SMART Recovery

1. Introduction

Version followed: SMART Recovery (USA) 4-Point Program as set out in the SMART Recovery Participant Handbook, 4th edition, and its 2025 facilitator guides (tool numbering 2.1–6.6). I note where older names (DEADS, DISARM, DIBS, Lifestyle Balance Pie, VACI, Urge Log, Three Questions) or other national versions (UK, Australia) differ. [source: Handbook V4 What's New; FG Tool Quick Reference Guide]

What it is. SMART Recovery (Self-Management and Recovery Training) is a free mutual-aid and self-management programme for any addictive behaviour, with a separate strand for family and friends. Addiction psychologists founded it in 1994. Its weekly groups (in person and online) are run by trained volunteer facilitators. The organisation's own opening statement says it is peer support, not professional therapy. A clinician does not "deliver SMART" as a treatment. You can do three things with it: (a) refer clients to meetings and work alongside them, (b) train and register as a facilitator and run a SMART meeting (for example in a treatment service), or (c) use the published SMART tools inside your own individual or group work. This guide is written for all three roles. [source: Montgomery County SMART Recovery Overview; SMART Meeting Opening and Closing; SMART 4-Point Training page]

Core idea of change. People change by building and keeping their own motivation, learning to ride out urges, changing the self-defeating beliefs that drive emotions and behaviour, and building a balanced life that makes the addictive behaviour less needed. The methods come from motivational enhancement (non-confrontational, client-generated reasons for change), CBT, and Albert Ellis's REBT (rigid demands, catastrophising and low frustration tolerance drive distress, and addictive behaviour is often a way to escape that discomfort). Change is framed as the person's own responsibility and within their control. [source: Montgomery County Overview; SMART Meeting Opening and Closing; OCA Fall Conference 2025 slides]

2. Framework

Not a stepwise programme. The four points are a set of skill areas you visit in whatever order the person needs, not sequential steps. SMART has no steps, day counts or sponsors. [source: Montgomery County Overview; OCA 2025 slides]

Point	Goal	Handbook v4 tools (number)
Foundations (chapter 2) [inferred]	Self-reflection and a kind stance toward oneself	Journaling (2.1), Practise self-compassion (2.2)
1. Building and maintaining motivation	Keep the wish to change alive after the crisis passes. Weigh costs and benefits. Clarify values.	CBA (3.1), Define your values (3.2), Five questions (3.3), Create a change plan (3.4)
2. Coping with urges	Recognise the trigger → craving → urge chain and ride urges out without acting	Identify triggers (4.1), Rank trigger risks (4.2), Log your urges (4.3), Plan your week (4.4), DENTS (4.5), Personify and disarm (4.6)
3. Managing thoughts, feelings and behaviours	Spot unhelpful beliefs, accept oneself, separate person from behaviour, treat lapses as setbacks, not failure	Dispute unhelpful beliefs (5.1), ABC (5.2), Problem solving (5.3), Planning positive conversations / PIVA (5.4), Healthy boundaries (5.5)
4. Living a balanced life	Rebuild physical, mental and emotional health. Fill the time the behaviour took with absorbing pursuits and goals.	Lifestyle balance wheel (6.1), New passions and pursuits (6.2), Effective goal (6.3), Meditation (6.4), PMR (6.5), Relaxing space visualisation (6.6)

[source: Montgomery County Overview for point content; 4-Point facilitator guides page and FG Quick Reference for tool numbers. Mapping each numbered chapter to a point is my inference from matching content. [uncertain]]

Stages of change as the organising lens. SMART uses Prochaska and DiClemente's stages: precontemplation (often there under pressure from a partner, employer or court; blames outside causes), contemplation (admits a problem, may delay), preparation (plans, still ambivalent), action (visible change, most effort), and maintenance (keeping the change going; without commitment, relapse usually goes back to pre-contemplation or contemplation). SMART US says most self-changers go round the cycle three or four times before succeeding without a slip, and it treats slips as learning. A 2025 SMART presentation adds "graduation/exit": leaving the programme after sustained change. The FG Quick Reference marks each tool for the stages where it helps. Which column each mark falls in is [uncertain]. [source: The Stages of Change (smartrecovery.org); OCA 2025 slides; FG Tool Quick Reference [uncertain on per-tool stage marks]]

Format and dose.

