Self Treatment for Alcohol and Drug Addiction?

Posted on December 20, 2011

Q&A with Tom Horvath, Ph,D.

Q: Hi, Tom. Thanks so much for talking with us today about the SMART Recovery Program. Perhaps you can start out by giving us a general overview of the SMART Recovery program? Something like a 1 minute “elevator pitch” for someone who is looking for help for possible addiction issues. What will someone who is new to SMART Recovery get out of the program?

A: SMART Recovery has a self-empowering approach to recovery. This approach is ideal for individuals who look at the future and think, “whatever happens, I’m going to do my best to make it work for me.” This self-empowering approach contrasts with the powerlessness or acceptance approach of the 12-steps. I suggest to people that they consider the Serenity Prayer: “God grant me serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.” Of course we all need serenity, and courage, not to mention wisdom! But some individuals, looking forward, imagine they’ll use courage, more than serenity. SMART Recovery works best for individuals who emphasize courage.

Q: What do people who start SMART Recovery have in common?

A: This courage approach to recovery translates into a desire to get engaged in the 4 Points of SMART Recovery. SMART Recovery participants really want to learn about how to maintain their motivation, cope with craving, manage their thoughts, feelings and behaviors, and live a balanced life.

Q: Although anyone who applies SMART recovery techniques to stay sober CAN stay sober, what types of personal qualities make program success more possible?

A: Any recovery program requires persistence. In SMART Recovery, being able to think for yourself is also a big advantage. We teach principles of recovery and self-management, but the application of these principles in a particular person’s life requires judgment.

Q: Do you track the success of SMART? How many people who join are sober 1 year later? 5 years? 10 years? What are the obstacles for tracking abstinence? If you don’t track success, can you start?

A: Tracking recovery time is not a part of our program. We don’t give awards, for instance, when you hit 30 days, 90 days, or a year. However, many participants do track it themselves, and we have no objection. The reality about recovery via support groups is that we know very little about it, and that reality includes AA and other support groups. You know who keeps showing up at the meetings, but you don’t know about anyone else. However, one difference with SMART Recovery is that we don’t assume that when someone stops attending meetings they have relapsed. Many individuals no longer need to attend meetings, so they stop. We encourage individuals to do what makes most sense for them. As to the specific answer to your question about how many are sober for 1 or more years, compared to how many started, no support group knows the answer. I’m confident that for all support groups, most of the people who show up once are not there later. We just don’t know a lot about what happens to them.

Q: Could SMART benefit from a mentoring model like sponsorship? Are there ways to put sponsorship, mentorship, or distance learning in place?

A: We do not have a sponsor system because we want everything about SMART Recovery to occur in public. We greatly reduce the chances that someone will get abused if all SMART Recovery activities are public. Individuals who want a sponsor might consider also attending AA and having a sponsor there, or seeing a psychotherapist. We have distance training in place for training meeting facilitators. Our online meetings could be considered a kind of distance training for participants.

Q: Can anyone be a facilitator of SMART meetings? Why do people volunteer to facilitate?

A: Being a facilitator is open to anyone, with or without a recovery history. Our volunteers have a range of motivations. Some want to strengthen their own recovery, or give back to SMART Recovery, or help the recovery movement because of a family member with addiction, or ensure that secular recovery options are available.

Q: SMART operates as a non-profit and that it operates on a shoe-string budget. If everyone were to donate money at a SMART meeting, how much would  one person need to donate at each meeting in order to help keep the organization afloat? In other words, what’s an “ideal” donation amount?

A: I have never calculated that amount! If every meeting that passes the hat in the US sent about $50 per month to the Central Office, the organization would be self-funding. Because there are often local expenses also, the meeting probably needs to collect about $100 per month. If there were 10 people each meeting, and each donated $2-3 per meeting, that would cover it.

Q: What’s your favorite thing about SMART?

A: I love all of our volunteers! SMART Recovery is filled with vibrant, energetic, creative and caring individuals! We have about 700 volunteers, and are growing daily.

Q: Will treatment centers start using SMART on the future?

A: SMART Recovery can be a useful adjunct to treatment. At our rehab we take residents to one or two SMART Recovery meetings per week. There are a few treatment facilities in the US that also send their clients to SMART Recovery. It remains to be seen whether addiction treatment facilities start offering multiple tracks (SMART Recovery and 12 step and perhaps other tracks) or whether the SMART Recovery oriented track will be offered primarily by new facilities that open specifically to do so.

