10 Ways SMART Recovery Differs From 12-Step Programs

SMART Recovery

By John Lavitt
First published on August 17, 2017 in The Fix

The organization’s approach emphasizes a secular and scientifically-based modality which is attractive for people who do not connect with the spiritual aspect of 12-step.

Since being founded in 1935 by Bill Wilson and Dr. Bob Smith in Akron, Ohio, Alcoholics Anonymous has proven to be the primary recovery fellowship worldwide. Combined with the many other 12-step programs that have followed in its footsteps, AA is the first open door usually offered to help people with alcoholism and addiction find the path to sustainable sobriety. AA also provides the theoretical backbone for the majority of treatment programs in the recovery industry while also being an essential part of sentencing mandates in the judicial system.

The actual long-term success of 12-step programs, however, remains controversial. A big part of this controversy is the debate over how effective 12-step programs are. For example, the percentage estimates of how many people manage to stay sober for one continuous year after their first 12-step meeting range substantially from 5% to 26%. Given this meager success, many new organizations and groups have popped up in the past quarter century hoping to offer an effective alternative.

Although none of these programs has gained enough traction to compete with the 12-step juggernaut, some of them, such as SMART Recovery (Self Management and Recovery Training), have experienced a definite modicum of success. Originally incorporated in 1992 as the Alcohol and Drug Abuse Self-Help Network (ADASHN), the organization soon switched gears and started operating under the SMART Recovery name in 1994.

As an international non-profit organization, SMART Recovery provides support to people seeking abstinence from addictive behaviors. The organization’s approach emphasizes a secular and scientifically-based modality which is attractive for people who do not connect with the spiritual aspect of 12-step. However, if the individual wants to include the spiritual component into their recovery, they are welcome just the same. The core of this approach employs non-confrontational motivational, behavioral and cognitive methods of treatment based on therapeutic principles.

As a Licensed Marriage and Family Therapist in private practice at Pacific MFT Network in Santa Monica, California, Matianna Baldassari is studying to become a facilitator at SMART Recovery meetings. Explaining her motivation to take this step, she says,

Given that many of my clients do not connect to the spiritual aspect of the 12-step programs, I wanted to be able to provide them with a real alternative. In SMART Recovery, they are given a choice. For me, it’s not about supporting this program or that program, but rather finding a way to help people with addictive disorders see the benefits of being sober and taking action.

The positive work of SMART Recovery has been recognized by both the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). After being embraced by many doctors, SMART Recovery also was endorsed by the American Academy of Physicians. None of these endorsements favor SMART Recovery over traditional 12-step programs. Instead, the endorsements are commendations or encouragements, signing off on SMART Recovery as a viable alternative to the 12-step programs.

Given the recent success and the appeal of SMART Recovery, those considering the program may be interested in how this program differs from the 12 steps. Full disclosure: I got sober in a 12-step program, and I still attend meetings on a regular basis. I am not, however, a 12-Step Big Book or Basic Text thumper, and I respect whatever sound choices a person chooses to make that lead to a recovery that works for them. After all, no two people are the same.

Although I have enjoyed my experiences at SMART Recovery meetings and I recognize their value, I choose to stick with what has worked for me for almost a decade. Moreover, given the simple fact that there are over 3,000 12-step meetings in Los Angeles County every week compared to 20 or so SMART Recovery meetings, easy access plays a major role in my decision.

As a writer that focuses on recovery, however, I wanted to explore how SMART Recovery differs from traditional 12-step programs. As opposed to planting flags and declaring one better than the other, I hope to provide insight into the SMART Recovery program through a compare and contrast. Ultimately, the choice of what program to embrace is at the liberty of each person. Finally, this compare and contrast analysis is far from definitive, comprehensive, or perfect. Rather than being a judge’s gavel banging on a bench, it’s meant to be a door opening that will inspire further investigation.

How SMART Recovery Is Different from 12-Step Programs:

1) Six Stages of Change vs. 12 Steps

As opposed to using the 12 steps as a guide to the progression of a person’s recovery, SMART Recovery highlights what they define as the six stages of change. Since participants tend to be in one or more of various stages of change, SMART Recovery believes that a different approach can be helpful at each stage of the recovery process.

The six stages of change are as follows:

  1. Precontemplation – The addictive behavior being faced may still be subconscious and not fully realized or acknowledged by the participant in the recovery process.

  2. Contemplation – Through a cost/benefit analysis, a participant evaluates the advantages and disadvantages of the addiction.