Meetings are weekly and free (donations invited), 60 or 90 minutes long, in person or online. The UK structure runs: optional 30-minute pre-meeting → welcome/opening (5 min) → check-in (5–20 min) → agenda setting (5 min) → group discussion and tool work (45–60 min) → check-out (5–15 min) → closing comments (1–2 min) → optional social time. [source: SMART Recovery UK meeting structure]
There is no fixed number of sessions. People attend for as long as useful and may "graduate". [source: OCA 2025 slides]
Separate Family & Friends meetings use a CRAFT-based approach. [source: Montgomery County Overview]

Moving between points or stages. SMART publishes no formal criteria. Its guidance is functional: move forward by resolving ambivalence before acting, shifting focus to the future, and committing to maintenance. [source: The Stages of Change] Working rules for a clinician [synthesis]:

Point 1 work when ambivalence is high (change-talk and sustain-talk are evenly matched; or the client is "here because of the court").
Point 2 when the client has decided and urges are the main threat.
Point 3 when emotion-driven lapses, shame or relationship conflict drive the behaviour.
Point 4 once urges are manageable and boredom, isolation or emptiness is the risk.
Go back to Point 1 after any lapse or when commitment fades.

Facilitator training and permissions. Running a meeting under the SMART name requires SMART facilitator training:

4-Point Training is online and self-paced, about 10 hours. It costs $199, carries 10 NAADAC CEs, includes a PDF facilitator manual and offers optional live Zoom sessions. It covers the 4-Point tools, meeting structure, basic MI and inclusive group facilitation.
A separate Family & Friends facilitator course exists.
After training you attend meetings, then start your own or co-facilitate, and receive ongoing facilitator support.
Facilitators do not need to be in recovery.
A 2025 SMART slide deck gives about 28 hours of self-paced study plus two live sessions (role plays; Q&A). The two figures conflict. [uncertain]
Meeting registration steps are [uncertain]. Ask support@smartrecovery.org. [uncertain]

[source: Path to become a facilitator; 4-Point Training course page; OCA 2025 slides]

3. Guiding principles

Self-empowerment. The person chooses goals and methods and owns the recovery. → Ask, don't prescribe. The client sets the goal (abstinence or reduction) and picks which tools to try. [source: Montgomery County Overview; Opening and Closing]
Peer support, not therapy. → In a SMART meeting, do not do individual therapy in front of the group. Keep clinical work for sessions. [source: Opening and Closing]
Broad-based. Any substance or activity counts, and members may add therapy, medication or other groups. → Never suggest a client must choose between SMART and twelve-step, therapy or prescribed medication. [source: Montgomery County Overview; OCA 2025]
Abstinence as a core option, harm reduction also valid (4th edition). Older meeting scripts centre on abstaining, while the 4th edition accepts harm reduction as a recovery path. → Name which goal the client is working toward and respect it. Local meetings may lean either way. [source: Handbook V4 What's New; Opening and Closing (2021)] [uncertain: practice varies by meeting]
Science-based and evolving (MET, CBT, REBT). → Use the current handbook version and tool names. [source: Montgomery County Overview; Handbook V4 What's New]
No labels, no Higher Power required. "Alcoholic" and "addict" are avoided. → Use person-first language and "addictive behaviour". [source: OCA 2025]
Ambivalence is normal. → Normalise both wanting and not wanting to change before trying to tip the balance. [source: FG Cost-Benefit Analysis]
Urges are temporary (they usually fade within 10–20 minutes) and are chances to learn. → Teach riding out and delaying, not fighting or obeying. [source: FG Customize DENTS; Montgomery County Overview]
Rate behaviours, not people. Unconditional acceptance of self and others. → Challenge global self-ratings ("I'm worthless") while still evaluating the act. [source: OCA 2025; Montgomery County Overview]
Lapses are setbacks, not failure, and are discussed openly. → Invite lapse analysis without shaming. Watch for complacency in maintenance. [source: Montgomery County Overview; Opening and Closing]
Participant-driven, non-judgemental facilitation. → Reflect, ask guiding questions and let the group generate strategies. Do not rush to fixes. Redirect avoidance toward active coping. [source: FG Customize DENTS]
Meeting norms. Respect, honesty and understanding. Anything important to one member matters to the group. Cross-talk is allowed after check-in, but long monologues are discouraged. Newcomers may just listen, and anyone may pass. Who attended and what they said is confidential, though tools learned can be shared. → Enforce these norms gently and consistently. [source: Opening and Closing; Montgomery County Overview]
Intoxicated attendees may observe but are asked to share another time. → Have a calm, prepared line for this. [source: Opening and Closing]
Inclusive and diverse. Harassment is not tolerated. → Intervene at once on harassment, including unwanted private messages online. [source: Montgomery County Overview; Opening and Closing]

