Practicing Recovery


Women in a meetingIf you’re struggling to make the 12-Step process work for you, don’t give up hope of a lasting recovery. Although Alcoholics Anonymous and other similar groups play a vital role in keeping millions of people clean and sober, these organizations aren’t right for everyone.

SMART Recovery is one AA alternative that you may wish to investigate as a resource for post-residential treatment support. The program can also be helpful as a supplement to AA meetings if you feel you are in need of additional recovery support.

About the SMART Recovery Program

SMART Recovery is an abstinence-based nonprofit organization offering self-help services for people wishing to overcome alcohol or drug addiction. It was founded in 1994 by a group of mental health professionals that included Dr. Joseph Gerstein, Dr. Tom Horvath, Dr. Philip Tate, Dr. Rob Sarmiento, Dr. Michler Bishop, Rich Dowling, Dr. Jeff Shaler, Ann Parmenter, LCSW, Peter Bishop, Dr. Robert Dain, and Dr. Hank Robb.

SMART is an acronym that stands for Self-Management and Recovery Training. The program is based on a cognitive-behavioral psychotherapy known as Rational Emotive Behavior Therapy (REBT). Developed in the 1950s by psychologist Albert Ellis, REBT teaches that changing your beliefs and emotions empowers you to change your actions in regards to self-destructive behaviors such as substance abuse.

SMART Recovery’s approach to treating addiction is recognized by a number of respected substance abuse treatment experts, including the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the American Academy of Family Physicians.

A 12-Step Alternative

Like Alcoholics Anonymous and other 12-Step programs, SMART Recovery meetings are free and intended to offer both support and information. However, there are some important differences between the two programs.

The SMART Recovery program:

  • Is secular and scientifically based
  • Focuses on the present instead of dwelling on the past
  • Encourages an empowerment mindset to change behaviors
  • Does not encourage individuals to admit to powerlessness over addiction
  • Avoids the concept of a higher power
  • Rejects the disease theory of substance abuse in favor of viewing addiction as a habit that can be overcome
  • Believes certain people have a predisposition towards addictive behaviors
  • Is open to people struggling with drug or alcohol addiction as well as process addictions such as eating disorders or sex addiction

Stages of Change

While AA uses the 12-Steps, SMART Recovery talks about four points that participants need to master:

  • Building motivation
  • Coping with urges
  • Problem solving
  • Lifestyle balance

The program also refers to the stages of change that people go through when gaining control over addiction.

  1. Precontemplation – The person doesn’t realize he has a problem.
  2. Contemplation – The person performs a cost/benefit analysis to determine whether addiction is interfering with life goals.
  3. Determination/Preparation – The person makes the decision to work towards personal change. A Change Plan worksheet may be completed at this time.
  4. Action – The person seeks out new ways of handling addiction-related behavior. This can include self-help, group support, or professional guidance.
  5. Maintenance – The behavior has changed and the person looks for ways to maintain this progress.
  6. Graduation/Exit – The person has been in recovery long enough to feel confident in graduating from the SMART Recovery program.

Under the SMART Recovery model, relapse is considered a side event. The program teaches that relapse is not inevitable, but a relapse does not mean change is not possible. If a relapse is handled well, it can serve as a learning experience that helps the person overcome addiction.

SMART Recovery Meetings

Every group is a little different, but SMART Recovery meetings typically run between 60 and 90 minutes in length. Meetings are open to the public unless they are specifically labeled as private or specialized.

Meeting facilitators receive SMART Recovery training before becoming volunteer group leaders. Some facilitators are mental health professionals, but others are concerned individuals who have overcome drug or alcohol addiction and wish to use their newfound skills to help others.

Meetings typically begin with a group welcome, followed by a check in where each person can discuss the challenges they’ve experienced in regulating their behaviors or the progress they’ve made in reaching specific life goals. New participants can share what brought them to the group, but all participation is optional.

After the check in, the facilitator will determine what issues the group will discuss. Everyone will brainstorm potential ways to use the SMART Recovery program to address the specific issue being discussed. Participants often say this part of the process helps them look at their problems in a new way and boosts confidence in their ability to tackle the challenges of building a sober life.