  3. Determination/Preparation – A participant decides to pursue personal change. In the process, a key part of this change can be the use of the SMART Recovery Change Plan Worksheet.

  4. Action – Once the decision is made, a participant seeks out new ways of handling the addictive behavior that plagues them. Such approaches include self-help, group support, and professional guidance. The purpose is to find what works to engender sustainable action that promotes continuous abstinence.

  5. Maintenance – After a period that varies from several weeks to several months, the change within and the movement away from the negative addictive behavior leads to positive gains. A participant then seeks to maintain such gains over time.

  6. Graduation/Exit – Once sustainable change has been achieved, a participant can choose to “graduate” from SMART Recovery.

2) Graduating vs. Never Graduating

The sixth part of the stages of change highlights a fundamental difference between SMART Recovery and 12-step programs. Unlike 12-step programs, SMART Recovery opens the door to leaving the addictive behavior behind. A participant can be “recovered” and not “in recovery.” In contrast, many people in 12-step programs identify as “alcoholics” or “addicts” in perpetuity, seeing recovery as an ongoing process that never ends. A favorite anecdote in 12-step rooms is the story of the person in long-term sobriety (usually 20 years or more) who relapses because they had “too many years and not enough days.” Thus, they stopped treating their disease on a daily basis. SMART Recovery believes such an approach perpetuates the stigma of addiction, not allowing the participant to be truly free of the negative implications of the addictive behavior.

3) 4-Point Program vs. the 12 Steps

In contrast to the 12 steps, SMART Recovery highlights a 4-Point program that helps a participant in the process of recovery. The 4-Point program covers a lot of the same ground that is covered in the 12 steps and helps the participant through the application of scientific principles:

  1. Building motivation and maintaining it over time
  2. Coping with urges
  3. Managing thoughts and feelings through problem-solving
  4. Learning how to live a balanced life

4) Being Active Despite Not Being Abstinent

Although the only requirement for attending a 12-step program is a desire to stop drinking or using, you are discouraged from taking an active part in a meeting if you have used drugs or alcohol in the past 24 hours. Although SMART Recovery is abstinence based, they take a different approach. A participant does not have to be abstinent to attend and take part in their meetings as long as the person is not disruptive. Even if you are unsure about the value of abstinence and you are not willing to admit that your addictive behavior is problematic, you are still welcome to attend and engage at SMART Recovery meetings.

5) Locus of Control vs. A Higher Power

SMART Recovery teaches self-empowerment and self-reliance as being the long-term keys to sustainable sobriety. The philosophical and psychological framework of SMART Recovery encourages participants to discover and map out their path to recovery. As a result, the “locus of control” of each participant is shifted to an internal position within the individual. The goal is to help participants shape their destiny. SMART Recovery firmly believes that healing from addictive behaviors works best through the empowerment of the individual; they need to develop the will to heal themselves through techniques such as motivational interviewing.

In contrast, 12-step programs insist that you cannot do it alone, and a person needs to surrender. You need to turn your will and your life over to a “Higher Power” that could be anything from God to the group itself to the waves of the ocean to a particularly influential doorknob. Although your Higher Power can be anything, the Christianity lurking behind the Big Book’s conception of spirituality is apparent. However, there is a strong argument that the self-empowerment that SMART Recovery brings forth happens in a similar manner as the process of surrendering by working the 12 steps. There is a great saying in the 12-step rooms that surrender means, in essence, the deciding to join the winning side. The winning side is the side of your Higher Power.

6) No Cross-Talk vs. Ample Cross-Talk at Meetings

In the vast majority of 12-step meetings, cross-talk is not allowed. You can comment on what was shared by the speaker or on the literature read, but you cannot talk about what another participant has said. In contrast, cross-talk is promoted at SMART Recovery meetings and becomes an essential part of the process. SMART Recovery facilitators do not have to be peers in recovery, and they also can be professionals like therapists or counselors.

7) Addiction as Temporary vs. Addiction as a Disease

Going back to the point about graduation, SMART Recovery sees addiction as a disease that can be overcome through modern scientific approaches. Rather than seeing addiction or alcoholism as a chronic disease and a participant as an addict or alcoholic, SMART Recovery believes in fighting the stigma of labels. Each participant is on their journey, and they have the ability to overcome the challenges they face. Although SMART Recovery is willing to accept the disease model, they do not emphasize it in their meetings or literature.

