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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Poverty and addictionThe relationship between addiction and poverty is complicated. Lower income people are slightly more likely to struggle with drug or alcohol abuse, but this doesn’t necessarily mean that poverty causes addiction. In some cases, financial troubles are the result of a substance use disorder.

Poverty Increases Addiction Risk Factors

There are several ways in which financial struggles increase the risk of a person developing a substance use disorder:

  • Poverty increases stress. Stress is well recognized as a risk factor for substance abuse and relapse after treatment. Worrying about how to afford shelter, food, and other basic needs causes a tremendous amount of stress. When you’re struggling to make ends meet, there is a great temptation to turn to drugs or alcohol to temporarily escape from your problems.
  • Poverty increases feelings of hopeless. When meeting daily expenses is difficult, dreams of attending college, buying a home, opening a business, or traveling the world seem impossible. Feeling as though you are powerless over your own future creates a vulnerability to substance abuse.
  • Poverty decreases self-esteem. In a culture that values material possessions and financial success, being poor can feel like a moral failing. This can lead to feelings of guilt, shame, and diminished self-worth. According to Psychology Today, people struggling with low self-esteem have an increased vulnerability to developing substance use disorders.
  • Poverty decreases social support. Having the emotional support of friends and family helps people cope with difficult situations in their lives. However, lower income adults are less likely to have strong social support networks simply because they are expending all of their energy on trying to survive from day to day. For example, a UCLA survey found that lower income adults are less likely to be married even though they value marriage just as much as their higher income peers.
  • Poverty decreases access to healthcare. Although the number of uninsured adults has decreased in recent years, the Henry J. Kaiser Foundation found that 45 percent of uninsured adults lacked coverage simply because the cost was too high. Despite the fact that most of these individuals had at least one working adult in the family, 1 in 5 admitted to foregoing recommended medical treatment due to cost. Access to preventative health care is also severely limited for members of this group. Untreated mental health conditions or chronic illnesses that are poorly controlled can lead to the use of drugs or alcohol to self-medicate symptoms.

One frequently cited example of how poverty affects addiction risk is the Appalachian opioid epidemic. Stretching from the Southern Tier of New York to northern Alabama, Mississippi, and Georgia, the Appalachian region of the United States has struggled with widespread poverty since the early 1900s. The majority of the available jobs are physically demanding, carrying a high risk of injuries despite their relatively low wages. Residents who begin taking opioids to cope with chronic pain from their employment-related injuries often find themselves spiraling into addiction. The effects of substance abuse make it nearly impossible to keep working, thus perpetuating financial struggles.

Addiction Can Cause People to Slip into Poverty

It’s important to remember that people with substance use disorders don’t necessarily develop an addiction simply because they are poor. Someone who is solidly middle class can easily slip into poverty as the result of an untreated drug or alcohol addiction.

As an addiction develops, it becomes increasingly likely that a person will have problems performing at work. This might include arriving late, missing shifts, failing to meet project deadlines, or getting into arguments with colleagues. Eventually, this can lead to job loss.

Being terminated for performance issues will make it harder to find another job. This increases the overall stress in the person’s life and provides an incentive to engage in criminal activity to fund continued substance abuse.

Middle class individuals can also slip into addiction-related poverty by selling assets or dipping into retirement savings to buy drugs or alcohol. Untreated addiction impairs judgement and critical thinking skills, which can lead someone who is normally very financially responsible to burn through decades of accumulated wealth in just a short time.

Promoting Recovery by Treating the Root Causes of Addiction

No two people with substance use disorders are exactly alike. To promote a lasting recovery, it’s vital that treatment plans address the underlying issues contributing to addiction. This could include providing job skills training, affordable housing resources, or access to community-based assistance programs for low-income individuals in addiction to detox and substance abuse counseling.

By working to heal the mind, body, and spirit, St. Joseph Institute helps clients move towards a future free from the burden of addiction. With personalized care, you can regain control of your life.

 

By Dana Hinders

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

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