Although meetings are free to attend, a hat is often passed for donations at the end to help with group expenses such as venue fees.

To find a meeting near you, enter your address or zip code in the SMART Recovery meeting locator tool. If you are interested in attending an online meeting, the SMART Recovery online meeting schedule provides a comprehensive list of all live online meetings.

You can visit the SMART Recovery website and use the meeting locator https://www.smartrecoverytest.org/local/  to find a meeting near you. An online forum https://www.smartrecovery.org/community/ is also available to provide supplemental support.

By Dana Hinders

To learn more about our programs, please visit our website.

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Two men talking“Continuum of care” is a phrase that’s commonly used in addiction treatment, but many people seeking help for a substance use disorder find themselves wondering exactly what this means.

Essentially, continuum of care refers to having a detailed plan for what services a person needs to help him or her stay sober after seeking residential treatment. This is a system where clients are guided and monitored over time as they progress through all levels and intensities of care. In some cases, this approach may be referred to as a “Recovery-Oriented System of Care” (ROSC).

There’s No Quick Fix

The most common misconception about addiction treatment is that detox and a quick inpatient stay are all that is needed to ensure lasting sobriety. Unfortunately, treating addiction is much more complex.

Addiction is widely recognized as an illness, but it’s not like getting strep throat and having your doctor write a prescription for an antibiotic. It’s more like being diagnosed with diabetes and having your doctor recommend diet changes, exercise, and blood sugar monitoring in addition to your medication.

You can live a full and productive life after being diagnosed with a substance use disorder, but you need to stay on top of your recovery. If you become complacent, you put your sobriety at risk.

Personalized Care Is Essential

No two people with a substance use disorder are exactly alike. Someone who has been abusing drugs or alcohol for many years has very different needs than someone who has only recently developed an addiction. Exposure to trauma, the availability of family support systems, and the presence of a co-occurring mental health disorder are also examples of factors that can widely influence what services are necessary after residential treatment.

Depending upon the client’s specific needs, some services that may be recommended as part of the continuum of care include:

  • Ongoing outpatient counseling
  • Intensive outpatient treatment that offers a more intensive counseling experience but still allows the client to return home each night
  • Sober living homes that serve as an interim step between residential treatment and living independently
  • Participating in 12-Step groups
  • Participating in alumni events sponsored by the residential treatment center
  • Online recovery education programs

Steps in the Continuum of Care

Every case is a little different, but the general steps in the continuum of care are as follows:

  1. Assessment: Determine the nature and extent of the substance use disorder, as well as any chronic illnesses or co-occurring mental health conditions that would complicate care.
  2. Treatment Plan: Develop an evidence-based plan for addiction treatment.
  3. Treatment: Use detox, counseling, and holistic treatment to build the skills necessary for long-term sobriety.
  4. Evaluation: Determine how successful treatment has been in helping to break old behavior patterns.
  5. Case Management: Develop a plan for ongoing care, such as intensive outpatient treatment or sober living.
  6. Extended Care: Provide the services necessary to ease the transition into independent living while addressing physiological, psychological, and spiritual concerns.
  7. Monitoring: Periodically check in with the individual to make sure there are no areas of concern.


Notice that the level of support gradually decreases as the client becomes more adept at practicing the skills necessary to manage the chronic nature of a substance use disorder.

Easing the Transition to Independent Living

Although the specifics are different for each individual, the goal of continuum care planning is to ease your transition from the structured environment of residential treatment to an independent sober life.

Your care team will help you determine what support you need to practice applying the skills you’ve learned to everyday situations. This includes:

Your continuum of care plan can help address specific goals you may have for yourself as you embrace the possibilities of a life without drugs or alcohol. For example:

Providing a Roadmap to Recovery

It may be helpful for you to think of the continuum of care in addiction treatment as a roadmap to recovery. You still need to do the work of building the skills necessary for sober living, but this approach provides you with a detailed plan and actionable steps to guide the process.

However, this does not mean that your continuum of care plan is set in stone. If you suffer an unexpected setback, the plan can be adjusted as needed. There’s no criticism or judgement, only a sincere desire to help you find the best way to move forward with your recovery journey.