8) Having a Sponsor vs. Not Having A Sponsor

There are no sponsors to guide a newcomer through the process of working a program in SMART Recovery. Although there is support in the meetings and participants can ask for help from more experienced members, each person is essentially on their own. In contrast, the 12-step programs recommend working the 12 steps with a sponsor. A sponsor helps guide newer members through the steps and assists them in their recovery. Sponsorship is at the very heart of the 12-step program because it allows members to pass the message of the program along and share their experience, strength, and hope.

In a sense, sponsorship is the ultimate realization of the first part of the 12th step — “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.” Through sponsorship, people in 12-step programs can carry the message. From a personal perspective, my sponsor has been a lifesaver. For over a decade, he has taken my phone calls and guided me in the right direction. When I have a problem that’s running circles in my head, and I am trying to think my way out of self-created misery, he has always said the same phrase time and time again: “How’s that working for you?” Almost always, I seem to reply, “Not so well.” Such a moment of admitting the truth is like a mini-surrender, and it provides me with the freedom to try a different approach. I am so grateful for the gift of sponsorship in the 12-step programs. Still, I can see how what has worked for me very well might not work for others.

9) SMART Recovery is Based in Scientific Tools that Continue to Evolve

The 12-step programs, particularly Alcoholics Anonymous, are based on a book that was published in 1939 and has remained virtually unchanged for over 75 years. In contrast, SMART Recovery is based on a combination of three relatively contemporary scientific methodologies: Motivational Enhancement Therapy (MET), Cognitive Behavior Therapy (CBT), and Rational Emotive Behavior Therapy (REBT).

Overall, the main ongoing inspiration behind the scientific and philosophical framework of SMART Recovery is Albert Ellis’ Rational-Emotive Behavior Therapy. Albert Ellis (1913-2007) was a well-regarded American therapist who helped to champion CBT and REBT in the therapeutic community. As the philosophical heart of the SMART Recovery approach, REBT’s focus is on changing negative thoughts and unhealthy behaviors into positive alternatives. This method is based equally on both the stoicism of the Greek philosopher Epictetus as it is on the psychoanalytical roots of Sigmund Freud. As Albert Ellis once proclaimed, “There is virtually nothing in which I delight more than throwing myself into a good and difficult problem… I love my work and work at my loving.”

10) SMART Recovery Treats All Addictive Behaviors as One Problem

Unlike the 12-step groups that tend to have different meetings for different substances (Narcotics Anonymous, Cocaine Anonymous) and different behaviors (Gamblers Anonymous, Debtors Anonymous), this is not true in SMART Recovery. All of the different addictions are treated as one. In the Frequently Asked Questions section of the SMART Recovery website, the decision to create the overarching category of addictive behavior is detailed:

Addictive behavior is over-involvement with substance use (e.g., psychoactive substances of all kinds, including alcohol, nicotine, caffeine, food, illicit drugs, and prescribed medications), or over-involvement with activities (e.g., gambling, sexual behavior, eating, spending, relationships, exercise, etc.). We assume that there are degrees of addictive behavior, and that all individuals to some degree experience it. For some individuals, the negative consequences of addictive behavior (which can involve several substances or activities) become so great that change becomes highly desirable.

As stated in the beginning of this article, this examination of the two programs is far from comprehensive. From my perspective, there are positive aspects to both programs, and I hope SMART Recovery continues to expand and find success as a sustainable alternative to 12-step programs.

As the San Francisco street poet Lord Buckley once said, “There is a great power within. / And when you use it, / it spreads like a living garden. / And when you do not use it, / it recedes from you.” I choose to see that power within as a window to God consciousness, and this is why I choose the 12-step programs for myself. My goal in my sober journey is to slowly open that window, getting rid of my ego and selfishness. I might not know what that power within is, and I might not be able to define it, but I have found that by surrendering to a Higher Power and embracing a different path, I was able to discover the almost clichéd realization of a life beyond my wildest dreams. Whatever path you choose, I hope you discover the same for yourself.

30 Responses

  1. George M says:

    The only thing that matters are the results the addict/alcoholic receives from recovery. No matter what the approach is SMART, 12 step, Religion or just stopping on their own with no help. I know this. I was sober for 20 years and relapsed. I was mainly going to NA but stopped going about 19 years in. I slowly drifted back to a drink.