Q: What would you say to people in 12 step programs who critique the method?

A: There are lots of reasons why someone might not resonate with SMART Recovery, just as there are other reasons why someone might not resonate with 12 step, or other approaches. Individuals seeking recovery should be informed about their options, and then make choices based on their own experience. What someone else thinks about a particular recovery approach is irrelevant if the individual has chosen it and it’s working well.

Q: Any last thoughts that you’d like to share with us?

A: I look forward to the day when everyone associated with recovery understands and states that there are as many paths to recovery as there are individuals.


Tom Horvath, Ph.D., is a California licensed and board certified (ABPP) clinical psychologist. He is the founder and president of Practical Recovery, a non 12-step self-empowering addiction treatment system in San Diego. He is past president of the American Psychological Association’s Society of Addiction Psychology (Division 50), the world’s largest organization of addiction psychologists. He is the author of Sex, Drugs, Gambling & Chocolate: A Workbook for Overcoming Addictions (listed by the Association for Behavioral and Cognitive Therapies as a “Self-Help Book of Merit”). He has been involved with SMART Recovery since 1990, and president for over a decade.


13 thoughts on “Self Treatment for Alcohol and Drug Addiction?

  1. Sandi G.

    38 years is a long way down the road of life. Remember, recovery is a journey, not merely a destination. As for me, I wont be able to accurately tally my success til the last breath has passed from my lips.

    The 12 steps were not enough for me. I sought out and learned many other steps/ tools to optimize my walk through the “other side of the jungle”. My hope for you in 2012 and beyond is that you continue to grow even more steadfast in your convictions, and not miss out on any opportunity to thrive as a fellow traveler. Alternative schools of thought can only enhance life in my ever so humble opinion.

  2. Heather

    Congratulations on your 38 years of sobriety using the AA method. That speaks well for both you and the support program you chose.
    Smart offers a different approach and is another fine option. I hope we are all on the same side of the equation, we want people to recover and go on to live fulfilling lives no matter which method they decide to use.

  3. Dean

    “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”

    -NIAAA’s 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions interviewed over 43,000 people. Using the criteria for alcohol dependence found in the DSM-IV

    I trust you had a very Merry and Happy Christmas Steve. The preponderance of evidence would strongly suggest that your personal testimony aside, that many, many folks recover and regain the life they wish to have sans AA. I would be one such indvidual. The tools I found and learned to use at SMART allowed me to exercise a degree of control over the choices I make that helped make that possible.

    Have a wonderous new year.

  4. Steve V.

    Your program is BS. I have been sober in AA and NA for 38 years and have NEVER seen anyone stay clean and sober using other programs. Talk is cheap show me your results.

    1. Admin Post author

      Hi Steve:

      38 years of sobriety is a magnificent achievement! I know you must be quite an inspiration to those in your recovery community. I am glad that you’ve found the support of AA and NA to be helpful for you as it has been and will continue to be for others.

      Many people who use SMART to support their recovery also use other programs including 12 step programs. Many others do not. We are open and accepting to all “paths to recovery” and acknowledge that no one program is going to be helpful for every single person who needs support.

      Wishing you continued growth in your recovery and a happy and healthy 2012.

    2. Jonathan von Breton

      Hi Steve,

      Congratulations on your 38 years. I have been alcohol and drug free for 28 years using SMART Recovery. I originally tried 12-Step programs because they were so readily available. I just plain didn’t like them. I’m glad they exist for those who do like them. I’m glad SMART exists for people like me who prefer that approach to recovery. Remember, what works for you may not work at all for someone else.

    3. Jim B.

      38 years is an AWESOME achievement, Steve! CONGRATULATIONS!

      While you most certainly may have “NEVER seen anyone stay clean and sober using other programs”, does that mean that it is so??? That it is a proven fact? That there aren’t any instances of long-term sobriety without the use of AA? This may be the view that you see in your corner of the world world, but if I may ask, how broad and far-reaching is that view? Does it reach to ALL corners of this earth? If this were so, you’d find that there ARE many, many instances of successful recovery that is not a result of AA.