4. Intervention inventory

How to read this section:

Each tool has a participant worksheet and a facilitator guide (FG), downloadable by facilitators from SMART's VolunteerHQ. Worksheets are fillable PDFs, so you can screen-share and complete them live on Zoom. Journaling, PMR and Relaxing-space visualisation are discussion-only, with no handout. [source: 4-Point facilitator guides and handouts]
The full facilitator content is drawn on for CBA, DENTS and ABC. For the other tools only SMART's own short descriptions are drawn on. Their steps are marked [synthesis]: my own way of running the tool as described, not SMART's FG wording. Download the FG before running those tools in a SMART meeting.
All example language is illustrative.

A. Clinician-level procedures (referral and working alongside)

A1. Assessing fit and referring [synthesis]

Purpose: Match the client to SMART, twelve-step, other mutual aid or none.
Steps:
1. Ask what the client wants from a group: skills or fellowship, abstinence or reduction, spiritual framing or not, label or no label.
2. Explain SMART's features: no steps, sponsor or Higher Power; cross-talk allowed; any addictive behaviour; medication and therapy welcome; online meetings available.
3. Help the client pick a meeting with SMART's meeting finder and plan the first attendance (date, in person or online, what will happen).
4. Describe the format so nothing surprises them: check-in, agenda, discussion, check-out. They may pass and just listen.
5. Agree that you will review the meeting together at the next session.
Example language (illustrative): "It's a skills-based group. You can just listen the first time. They'll go round and ask how your week was, and 'pass' is a fine answer."
Watch for: Court-mandated clients may need attendance verification, which SMART offers. Clients who strongly want a spiritual fellowship or a sponsor may fit twelve-step better. Clients with acute withdrawal risk, active psychosis or high suicide risk need clinical care first. A meeting is an adjunct, not a substitute.

A2. Using meetings and tools inside therapy [synthesis]

Purpose: Turn meeting learning into therapy material and the reverse.
Steps:
1. At each session, ask which tool came up at the meeting and what the client took from it.
2. Complete or refine the client's worksheet together, with the same tool name and version as the group, so the language matches.
3. Set one tool as between-session practice.
4. Bring the results to the next meeting's check-in.
Watch for: Different handbook editions in use, so check tool names (e.g. DEADS vs DENTS). Clients may feel watched, so ask permission before reviewing what they shared in the group. Never contact the group or facilitator about a client without consent.

B. Meeting-level procedures (for a trained facilitator)

B1. Opening statement and ground rules

Purpose: Set expectations and safety.
Steps:
1. Welcome everyone.
2. State that SMART is volunteer peer support, not therapy, and open to anyone.
3. Say that attendees may participate or just observe.
4. Name the focus: self-directed change, with skills for motivation, urges, problem solving and life balance.
5. Give the ground rules: respect, honesty and understanding; stay on topic; lapses are welcome topics; cross-talk only after check-in; anyone who has been using observes and shares another time; confidentiality about who said what; report unwanted private messages (online).
Example language (illustrative): "What's said here stays here, but the tools you learn are yours to take anywhere."
Watch for: Newcomers who look anxious. Remind them they can pass. [source: SMART Meeting Opening and Closing; UK meeting structure]

B2. Check-in

Purpose: Hear how each person is and gather possible agenda items.
Steps:
1. Go round the group. Each person says how they are doing, plus any success, issue, question or concern they want to discuss.
2. Allow passes.
3. Hold cross-talk until check-in is complete.
4. Note agenda candidates as you go.
Example language (illustrative): "How has your week been, and is there anything you'd like the group's help with tonight?"
Watch for:
- Check-ins that become long monologues: summarise them and park the content for the agenda.
- Lapse disclosures: thank the person and offer an agenda slot.

