that self-examination can be very helpful to setting goals and determining why one wants to cease the addictive behavior. And many of the tools are designed to examine our thoughts/feelings/behaviors (rewiring the brain, so to speak as you note).  And it's also helpful to come up with some what we refer to as Vital Absorbing Creative Interests (VACIs) to replace the time that used to be spent drinking/drugging.  I'm not sure if that's a very helpful answer, but I think self examination is crucial to not only give up the drink/drugs, but to gain a rewarding and fulfilling life.

Here's a fun tool, and perhaps you'll help me out by participating.  (Don't mean to put you on the spot, all may feel free to do this.)  This is what we refer to as the Hierarchy of Values.  Write down the 5 most important things in your life.  Doesn't have to be in exact order of importance, just the things that are most valuable/important to you.  After you've all had some time to think about this, I'll come back and share some more.  (This is almost like homework, eh?!)   

[Pastafarian]

Awwwww moooooom! 

Ok.
      Family. (being a good husband and father)
      Creating music
      Entertainment (a fun life. Good TV shows, this forum, the Internet, reading)
      Learning (Chinese, science, music production)
      Discussing life, the Universe and everything with friends.

[Kiahanie]

1.Family
2.Political activity
2.Life in the Spirit
2.Being outdoors
3.Learning about other cultures & times (travel, history, archeology, anthropology)

[Shari]

Pata and Kia, excellent examples.  Now, if you plan to participate in this little exercise, and haven't written down your top 5 values, please do so before reading below.

What's really interesting is that people NEVER (or at least very rarely) ever put "booze" or "drugs" as being highly important, but often those behaviors are controlling their lives!  So, in a gentle manner, we then inquire how are the booze or drugs (or behavior) benefiting the things that you most value in life?  Most often, they don't!  In the case of family, often there are issues based on the drinking/drugging that impact spouse/kids/parents, etc.  Then, if the people carry their list, when an urge strikes, it's another item to take out of your pocket to remember that these are the things that are most important to me, and are not helped by drinking, etc.

Pasta, it would be sort of interesting if you would view drinking as being helpful to your creativity when creating music?  It's rare that the behavior is actually helpful to what we most value, but in that case, you might be able to honestly say "I feel more creative and can create more music if I have a bit of a buzz going?"

Anyway, hopefully that helps to gain a little insight as to how the addiction is impacting the things that are most important in your life.

[Pastafarian]

Ok. That's cool. A simple list to carry with me (along with the CBA exercise) as ammo. Makes sense.

Pasta, it would be sort of interesting if you would view drinking as being helpful to your creativity when creating music?  It's rare that the behavior is actually helpful to what we most value, but in that case, you might be able to honestly say "I feel more creative and can create more music if I have a bit of a buzz going?"

Well, I know that weed enhances my hearing. I can hear the size of the room a snare drum was recorded in with weed but a) similar results can be achieved by hard work and practice b) I hate the feeling marijuana gives me and c) it certainly doesn't make me more creative. I get dumb on the stuff.

Alcohol, I've discovered, makes my reaction time too slow to play well live and when creating in studio it makes me too unfocused and lazy. Lucky me on all counts, I guess 

But loads of great jazz muzos went down this way :/

[Shari]

Pasta, that's actually good news that you don't find drinking/drugging to be helpful to your creativity with music.  Sometimes when we do a Cost/Benefit Analysis (CBA) people are surprised that we "admit" that there are perceived benefits of drinking/drugging.  (Hey, people wouldn't do it if there weren't.)  So in case some of you are wondering, what's a CBA, feel free to give this a whirl.

Take a piece of paper and divide it in half using a pen or pencil both vertically and horizontally.  You'll have 4 empty squares on the page.  Top left, put "Benefits".  Top right, put "Costs".  On the left side of the page on the top half, write "Continuing to Use".  Left side bottom of the page write "Quitting".