    The only reason I’m sober today is because I want to be. Pain is what made me want to get sober, I completely destroyed almost all I accomplished in 20 years of sobriety. But being away from the rooms of AA/NA got me drunk for 8 years. I am just now getting sober again after numerous attempts. No approach will be effective until the alcoholic truly wants to stop and will do anything to stay that way. It’s a hard learned lesson for this alcoholic.

    Do I agree with everything in AA, no I don’t. AA has given me the principle of open-mindedness though, which means I am open to any an all ideas that will contribute to my staying sober, happy, joyous and free. If other members disagree with me then they do but I can adapt the program to fit my life once I have honestly tried any and every suggestion, this is how I find out what works for me. Most people that come back after going out say they didn’t try it 100 percent or they let up or put something in front of their recovery.

    There is a lot of scientific information about addiction mainly around addiction being a brain disease and I believe it because the evidence is there but there still isn’t a cure, there isn’t anything that will make me a non-alcoholic. I wish I could drink normally but I am not capable of it. So finding whatever means works for the individual is the best approach but AA gives us power we never had when drinking and it’s why I keep going back.

  2. Jennifer T. says:

    For many years, society viewed addiction as a moral failing, and substance misusers were almost always referred to with the familiar language of stigmatization—drunks, junkies, crackheads. So, addiction came as a double whammy—the addiction itself plus the burden of stigma, which compounded the lethality. “Addicts” were generally sent off to find help in 12-step programs outside of the medical and treatment communities. Eventually the concept of addiction as a biopsychosocial disease began to take hold, albeit one that had a simplistically envisioned goal—abstinence from everything for everybody. A variety of treatment approaches were developed, many extremely effective, but these developed alongside an enormous dose of attention from the criminal justice system. Psychologist and psychoanalyst Debra Rothschild argues that we are shifting again in our view of addiction, to a “Third Wave” of treatment that appreciates the myriad complexities that each client brings to treatment.

  3. Jennifer T. says:

    Everything is very open with a very clear explanation of the issues. It was really informative. Your article is useful.Many thanks for sharing!

  4. Kit G says:

    Thanks for posting, Roger.

    Reminds me of the movie, “Miracle on 52nd Street” when old crackpot Kris Kringle recommended that shoppers go to Bloomingdale’s if they couldn’t find what they needed at Macy’s! The kind and helpful and uncultish thing to do, making the shopper/newcomer more important than the “bottom line”/dogma!

  5. John says:

    Hey Roger, thank you so much for posting this article. I see that most of the comments are from folks who seem to be steeped in knowledge of the recovery world. I, however, am not. I know about AA and have family who have gone though the program, but that’s about it. For me, I am an agnostic who wouldn’t call myself and “addict” but I recognize that alcohol can be hard to control once I get started… I’m not sure what you’d call that.

    Anyway, I’ve followed your blog for awhile as a way to think about sobriety without the religious connotation. This was an amazing article about another way to think about fully taking control of my life without any of the icky labels or a dependence on a “god” for “strength.”

    I see a number of these comments talk about even more programs, which I might explore, but for now I think I’m going to check out SMART. Google shows a few UU churches in my area with groups, which is pretty cool.

    Anyway, thanks again. It was a great article for me.

    • Tim S says:

      Hey, John. I’m glad you’re looking and hope you find it.

      A clarification, perhaps: I don’t so much think about it as “going through the program.” Many of us find that AA leads us on a lifelong journey to a different way living and of perceiving our role in it. I’m almost 72, haven’t had a drink or a toke since I was 39, and I don’t expect ever to graduate from AA. I’ve also been a self-declared “practicing” atheist since I was 15. I don’t expect that to change either. Good luck. Millions of us – censuses (censi?) notwithstanding – are ready to extend a welcoming hand if you find yourself walking into one of our meetings.

  6. Sharon J. says:

    I feel “all roads lead to Rome.” This well written article does an excellent job describing the journey along two of the many available paths to freedom from addiction. Thank you.

  7. Laurie says:

    ‘Upon therapy for the alcoholic we surely have no monopoly’ and ‘We realise we know but little, God (sic) will constantly reveal more to you and to us’ (Big Book). So AA has no quarrel with SMART recovery, or indeed any other treatment/therapy program. But, please, no more misinformation about AA’s so-called ‘success’ rates. Arthur S., Tom E. and Glenn C. wrote the definitive paper on this subject titled ‘AA Recovery Outcome Rates: contemporary myth and misrepresentation’. It is available on Wikipedia and the Hindsfoot Foundation website – scroll down the Index to 1/1/08 Arthur S., Tom E. and Glenn C.