By Dana Hinders

 

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What To ExpectWhen you’ve made the decision to seek addiction treatment, it’s hard to imagine what your life will be like without drugs or alcohol. Although no two people are exactly alike, this article outlines some of the issues you can expect to deal with during your first year in recovery.

Withdrawal

The term withdrawal refers to the physical symptoms you experience after drugs or alcohol leave your system.

Withdrawal symptoms depend upon the substance being abused and your length of use, but often include stomach upset, sweating, headache, anxiety, sleep disturbances, and mood swings. A medical detox helps you avoid dangerous side effects and keeps you as comfortable as possible.

Acute withdrawal symptoms start to taper off as your brain chemistry adjusts to a normal level. However, post-acute withdrawal symptoms can last anywhere from six months to two years. Common post-acute withdrawal symptoms include difficulty with memory and concentration, decreased physical coordination, and trouble managing emotions.

Counseling

Once detox has been completed, counseling is vital part of setting the foundation for long term sobriety. Counseling typically involves a mixture of individual, group, and family sessions. Your counselor may also recommend experiential therapies such as art, music, or equine therapy.

If you suffer from a co-occurring mental health disorder such as depression or PTSD, your treatment plan will need to address both issues simultaneously. Often, people with mental health disorders turn to substance abuse to self-medicate the symptoms of their condition. If their mental health needs aren’t addressed, it becomes extremely difficult to maintain sobriety.

Celebrating 30 Days of Sobriety

Having 30 days of sobriety under your belt is considered a huge milestone. At this time, your withdrawal symptoms have become more manageable and your counseling sessions have provided you with the tools you need to begin a life free from the burdens of substance abuse.

Near the 30-day mark, you’ll likely be transitioning from an inpatient treatment facility to outpatient care. Your counselor will provide you with a detailed aftercare plan to make the adjustment process easier.

Creating a Strong Support System

After leaving an inpatient treatment facility, you’ll want to keep up the recovery momentum by creating a strong support system for yourself. Your facility’s aftercare resources are a good place to start, but you can also turn to support groups such as Alcoholics Anonymous to connect you with people who understand the challenges you’re facing.

People in the early stages of recovery often find that turning to their faith provides comfort. The new friends you meet in worship services and church activities can play a vital role in your recovery by providing encouragement and accountability, even if they have no personal experience with substance abuse.

Building Routines

During the first year of recovery, much of your time will be spent creating a routine for yourself. You’ll need to figure out how to balance work, family, social, and treatment obligations. Using a traditional day planner or a scheduling app on your phone may make it easier to keep track of appointments.

As you’re building a routine for yourself, remember to be realistic about what you can accomplish. Not giving yourself enough time to relax can create stress, which places you at risk of relapse.

Repairing Relationships

When you’re struggling with addiction, it’s easy to inadvertently hurt the ones you love. Restoring trust with friends and family will take time, so be patient with this part of the process.

A sincere apology is always a good place to start, but most people in recovery find that their loved ones respond well to seeing how hard they are working to stay sober. Keep your loved ones informed of your recovery milestones while making an effort to communicate honestly and openly.

Discovering Sober Hobbies

One of the most exciting parts of embracing a sober lifestyle is developing new hobbies. During your first year in recovery, give yourself permission to explore areas of interest—even if they put you outside of your comfort zone.

As you’re thinking about what activities appeal to you, consider aiming for a mix of solo and group hobbies. Solo hobbies such as reading, creative writing, gardening, or painting provide a way to distract yourself when cravings hit. Group activities such as joining a bowling league, volunteering at a local nonprofit, or trying out for a community theater production let you expand your social circle.

Avoiding the Dangers of Overconfidence

As you get closer to the one-year mark, it’s natural to become more confident in your sobriety. Feeling comfortable living clean and sober is an excellent sign, but overconfidence can be a risk factor for relapse.

It’s important to remember that addiction is a chronic illness. Just as someone with diabetes needs to continually monitor their blood sugar, eat right, and exercise, you’ll need to stay on top of your treatment plan to manage your sobriety.

By Dana Hinders

To learn more about our programs, please visit our website.

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