Then, begin to fill in each of the blocks, being honest with yourself.  There's also a version of this that I'm fond of where the top left side is "Short Term", and the bottom left side is "Long Term".  That tends to help people see rather clearly that some of those short term benefits (such as lubricates socialization, etc.) are outweighed by long term costs (money, health, etc.)

(That's a difficult exercise to describe without the benefit of being able to draw!  Hopefully it made sense.)

[JudoChop]

Hi Shari, a member has asked me to post his questions here as he can't do it himself at the minute due to being restricted in the forum dungeon for naughty boys and girls. :D He can read your response but can't reply as his privileges have been temporarily removed.

First, I would like to say that I applaud any effort to help alcoholics and drug addicts recover, and point out that Alcoholics Anonymous, like Smart Recovery, encourages those who attend to follow their own conscience when choosing the path that will work best for them.  Certainly with the scope of the problem in our society today, other effective alternatives are desperately needed.  Sadly, my experience is that those who want to recover are generally able to do so if they have help, and those who do not are able to find excuses why they cannot or don't need to stop or moderate their addictive behavior.

I have been active in the recovering community in Greater Cleveland for over 25 years now, and this is the first I have ever heard of Smart Recovery, even though your headquarters is in Mentor, just east of Cleveland.  Why do you suppose that is?  Do any treatment centers in our area recommend or offer Smart Recovery as an alternative to AA?  Do any of the courts which frequently send violators to AA and NA meetings permit attendance at Smart Recovery meetings instead?

Finally, I know AA has had a big head start here, but there are over 1000 weekly AA meetings in The Greater Cleveland Area, and just one Smart Recovery meeting, at your headquarters in Mentor.  Why do you think your program is having such a hard time catching on here?

[Shari]

Hi, David!  Oh, yes, publicity and PR, i.e., becoming known, has been a challenge for each of the alternative programs, a good bit based on the fact that we don't have large budgets.  But ... I will say that I'm starting to see major progress with SMART Recovery (and other programs) becoming better known.  Much of that is due to therapists becoming familiar with alternatives and recommending them to clients. And, as is the case here, we try to take the opportunity to share information in "free" forums, etc.  But, I'm with you ... we need to determine more ways to get the word out.  AA has 75+ years, whereas most of the alternative groups have 12-20.  And I also think that AA is so well known within the treatment community that it's often the "go to" recommendation.

We did have a meeting for a number of years on the campus of Case, but the facilitator ended up moving.  The meeting in Mentor is actually run by my husband, who grew weary of me lamenting we didn't have a meeting nearby the headquarters.  :)  He took our distance training and started a meeting a bit over 2 years ago. (By the way, he finds the experience tremendously rewarding.)  I'm not familiar with any treatment programs in NE Ohio that recommend or offer meetings, though I have heard from a few folks over time who heard about SMART via the pain management clinic at the Cleveland Clinic. 

The court question is an interesting one! More and more courts seem willing to accept meeting verifications from SMART Recovery (including our online meetings).  It seems a tad hit and miss, and we sometimes send a letter encouraging the person's parole officer or courts to agree to allow for SMART meetings.  Our summer issue of the News & Views newsletter will have an article about courts -- that's due out July 1st.  Here's a link to the spring issue:  http://www.smartrecovery.org/resources/library/Newsletters/Newsletters/Spring2011News&Views.pdf

Interestingly, SMART Recovery is being very well received in the UK and Australia, and we now have SMART Recovery organizations in both locations.  It's been a slow go, but I do see things "picking up", and hopefully in the not-too-distant future, SMART Recovery and the other programs will be known to all.

And I'm in 100% agreement that unless the person is motivated to change, there are all sorts of excuses that can be employed to prevent doing so, regardless of the program.

(Thanks, JudoChop, for posting the questions.)