    • Steve V. says:

      Well hang on, there’s been literally dozens of independent studies over the last 20 years or so coming to some pretty similar conclusions about a pretty low success rate of AA. The study you refer to has many that challenge it’s conclusions and methodologies. Hardly definitive.

      • Mike B says:

        Thanks Roger for the informative article.

        My comments are mainly directed towards the issues and questions around “what is the true recovery rate in AA?

        Starting with the basic premise that, “liar’s figure and figures lie” it would be nearly impossible to come up with a truly accurate number. The best we can hope for is something close to the truth as many uncertain factors impact the end results of any AA survey.

        The forward to the second edition of the BB
        (p xx) states,” Of alcoholics who came to AA and really tried, 50% got sober at once and remained that way: 25% sobered up after some relapses, and among the remainder, those who stayed on with AA showed improvement”. The 2nd edition was published in 1955; 20 years after the founding of our fellowship. I believe there were more down-and- out, desperate, hard core alcoholics coming through the doors of AA then than there are today. I believe these numbers are somewhat inflated but my sense tells me the recovery rates in the 1950’s were likely higher, for many reasons, than today.

        Many newcomers today (most are on everything but roller skates) have multiple addictions which many feel are outside the primary purpose of AA. These cases are difficult for many old timers and real alcoholics who are unable or unwilling to identify or help.

        The last AA survey I read 4-5 years ago, conducted and published by GSO and the Grapevine, concluded that less than 5% of newcomers stayed sober more than 5 years. Could the numbers be higher? Perhaps, but the bottom line is AA success rates have been in decline for decades.

        AA has failed to change with the times and is not relevant or attractive to many in today’s secular, multicultural and pluralistic society.

        I am grateful there are alternate recovery programs available besides AA. Perhaps someday I might need their help as I don’t think AA’s survival is guaranteed.

        Thanks for the part all of you play in my sobriety and for the valuable knowledge I gain from AA Agnostica.

        Mike B.
        Oliver, BC.

      • Laurie says:

        Fair enough, but I hope people will read both (all) sides before making up their minds. Clearly I’m biased because AA has kept me sober for 33 years. Yours aye.

      • Dan H. says:

        Here we are again about success rates. Say you take a given group of 40. 10 are bussed in from a county-sponsored recovery center that houses probationers and parolees. 9 of them have no intention to stay sober (but one “catches” alcoholism and stays). Does that skew the group’s success rate? If someone comes in and puts together 10 months, then drinks for a week and comes back, is that an AA failure? I have a friend who has been sober 19 1/2 out of the last 20 years but never put together more than a year. How does that work out in determining statistical outcomes?

        Do any of the studies isolate willing, self-motivated participants (as opposed to those coerced by the courts, by parents, or by some other intervention) and track their collective success rate?

        • Eddie S. says:

          Thanks Dan for points well taken. Success is in the eye of the beholder. I’m coming up on 34 years without a drop of alcohol, worked with countless newcomers, yet with chronic depression, I haven’t always been a happy camper. Bottom line is, like myself, AA isn’t perfect what with the intrusion of all the god talk and addicts however I’m almost 80 and without the fellowship of AA I would have been dust decades ago.

      • Mike B says:

        Well written Dan.

        As I stated in my post, “The best we can hope for is something close to the truth as many uncertain factors impact the end results of any AA survey”.

        The results can be skewed to support almost any point of view. I do believe that AA has a long way to go to widen the gateway to be attractive to all alkies of every stripe.

        AA membership has flat lined around the 2 million mark for the past 20-30 years. Although AA is not a pyramid marketing scheme there must be plausible and controllable reasons why our membership doubled every 10 years for the first 5 decades but has failed to grow for the last 30 years.

        Just wondering?

  8. Jerry F. says:

    Before I pick away at the article, Roger, let me thank you for writing it. It explains some things that I didn’t know about SMART recovery. I wonder if you might some day perform the same service for us on Rational Recovery.

    In article 4, Being Active Despite Not Being Abstinent, “you are discouraged from taking an active part in meetings if you have used drugs or alcohol in the past 24 hours.” That is not part of AA dogma and I’ve seen many chronic slippers commenting on a topic when they were, once again, getting a desire chip. And even if the person were a true newcomer, “you are discouraged from taking an active part in a meeting,” what sort of censorship are we envisioning here? Throw the bum out? Tell him/her to to shut up? That’s not the AA I’ve experienced as I attended all of my early meetings totally wasted.