[source: Opening and Closing; UK meeting structure (5–20 min)]

B3. Agenda setting and group discussion with tool work

Purpose: Turn the issues raised into skill practice.
Steps:
1. Choose one to three issues from check-in (about 5 min).
2. For each issue, choose a fitting tool from the inventory below.
3. Use a volunteer's real example or a scenario, and let the group generate ideas. Use guiding questions rather than advice.
4. Close each item by asking what the person will try. (45–60 min in total.)
Example language (illustrative): "Sam's described a Friday-night urge. Shall we run that through DENTS together?"
Watch for: One member dominating. Advice-giving that turns into prescription. Drift away from the skills focus. [source: UK meeting structure; FG Customize DENTS (participant-driven, reflect rather than prescribe)]

B4. Check-out and close

Purpose: Consolidate learning and commitment.
Steps:
1. Go round once more. Each person names what they are taking away and one thing they will practise this week.
2. Make brief closing comments, mention donations, and invite members to stay for social time.
Example language (illustrative): "One thing you're taking from tonight, and one small step for this week?"
Watch for: Vague commitments. Help the person make them specific. [source: UK meeting structure (check-out 5–15 min); Opening and Closing] Note: the 2021 online script has no check-out questions, while the UK structure includes a check-out. The check-out questions above are my wording. [synthesis]

C. Foundations

2.1 Journaling (discussion-only)

Purpose: Regular self-reflection on urges, feelings and progress. SMART marks it useful at all five stages. [source: FG Quick Reference; 4-Point facilitator guides page]
Steps [synthesis]:
1. Agree a brief daily or after-event entry: what happened, thoughts, feelings, what I did, what I learned.
2. Review entries for patterns at the next session or meeting.
Example language (illustrative): "Five lines a night is enough. We're looking for patterns, not essays."
Watch for: Rumination or self-attack in entries. Pair journaling with self-compassion (2.2).

2.2 Practise self-compassion

Purpose: Respond to shame, guilt and frustration with care instead of judgement. It is new in the 4th edition and marked for all stages. [source: Participant tools page; Handbook V4 What's New; FG Quick Reference]
Steps [synthesis]:
1. Name the painful feeling and its trigger, such as a lapse.
2. Note that others struggle in the same way.
3. Write what you would say to a friend in the same position, then say it to yourself.
4. Choose one caring, constructive action.
Example language (illustrative): "If your best friend had slipped on Saturday, what would you say to them? Can you try saying that to yourself?"
Watch for:
- Self-compassion heard as "letting myself off the hook": link it to REBT's distinction between rating the act and rating the person.
- Signs it's working: less shame-driven hiding of lapses, and quicker return to plans.

D. Point 1: Building and maintaining motivation

3.1 Cost Benefit Analysis (CBA)

Purpose and when: Use it when the person is torn between changing and not changing, especially when immediate rewards hide long-term costs. It assumes the behaviour meets some need and checks whether its benefits still outweigh its costs. [source: FG Cost-Benefit Analysis]
Steps:
1. The person names the behaviour and dates the sheet.
2. Draw four boxes: benefits of doing it, costs of doing it, benefits of not doing it, costs of not doing it.
3. Offer starter examples (the handbook has guiding questions).
4. Fill each box.
5. Star the long-term items.
6. Discuss where short-term satisfaction undermines future goals. [source: FG Cost-Benefit Analysis]
7. Re-do the CBA when motivation dips or after a lapse, and compare it with the dated earlier version. [synthesis]
Debrief questions (paraphrased from the FG): Do the benefits still outweigh the costs? Which starred items matter most for the future you want? What do you gain and lose by not changing? Which costs of continuing feel most pressing?
Example language (illustrative): "Let's be honest about what drinking does for you first. It's doing a job, or you wouldn't do it."
Watch for:
- Skipping the benefits of using: this makes the exercise feel like a lecture and lowers its validity. Normalise ambivalence.
- Signs it's working: the person spontaneously cites starred long-term costs, and change-talk increases. [source: FG CBA tips; synthesis for indicators]

3.2 Define your values (Hierarchy of Values)

Purpose: Write down and rank what matters most, then check behaviour against it. [source: Participant tools; Montgomery County Overview; OCA 2025]
Steps [synthesis]:
1. List what matters most, e.g. people, health, work, integrity, freedom.
2. Rank the top five.
3. For each value, rate how the addictive behaviour helps or hurts it.
4. Note the gap between ranked values and where time and money actually go.
5. Pick one action this week that serves a top value.
Example language (illustrative): "You ranked being a reliable dad second. Where does Saturday's drinking leave that?"
Watch for: Values imposed by others ("what I should value"): ask whose list it is. Shame when the gap shows: shift to self-compassion and next steps.

3.3 Five questions (formerly Three Questions)

Purpose: Get clear on how to get what you want. The questions cover what you want in the future, what you are doing now and how it feels, what else you could do, and how you would feel then. [source: Participant tools; Handbook V4 What's New]
Steps [synthesis]:
1. Ask each question area in order and write the answers in the person's own words.
2. End with the alternative action that fits their wants best, and a first step.
3. The exact wording and count of SMART's five questions is [uncertain]. Use the worksheet. [uncertain]
Example language (illustrative): "Picture a year from now going well. What are you doing differently?"
Watch for: Wants stated only as stopping something: also ask what they want to have or be.

