SMART – The Therapist’s Bind

SMART – The Therapist’s Bind

SMART – The Therapist’s Bind Since its inception, AToN has integrated components of SMART Recovery into its curriculum. As the acronym suggest, SMART promotes autonomy in recovery. An alternative to Step work, the Self-Management and Recovery Training model is commonly referred to as the self-empowering approach. Fundamentally, SMART aims to enhance self-control. It promotes the idea of change and concludes, with a degree of controversy, that recovery is not necessarily a lifelong struggle.

While the format of the SMART approach often relies on Cognitive Behavioral Therapy, its philosophy is grounded in a humanistic, Rogerian ethos. True to that philosophy and its emphasis on self-development, SMART champions choice as arguably the quintessential experience that sustains recovery. Much akin to Motivational Interviewing, SMART stresses that those in early recovery must experience a voice. They must be able choose who and what is a part of their recovery – for better or for worse. Choice, it is argued, enhances a person’s motivation to change.

Therapists often struggle with that philosophy, especially when a person new to recovery believes that he or she can moderate using and/or drinking. It’s quite a bind to be in clinically. Do I agree to a treatment plan that incorporates moderation, for the sake of anchoring rapport and accenting someone’s change-talk, all the while ignoring the research that plainly proves that moderation is harder to achieve than abstinence?

Or, do I confront the person and preach abstinence, with the risk of amplifying his or her ambivalence over any change at all? Most SMART-oriented clinicians will explain the risks inherent in moderation, and advocate for a period of abstinence over a 3-6 month period prior to any attempts at moderate drink or use. And, most SMART-oriented clinicians will also explain that, if someone’s addictive behavior has progressed to the point that he or she needs residential care to stop, then moderation is not likely to work. Ultimately, though, a SMART clinician must yield to the client’s choice, and build on any degree of motivation to change.

For more information about SMART recovery programs contact AToN Center or take the tour 888-535-1516

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