[Shari]

I'm soon heading out for a seminar that runs until 8:30 p.m., then I'll be hurrying home to try to catch Dr. Horvath's SMART Recovery interview at 9 p.m. EDT (reminder, all are welcome, info here: http://bit.ly/ijmXTA).  So, if you post a question ... I'm not ignoring you, and I'll very much look forward to responding tomorrow!  It's been a real pleasure "meeting" so many of you today.  A lovely evening to all!

[Mooby the Golden Sock]

^^ Podcast is still going for those joining in late.

[JustMyron]

I caught the latter half of that podcast, and it was really cool.

A survey they mentioned, which has some interesting findings about alcohol dependence in the US population: http://www.spectrum.niaaa.nih.gov/features/alcoholism.aspx

Also, Shari, this reminds me of another question I had. I see on your website, it says that your approach to addiction recovery evolves as evidence-based practices in addiction recovery evolve. So I was wondering, how has the SMART recovery approach changed over time, and what sources of information do you use to guide that change?

[Pastafarian]

That study is super encouraging. My fellow band members are under 30 and while one of them can't abstain at all another takes 6 weeks off every year. He's an animal the rest of the time. Something besides AA is needed for him, clearly.

[Hemingway]

Wow..... here is some information from the link Myron provided that surprised me:

About 75 percent of persons who recover from alcohol dependence do so without seeking any kind of help, including specialty alcohol (rehab) programs and AA. Only 13 percent of people with alcohol dependence ever receive specialty alcohol treatment.

Very interesting...... 

[Shari]

Good morning from NE Ohio!

I'm so delighted that a few of you were able to catch the blog radio show last night. It was interesting and I think Tom did a great job of answering questions as they arose. 

Thanks much for posting that link, JustMyron! Hemingway, it is rather amazing that as much as 75% of people recover without treatment or programs.  That's referred to as "natural recovery".  When I think about that, I'm even more amazed because of the # of people who attend AA and other meetings.  Lots of people out there with alcohol-related issues, for sure.

About the "science" question. We have a collection of professionals who monitor what's going on in the field of addiction treatment, and if there's a new area that has proven successful, we then review how to best incorporate it into the program (by adding new tools, etc.)  We'll soon be adding some information to the program regarding relaxation and awareness techniques that have been proven to be helpful to those in recovery.  I can't point to any massive changes in the program since its inception, but then I guess science and the treatment of addiction take time to evolve.  As it does, we incorporate what has been researched and proven helpful.

Which reminds me of one other difference about SMART Recovery.  We have a collaborative approach between professionals, peers, and non-peers to facilitate meetings and run the organization.  That's a little different model than other organizations, which are generally 100% peer led.  (That wouldn't necessarily be obvious to a person attending the program, but it is a little different structure.)  Just another little tidbit of info there.   

Reminder ... if I missed any questions, or misunderstood a question, don't hesitate to let me know.  I am thoroughly enjoying the conversations here.

[Former Believer]

One of the key differences between AA and approaches like SMART, SOS, and Rational Recovery is that AA emphasizes that one is powerless over alcohol and in need of a deity for sobriety.  How does SMART address these issues?

[rickymooston]

One of the key differences between AA and approaches like SMART, SOS, and Rational Recovery is that AA emphasizes that one is powerless over alcohol and in need of a deity for sobriety.  How does SMART address these issues?

higher power doesn't have to be a deity tho, its left undefined.

[Former Believer]

I have found Jack Trimpey's AVRT (Addictive Voice Recognition Technique) to be an extremely helpful tool in combating urges to use.  For those unfamiliar with Trimpey's approach, he basically says that there are two voices within your head.  The first, which is based in your primitive, midbrain, is the "Addictive Voice" or "Beast".  The Beast is fed by one's instinctual biological urges and cares only about getting high.  The other voice is the real "You" which resides in your cerebral cortex and which has ultimate control over whether you drink or use.

Trimpey compares the Beast to a quadriplegic which is completely dependent on "You" to give it what it wants.  All it can do is whine or beg or try to convince you that it is in your best interests to drink or use.  But "You" must give it what it wants. 

