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"We are what we repeatedly do. Excellence, then, is not an act, but a habit."

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"We are what we repeatedly do. Excellence, then, is not an act, but a habit."

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– Aristotle

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Use motivational interviewing to strengthen goals.

Incorporate DBT distress tolerance skills for managing cravings and relational conflict.

Normalize relapse risk as part of recovery, not failure.

Encourage integration of meetings or a sober network outside of therapy.

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Drug & Alcohol Counselling - Rehabilitation Services | SMART Recovery

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SMART Recovery (Self-Management and Recovery Training)

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SMART Recovery (Self-Management and Recovery Training)

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Purpose:

1. Build and maintain motivation

2. Cope with urges and cravings

3. Manage thoughts, feelings and behaviors

4. Live a balanced life

SMART is an evidence-based self-help group that emphasizes self-empowerment and the use of cognitive-behavioral strategies.

Unlike 12-step programs, SMART Recovery is grounded in science rather than spirituality, offering clients tools to manage thoughts, emotions, and behaviors related to substance use.

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Drug & Alcohol Counselling - Rehabilitation Services | SMART Recovery Australia

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SMART Recovery is the leading evidence-based addiction recovery program. Join a free meeting today and begin experiencing a Life Beyond Addiction.

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Provides practical Rational Emotive Behavioral Therapy (REBT) and Cognitive Behavioral Therapy (CBT) tools that align with evidence-based therapy models.

Flexible and inclusive for individuals who may feel disconnected from spiritually oriented groups like AA.

Encourages personal responsibility and skill-building, which can support long-term relapse prevention.

Can be integrated into treatment plans, reinforcing skills taught in therapy sessions.

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Less widespread than AA, leading to fewer local in-person meetings in some communities.

Online meetings are available, but clients without reliable internet access may be excluded.

Some clients may prefer the sense of tradition, spirituality, and community found in 12-step models.

Limited research compared to the long history of AA, though evidence is growing.

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Hays Model:

Age: 57

Disabilities: Possible Cognitive Delay

Religion: Non religious

Ethnicity/Race: White/Irish/Italian

Economic Status: Upper Middle Class

Sexual Orientation: Heterosexual

Indigenous Heritage: N/A

National Origin: US Born

Gender: Male

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The patient is a 57-year-old male who was referred for outpatient treatment following discharge from an inpatient hospitalization for alcohol detoxification. He presents with a long-standing history of alcohol dependence and symptoms consistent with Major Depressive Disorder (MDD), including depressed mood, anhedonia, low energy, and feelings of hopelessness. His alcohol use has contributed to significant functional impairment, including health complications, social isolation, and disruptions in daily responsibilities. The client reports using alcohol as a coping mechanism for emotional distress, which has exacerbated his depressive symptoms.

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Alcohol use worsens depressive symptoms, while depression fuels cravings and relapse risk.

Patient has not been honest and lacks vulnerability throughout treatment.

Reliance on alcohol as a maladaptive way of coping with isolation.

Patient is a “Planning” user

Strained relationships and social isolation.

Stress, isolation, family and depressive episodes increase likelihood of relapse.

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R is a 57-year-old male with alcohol dependence and Major Depressive Disorder. His alcohol use has caused health issues, social isolation, and relational distress, particularly with his wife. He uses alcohol to cope with emotional pain, which worsens his depression and anxiety. Randy fears losing his wife and son, which fuels avoidance behaviors and negative thinking. Despite these struggles, he demonstrates motivation for change, insight into his relational challenges, and a desire to rebuild trust. His strengths include treatment engagement, self-awareness, and willingness to practice new skills. A DBT framework is helpful for addressing his emotion regulation, distress tolerance, and interpersonal difficulties.

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The patient was referred to outpatient mental health and substance use treatment following discharge from an inpatient hospitalization for alcohol detoxification.

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The patient lives with his wife and son. The home is stable, but his relationship with his wife is strained due to the impact of multiple relapses. He receives emotional support from his two adult sons who live independently and remain involved in his recovery.

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Learn About SMART Recovery - SMART Recovery

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Learn about SMART Recovery with these videos and slideshows. Learn what to expect at meetings, how SMART Recovery works, and get started with the ABC and CBA tools from the SMART Recovery Toolbox. Check out the SMART Recovery ABOUT video (below). What to Expect at a SMART Recovery Meeting Lorie…

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Working on R’s case reminded me that recovery is not only about substance use but also about rebuilding relationships and trust.

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The importance of offering multiple support options (like SMART Recovery) to meet clients where they are, especially when spiritual or traditional models feel misaligned.

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This case highlighted for me that external motivation is important and often comes from relationships. R's love for his family is his biggest driver for change, which makes it vital to incorporate family into the treatment process.

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Working with R deepened my understanding of the stigma men often face in expressing emotions. It reminded me as a future counselor to create safe, validating spaces where clients feel free to be vulnerable.

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Substance Abuse and Mental Health Services Administration.

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NIDA.NIH.GOV | National Institute on Drug Abuse (NIDA)

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NIDA's mission is to advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health. NIDA is one of the National Institutes of Health.

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For Counselors & Continuing Education

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NAADAC represents the interests of 100,000 addiction professionals across the U.S.

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Steve Kind’s alcohol use started in high school and progressed to a real problem over the years. After several attempts at treatment programs, he met a counselor who knew about SMART and suggested he look into the program.

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R is a white, middle-aged male, and has beliefs that shape how he views treatment, emotions, and help-seeking.

R is self sustainable, has a steady income and is self employed.

Anxiety about failing treatment can keep clients from fully engaging.

Difficulty acknowledging the severity of alcohol use or mental health struggles.

Stigma around male vulnerability may limit his willingness to openly engage in groups.

SMART Recovery’s skills-based model may be more culturally inclusive for those who do not identify with the religious language of AA.

Counselors must remain aware of how cultural background, socioeconomic factors, and access to care impact recovery pathways.

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— René Descartes

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“I have come to believe that caring for myself is not self-indulgent. Caring for myself is an act of survival.”

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“I have come to believe that caring for myself is not self-indulgent. Caring for myself is an act of survival.”

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– Audre Lorde

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SMART Recovery works in real life, helps many people who stay involved, and can be used along with other kinds of support.

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✉Correspondence to Professor John F Kelly; jkelly11mgh.harvard.edu ✉Corresponding author.

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An investigation of SMART Recovery: protocol for a longitudinal cohort study of individuals making a new recovery attempt from alcohol use disorder

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Alcohol use disorder (AUD) remains one of the most pervasive of all psychiatric illnesses conferring a massive health and economic burden. In addition to professional treatments to address AUD, mutual-help organisations such as Alcoholics Anonymous…