    Article 6, Cross Talk. In my part of the world it is common for meeting attendees to refer to the sharings of those who have gone before if they do so without criticism or disagreement.

    Article 9, the BB. Just a favorite discussion point for me but you write that the BB “remained virtually unchanged for over 75 years.” There were 401 changes to the first 164 pages from the first printing of the first edition to the last printing of the first edition. Then there were changes made in all of the subsequent editions. Even the Doctor’s Opinion changed. Perhaps, being dead at the time, he had greater insight to share with us. Perhaps, “It has been substantively and trivially changed and re-changed many times in the past 75 years.”

    Still, Roger, excellent article.

    • Roger says:

      As long as you understand that I didn’t write it Jerry.

    • Tim S says:

      A very small nit but I think the issue of 24 hours before speaking is regional. In my 3 decades of sobriety (without god), I’ve occasionally heard it spoken as a guideline or request but only in a small minority of the estimated 5000 meetings I’ve attended in 20 states.

  9. Jack B. says:

    C’mon people, it’s 2017!!

    1939 is a lonnng way behind us; we’ve quintupled at least our knowledge of addiction and recovery since then.
    The more avenues to recovery from addiction(s) there are, the better
    off for all involved. AA, AAAA, RR, SMART, Lifering et al, are all valid.

    All doors to any and all methods must be kept wide open to all always.

    The important thing is to keep trying.

  10. Garry U. says:

    “For example, the percentage estimates of how many people manage to stay sober for one continuous year after their first 12-step meeting range substantially from 5% to 26%. Given this meager success…” Statistics such as these always strike me as bizarre. Not much is mentioned about how they are arrived at. I do not know many members of AA who succeeded in establishing continuous sobriety following their first meeting. (That might be a more reliably accessible statistic. Simply ask members with more than a year how many meetings they attended before abstinence finally took hold.) In my community it seems that most initial visits are precipitated by “unmanageable” life event such as DUI, marital discord, employment problems, etc. Not by a desire to quit drinking but rather a desire to have the problems go away. Thankfully, our stories in AA help some to see the correlation between intoxication and poor decision making. Frankly, if alcohol didn’t have negative consequences, why in the world would you want to stop. Not drinking is extremely difficult for some and is beyond their internal resources to accomplish, it seems. Thus, us. The fellowship. We help many to succeed where a single doctor visit was insufficient.
    After the last election, I am very leery of statistics. And whereas many Americans claimed they would move to Canada if the last election did not go their way, they actually seemed to have stuck around and become an active movement for change. That’s how I feel about AA. I want to be part of the change in it.

    • Andrew in DC says:

      I was also struck by that statement of/about those statistics.

      I don’t think you can rightly characterize AA’s efficacy as “meager” without context. AA’s success rate is poor in relation to what? In relation to SMART? SMART’s efficacy rate is conspicuously absent from that statement. In relation to placebo? In relation to 100%?

      In some areas of medicine a 98% efficacy rate is intolerably low. In other areas of medicine a 13% success rate is a critical breakthrough. Simply asking yourself, “How close does that number seem to 100?” isn’t a great way to evaluate a therapeutic success rate.

      How about comparing AA’s efficacy in relation to standard treatments for other pernicious, high-relapse psychological disorders? Despite all the clinical resources and research devoted to schizophrenia, sufferers still have about an 80% of chance of relapse within 5 years after an acute episode. I’m not sure how much credence to give that “5% to 26%” claim, but even if we take them as accurate, on the higher end, AA is going a better job than the medical industry is doing with schizophrenia.

  11. Andrew in DC says:

    There is a real, serious question to be addressed today: Now that an expressly secular alternative exists, why would a secular recovering person choose to remain involved in Alcoholics Anonymous, despite the secular person’s perpetual subaltern status there?

    I recognize the tension. There is certainly an incongruity of stated goals and values. Doubtless a critic could find plenty of cognitive dissonance within the secular remnant in AA. Maybe could even fairly accuse the secular AA contingent as being an agent of its own alienation. I won’t argue with it. I can restate it because I’ve thought it myself, plenty of times. And it resonates, for sure. To an extent, that’s all true. But I remain in AA despite the conflict.

    Because, despite how compelling that line of thinking, other considerations prevail over them. I’ll explain.