Although I haven't seriously contemplated using again in recent years, I do get cravings for beer and drugs (although they almost always relatively mild).  Sometimes when I'm in the grocery store and pass by the beer, I think "Wow, a cold beer sounds good right now".  But then, I identify it as the "Beast" speaking to me and think of it as a pathetic little bastard, sitting in a wheelchair, begging me for a drink.  Two things about this image help me:  First, by externalizing my urge to use as coming from a separate entity, I view the desire to use as coming from an enemy, not me.  "It" wants a drink, not "me".  It is much easier for me to deprive an enemy of something that it wants than to deprive myself.  And secondly, by viewing my enemy as a pathetic, impotent creature constrained to a wheelchair, I realize just how much power I have in refraining from using.  I can't begin to tell you how such thinking mitigates the feelings that one gets that the urge to use is almost too great to resist.  Bottom line is that once I identify the "addictive voice", I remember what it did to destroy my life, see it as a pathetic shriveled up beggar, and dismiss it with a curt little "f---k you".  (Excuse my language, but that terminologyording really works for me.)

Although Trimpey has trademarked the term "AVRT", I was wondering if SMART uses anything similar (not talking about REBT) to AVRT and the concept of the "addictive voice" or "beast"?

[Shari]

One of the key differences between AA and approaches like SMART, SOS, and Rational Recovery is that AA emphasizes that one is powerless over alcohol and in need of a deity for sobriety.  How does SMART address these issues?

SMART stands for Self-Management & Recovery Training, and individuals who find the program beneficial generally aren't inclined to feel powerless over their drug of choice, but believe that they can change their behavior.  The SMART program focuses on the individual's ability to use the tools and techniques to overcome the behavior ... so it's more of self-empowerment vs. considering oneself powerless.   SMART Recovery?s Position on Spirituality: We believe that the power to change addictive behaviors resides within each individual and does not depend upon adherence to any spiritual viewpoint. The use of religious or spiritual beliefs and practices in recovery is a personal choice and not a part of our program.  We have people from a variety of spiritual backgrounds -- devout Christians, Buddhists, etc., and we also have folks who are agnostic or atheist.  It doesn't create an issue because spirituality is not part of the program or meeting discussions.

[Shari]

FB asked:  Although Trimpey has trademarked the term "AVRT", I was wondering if SMART uses anything similar (not talking about REBT) to AVRT and the concept of the "addictive voice" or "beast"?

Excellent question.  One of the SMART Recovery Tools is DISARM (Destructive Images Self-talk Awareness & Refusal Method).  Here's a link to a file with more info.  http://www.smartrecovery.org/resources/library/Tools_and_Homework/Other_Homework/Disarm.pdf.  Hope that helps.

[none]

read the pdf...
I think you are taking a gamble that people don't die tomorrow.

[Former Believer]

read the pdf...
I think you are taking a gamble that people don't die tomorrow.

Not following what you are saying, None.

[none]

people die, and their death doesn't happen tomorrow.
'eat, drink, and be merry for tomorrow we die' was the reference.
I take it to mean if you don't do x,y,z today, tomorrow you will not have a chance.

[Shari]

Hi, None.  I think I'm following you.  You're referencing this statement: "Indeed, the trouble with a philosophy of 'Eat, drink and be merry for tomorrow we die' is that tomorrow comes and we aren't dead! So, we are wise to first make ourselves aware of our destructive self-talk (thinking that is contrary to our long-term interests) and then refuse to go along with it."

You're correct, it's not impossible that someone will be dead tomorrow! I think that's a little "play on words" to show that our behaviors of today can have long-term impacts, if not immediate ones.  Do you get the broad picture of DISARM, though?  The concept of refusing to go along with destructive self-talk?

[none]

nope.
I pretty much drink, eat, and be merry all the time.
but now I don't have time to stay online.
I have to go fix a door some crackhead kicked in.