3.4 Create a change plan

Purpose and when: Use it at preparation and action to set out the changes, reasons, steps and supports. [source: Participant tools]
Steps (fields as described in SMART materials):
1. The changes I want to make.
2. My most important reasons.
3. The steps I plan to take.
4. People who can help, and how.
5. How I'll know the plan is working.
6. What might get in the way.
7. Rate importance (0–10) and confidence (0–10). [source: Montgomery County Overview]
8. Explore the ratings MI-style: ask why the rating is not lower, and what would raise it by one point. [synthesis]
Example language (illustrative): "You gave confidence a 5. Why a 5 and not a 2? What would move it to a 6?"
Watch for:
- Plans that are too ambitious: shrink the steps until confidence is at least moderate.
- Missing obstacles or supports: these predict a stall.
- Review the plan when it isn't working. [synthesis]

E. Point 2: Coping with urges

4.1 Identify triggers

Purpose: List the people, places, emotions, times and situations that set off cravings and urges, along with healthy alternatives. SMART's model is a chain: trigger → craving → urge. [source: Montgomery County Overview]
Steps [synthesis]:
1. Brainstorm triggers in categories: social settings, emotions (stress, loneliness, boredom) and habits or routines (after meals, after work). These categories come from the DENTS FG.
2. Add internal triggers: thoughts, body states.
3. Beside each trigger, write one alternative response.
Example language (illustrative): "Walk me through the hour before the last three times you used. What was around you, and what were you feeling?"
Watch for: Lists that are only external. Probe emotional triggers.

4.2 Rank trigger risks (formerly Trigger Risk)

Purpose: Prioritise which triggers need planning first. [source: Handbook V4 What's New]
Steps [synthesis]:
1. Rate each trigger from 4.1 for how likely it is to lead to use.
2. Order the triggers by rating.
3. Plan avoid or cope strategies for the top three.
Example language (illustrative): "Which of these is most likely to tip you over this week?"
Watch for: Underrating "safe" triggers that were linked to past lapses. Check the ranking against the urge log.

4.3 Log your urges (formerly Urge Log)

Purpose: Record when and why urges occur and how you coped, to reveal patterns and better responses. [source: Participant tools; Montgomery County Overview]
Steps [synthesis]:
1. For each urge, record date and time, situation or trigger, intensity, duration, thoughts, what you did, and how it turned out.
2. Review the log weekly for repeating times, places and feelings.
3. Note which coping strategies cut duration or intensity.
Example language (illustrative): "Notice how long that urge actually lasted. You wrote 15 minutes."
Watch for:
- Non-completion: simplify the log to three fields, or use SMART's app.
- A sign it's working: the client sees urges peak and pass, matching SMART's claim that urges usually fade within 10–20 minutes. [source: FG Customize DENTS]

4.4 Plan your week (formerly Weekly Planner)

Purpose: Schedule activities that support balance and pre-plan for high-risk times. The OCA slides call this activity scheduling. [source: Handbook V4 What's New; OCA 2025]
Steps [synthesis]:
1. Block out the week.
2. Mark the high-risk times found in the urge log.
3. Place a planned activity or support in each high-risk slot.
4. Review the week: what happened in the planned slots compared with the unplanned ones.
Example language (illustrative): "Friday 6 to 9 is your danger zone. What's going in that slot this week?"
Watch for: Over-packed plans that collapse. Leave rest time.