    First, and most important of all, long-term recovery in my experience has been made possible only by a community of successfully sober others, and the larger the better. Still today, I suffer from a number of issues, including the persistent life-long symptom of the substance abuse disorders: intermittent relapse ideation. But I engage with others in my AA community, and we continue to stay sober because we continue to model successful sobriety for each other generally, mostly through demonstrating specific adaptive strategies for one another. Recovery is ultimately about changes in ideas and behaviors, but the essential vehicle for the cognitive is the social. Of course, SMART is also an interpersonal experience (even if it’s not always peer-to-peer), but AA brings something to the table that SMART does not: the AA-affiliated recovery community has infiltrated the general global community to an extent that is nearly pervasive. SMART is just offering a much, much smaller community of people.

    So the contest between the two communities is clearly lopsided along the dimension of quantity. But, I’m sorry to say, in my experience anyway, that is also the case along the dimension of quality. On those occasions that I’ve been to SMART meetings, I have found newcomers, but not much more than newcomers. Maybe this is a sign of success: people for whom SMART works are encouraged to “graduate.” But this means that the community is going to largely consist of newcomers-helping-newcomers, inherently and by design, which is frankly very often a matter of the blind leading the blind. Or, if it’s not designed to be newcomers-helping-newomers, it is inherently more hierarchical by design, with the small number of expert facilitators assuming roles of power and authority that AA members would balk at. Either way, I can’t help but question whether there really are large numbers of successful SMART recovery stories that have graduated. And the relative paucity of old-timers is a big part of the reason why I think that. There’s no substitute for experience, and there’s no experience like diversity. he lack of old-timers is a lack of both of these, and I project a correlated lack of success.

    I also think that SMART just gets a few things wrong. It approaches the alcoholic as a person who makes decisions based on rational calculation. Now, I believe in science. And I categorically reject appeals to magic of every variety. But current science is giving us clear indications that many Age of Reason beliefs about how people make decisions, get persuaded of things, and change their behavior are antiquated and ineffective. Drunks don’t stay drunk because of a rational calculation, they stay drunk because of their emotional impressions of their experience. Drunks don’t get sober as a matter of rational calculation either, they get scared, or ashamed, or some other emotional driver of change motivates them. Current brain science is pretty confident that without some chemical signal from the limbic system, NO decision will ever get made. You even need a feeling to decide on what clothes to wear (so say studies of executive dysfunction in people with certain aphasias). And so, approaching the wet drunk as though he was Adam Smith’s mythical Homo Economicus is a mistake. AA communicates through personal stories, the repetition of adaptive maxims, the expression and sharing of feelings. And that’s why people stay, and stay sober.

    I’d love it if I were wrong. I hope one day things will change and I will be proven wrong eventually. But today, AA gives secular newcomers a dramatically better chance of recovery in my estimation. And I want to be there to help them.

    And I also want to be around in AA for the dramatic changes that will inevitably come, setting a more welcoming tone for secular people in recovery.

    • Garry U. says:

      Wow! I really appreciate your insights and lucid prose. Thank you posting.

    • Eddie S. says:

      Thanks Andrew for your very cogent sharing as I found myself nodding and smiling along the way.

      While my original angst with the suffocating god dogma continues unabated after some 34 years, like you it’s where I grew up. And where it’s one for all has a nice ring to it.

      I also might add that after listening to thousands of stories over these years scientific information(facts) has seldom been mentioned except with a statement that it had been ignored.

    • Dan K says:

      This is excellent Andrew.”The essential vehicle for the cognitive is the social..a larger community is essential” Although,I stayed drunk because I was physically addicted to alcohol and got sober after my last detox because I didn’t want to check out just yet.

  12. life-j says:

    Roger, thanks for posting this well written article. It is important that we promote the various new secular programs, just to help relieve the stranglehold AA has on recovery.

    As for SMART recovery – the name gives me the creeps enough to not want to associate myself with it, which is a shame. Maybe one day I’ll get over it, and embrace it, along with Facebook, I-phones, television, x-factor, Disney and all the other things that give me the creeps.

    I did read a smart recovery book a while back, and I came away feeling that the program is almost too structured – based on scientific principles which is good, as opposed to being structured on a basis of religious nonsense like AA is – but a bit too structured nonetheless. Of course there are people who appreciate that structure, and maybe even need it. Myself I have always rebelled against it, which may of course be a hangup of mine.
    LifeRing seems a bit more open in its approach. More Californian, I guess. That’s me.