      Again, 38 years is an AWESOME achievement! You most certainly found what “worked” for you. But I’m sure you’ll agree that people differ… what works for one may not for another. On the flip side, what doesn’t work for one might work for another. In this rather dated quote, C.W. Spalding once said:

      “People differ. Some object to the fan dancer, others to the fan.”

      But the concept within his words have withstood the test of time and remains true yet today…

      SMART Recovery® believes that each individual finds their own path to recovery, finding what “works” for them. I’m aware of many instances of our members using both SMART Recovery® and traditional 12-step programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). While our approach differs from 12-step programs, it does not exclude them… or any other recovery program. Some of our participants choose to attend AA, NA or other meetings when they cannot attend a SMART Recovery® meeting, finding what they hear at those meetings to be helpful to them on their own path to recovery.

      Regardless of any differences in approaches, we are all in this together and we share the same worthy goal… helping people overcome their addiction. I’m also sure that we can agree that successful recovery requires making good choices. The right method and approach for making those “good choices” are as varied and different as the individuals who are making them. Research shows that people who are allowed to choose their recovery method are more successful than those who are required to use a particular method, no matter which it might be.

      SMART Recovery® fully supports CHOICE in recovery, as is reflected in our slogan, “Discover the Power of Choice”.

    4. Robert S.

      Hi Steve,

      I have been sober now for 4 years and 3 months. I tried AA for 6 months. AA is fine but personally I needed the tools, and the fourpoint program SMART offers. I am glad AA has worked for you. Congrats on your 38 years.


    5. John

      Steve V.

      I have attended and chaired many an AA mtg and don’t remember the message ever being about non-acceptance or condemnation of others. Maybe over the next 38 yrs you can concentrate on not developing resentments. There are tools here at SMART for just such self development.

      May you find serenity and a much more productive outlet for your energy.

    6. David P.

      Good work, Steve. You have to your credit decades of sobriety and a few days of bringing out reasoned responses to your terse dismissal of SMART. AA works well for you and for many others, and poorly for just about the same number. Probably ditto SMART and other recovery programs. Many people recover without any help from programs. You’ve never seen anyone stay sober outside of AA. You must live full time in AA meetings. Out in this part of the world there are lots of folks doing well in a variety of programs, yours included.

    7. Iain R.

      Hi Steve,
      Well done 38 years is great.
      I have been sober for 4 years 2 months and 1 week.I have never used AA.
      WHY ???
      I don’t know why !!!! I did an internet search for help with alcohol SMART RECOVERY came up and I have never looked back.
      AA has obviously worked for you …why Knock and want proof that other programs work……Accept that there are other ways to recovery other than AA..the same way there are other routes to the grocery store rather than going the same way as everyone else .
      once again congrats on 38 years you are an inspiration to everyone in recovery.

    8. Joel B

      Congratulations on your 38 years. I would hope after all this time sober, your attitude would be a bit more compassionate and open-minded towards the plight of the millions of people, like me, for whom AA/12-step did not prove to be the answer.

      Do you actually believe nobody can or has ever stayed sober without AA? Not a single person? I could introduce you to some myself, including a family member with 30+ happy and productive years sober, a successful family and business man, who started with AA then decided it was no longer for him and went about his life.

      If you want actual scientific studies, which are more reliable than anecdotal evidence, apparently only 5% of people who attend AA are still there after one year. My own experience confirms this, and I am sure yours does too. Most newcomers do not stick around.

      According to this study referred by the National Institute of Health, people attending conventional AA meetings did worse than people who received no treatment at all:

      From a very intelligent and thorough Wired Magazine article:
      “A 1999 meta-analysis of 21 existing studies, for example, concluded that AA members actually fared worse than drinkers who received no treatment at all. The authors acknowledged, however, that many of the subjects were coerced into attending AA by court order.”

      AA may help some, but there is a “survivor bias.” You do not see the majority of people for whom AA did not work at meetings, because they no longer go to meetings.

      I still attend AA occasionally, primarily because there are plenty of progressive, open-minded, not-overly-dogmatic meetings here in New York City, but I personally would not attend a rigid orthodox “by-the-book” meeting if that were the only option. We even have Agnostic/ Atheist/ Humanist AA meetings here in New York, with members who have been happily sober as long as your 38 years.

      The Spiritual/Religious aspect of AA works for some, though not for the majority of sufferers. The Rational emphasis of SMART recovery works for others.

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