    Anyway, the more ways to recover, the better.

  13. John L. says:

    I’ve never attended a Smart Recovery meeting. There are only a couple in the Boston area, whereas there are hundreds of AA meetings. That’s a big plus for AA.

    Although the mainstream media and even AA literature describe AA as a “12-step program” and as being “spiritual”, for me it is not. The True AA, as I see it — the AA that works — is based on the twin pillars of the 24-Hour Program and the Fellowship. A day at a time we stay away from the First Drink. We share experience, strength and hope to help each other stay sober and lead good lives in sobriety.

    The author writes: “SMART Recovery is based on a combination of three relatively contemporary scientific methodologies: Motivational Enhancement Therapy (MET), Cognitive Behavior Therapy (CBT), and Rational Emotive Behavior Therapy (REBT).” I disagree. These three forms of therapy are far from “scientific”. Maybe they help, maybe they harm, but they are not scientific.

    The author raises the issue of “cross-talk”, which has changed radically since I came into AA 49 years ago. Back then, “cross-talk” meant interrupting someone or speaking out-of-turn or when not called on. One person was supposed to speak at a time. It was never forbidden to comment on what someone else had shared. For example, if a newcomer is upset because he or she had had a dream about drinking, then those with more sobriety can explain that almost all of us have had such dreams, which may even be a sign or recovery.

    For me, Smart Recovery is tainted with the therapy approach, the misguided belief that alcoholism is a psychological problem. The best refutation to this “psychogenic” approach is *Under The Influence* by James R. Milam, which may be the best book ever written on alcoholism. Alcoholism is largely, if not entirely, a physical addiction to the drug, ethyl alcohol.

    If Smart Recovery works for some alcoholics, fine. But for now I’ll stick with AA — which we should defend when it is right as well as criticise when it is wrong.

  14. Thomas B. says:

    Indeed, a most effective, well-balanced article that compares and contrasts Smart Recovery and 12-step recovery without lording or bashing one over the other. Thanks Roger . . .

    It strikes me that many of the secular AA meetings I’ve attended combine the more scientific approach of Smart Recovery within the language and traditions of 12-step meetings, so that recovery becomes enhanced, not either/or but both/and.

  15. Pat N. says:

    Well-done article. I got to attend several SMART meetings in Victoria, B.C. this year, and found the same warm, welcoming atmosphere as AA, which will always be my sobriety home, especially the secular subculture.

    I can’t remember if AAagnostica or Beyond Belief has ever published a similar description of LifeRing, which I also attended in Victoria and which was equally powerful. The main differences between AA and these two are their reliance on a leader to guide discussion and a different set of core vocabulary and literature. They share the same healthy secularism of my agnostic home group.

    An article on Women For Sobriety would be good as well. Whatever works.

    Thanks for posting this, Roger.

  16. Steve V. says:

    Terrific article and I read it when it was originally published in The Fix. I really hope that SMART Recovery becomes more widely available especially here in Canada so that people have another option besides the 12 Steps. I like how the author doesn’t bash the 12 Step movement but points out that since it does seem to have a low success rate (most approaches do) that there’s room for other approaches that might work for people. Particularly for people who have tried 12 Steps many times without success. All too often the person who doesn’t succeed in AA/CA/NA is blamed for that – “they weren’t willing enough”, “they didn’t pray enough” etc. and if that person doesn’t have other options, they end up feeling like a complete failure and in some instances (maybe many?) give up trying altogether.

    • Dan K says:

      Enjoyed reading this and thanks for posting Roger. There is an article on the current Humanist homepage discussing SMART, it’s founder, it’s rationale and a request for paid facilitators to implement weekly online programs. Wasn’t clear if they were receiving NIH funding. Regardless, I replied that after decades of drinking in isolation a weekly ninety minute course wasn’t going to cut it. I needed to be part of a sober community of my peers in a democratic/pluralistic fellowship where I’m free to express (share) what works for me. Whether you choose to call it CGT, CBT or REBT or human power (imagination/placebo) it’s all good if it supports long term sobriety. Science or alcoholism for that matter doesn’t care what you think/believe. My success is a direct result of the empathy and compassion received by sustained participation and the human connection achieved by becoming a regular in the herd.

      We all have a moral obligation (higher purpose) to help each other. Perhaps these additional tools (modalities) would make that easier for this secular alcoholic in Tallahassee. Thanks again.

Translate »