4.5 Customise DENTS for you (formerly DEADS)

Purpose and when: Use it in the moment of an urge. It helps the person pause, assess and choose a response instead of reacting on autopilot. [source: FG Customize DENTS]
The letters (paraphrased):
- Deny/Delay: don't act now; wait, knowing urges subside.
- Escape: leave the triggering place, people or routine.
- Neutralise: use logic and observation to weaken the urge; treat it as a passing feeling, not an order.
- Tasks: absorb the mind in an activity.
- Swap: change your self-talk or switch to a different action to shift your mood.
- The older DEADS was Deny/Delay, Escape, Avoid (or accept), Distract, Substitute. [source: FG Customize DENTS; Montgomery County Overview]
Steps (group version, per the FG):
1. Introduce: urges are manageable and temporary, and the person can choose their response.
2. Brainstorm what makes urges hard (social, emotional, habitual triggers). Normalise, reflect, don't prescribe.
3. Teach each letter, each with a guiding question to the group (how do you delay; what could you step away from; when has logic helped; what tasks absorb you; what thought or action swaps have worked).
4. Practise: a volunteer shares a recent urge, or you give a scenario. The group works through each letter, then the volunteer rehearses the response as if the urge were happening now.
5. Close: urges pass and options exist. Each person commits to practising one letter this week.
6. One-to-one adaptation: build a personal DENTS card with one concrete option per letter. [synthesis]
Debrief questions (paraphrased from the FG): How did applying it feel? What obstacles might arise? What one small change will you make this week?
Example language (illustrative): "Your urge is at a 7. Can we delay 15 minutes, starting now? Where could you go, and what will you do with your hands?"
Watch for:
- "I just ignore urges": explore what happens when the urge is actively managed instead. The FG says to redirect avoidance-only answers toward active coping.
- Keep steps small and realistic.
- A sign it's working: urges acted on fall as a share of logged urges. [source: FG Customize DENTS; synthesis for indicator]

4.6 Personify and disarm (formerly DISARM)

Purpose: Treat the urge as separate from yourself, so it becomes concrete and easier to refuse. The original DISARM ("Destructive Images and Self-talk Awareness and Refusal Method") trains noticing the destructive images and self-talk that push toward use, then refusing them. [source: Participant tools; Montgomery County Overview; OCA 2025] The FG marks it for one stage only, likely action. [uncertain]
Steps [synthesis]:
1. Give the urge a name or character.
2. List its typical lines, the permission-giving self-talk ("just one", "you deserve it"), and its typical images.
3. Write a firm refusal and a counter-statement for each line.
4. Rehearse the refusal aloud, in session or with the group.
5. In the moment: label ("that's the urge talking"), refuse, then move to DENTS.
Example language (illustrative): "When 'the Gremlin' says you've earned a drink, what do you say back?"
Watch for:
- Clients who argue at length with the urge: the refusal should be brief and final, not a debate.
- For clients with psychotic symptoms or dissociation, personification may be confusing. Use plain thought-labelling instead. [synthesis]

F. Point 3: Managing thoughts, feelings and behaviours

5.1 Dispute unhelpful beliefs (formerly DIBS)

Purpose: Identify and challenge beliefs that fuel addictive behaviour. SMART contrasts four self-defeating patterns with their self-helping alternatives:
- rigid demands vs flexible preferences
- catastrophising vs accurate appraisal
- low vs high frustration tolerance
- conditional vs unconditional acceptance of self and others
[source: Participant tools; OCA 2025; Montgomery County Overview]
Steps [synthesis drawing on these REBT categories]:
1. Write the belief verbatim.
2. Classify it: demand, awfulising, "I can't stand it", or self- or other-damning.
3. Ask: is it true (evidence)? Is it logical (does a preference make it a must)? Is it helpful (where does it lead)?
4. Write a flexible, accurate alternative.
5. Repeat the alternative regularly. SMART says new beliefs are built through repetition.
Example language (illustrative): "Where's the evidence you can't stand this feeling? You've stood it for an hour already."
Watch for: Disputing in a hostile or debating tone. Keep it collaborative, and dispute the belief, not the person.

5.2 ABC exercise

Purpose and when: Use after an urge or upset, to see how a belief (not just the event) drives emotion and urge, and to replace it. Based on REBT and CBT. [source: ABC page (smartrecovery.org)]
Steps (paraphrased from SMART's page):
1. A (Activating event): what happened just before the urge, including stresses and triggers.
2. B (Beliefs): the automatic thoughts about self, situation or others. Watch for "must" and "should".
3. C (Consequences): emotional and physical reactions, the urge, and whether you acted on it.
4. D (Dispute): is the belief accurate? Is it helping? Is there another view? What would a supportive friend say?
5. E (Effective new belief): a balanced, useful thought; notice how you feel holding it; decide what you'd do differently.
6. Afterwards: which step helped most, how the urge changed, and where you'll use the tool this week.
SMART's worked example (paraphrased):
- A: public criticism from a boss.
- B: "this is unjust and I can't handle it".
- C: anger and a craving to drink.
- D: does he do this to everyone? Must life be fair? Can I get through this without a drink?
- E: he often blows up; it was unpleasant but it's over; drinking would cost more than it's worth.
Example language (illustrative): "Let's slow the tape down. What did you tell yourself between the meeting and the off-licence?"
Watch for:
- Clients who put feelings in B, or the event in C: re-sort them together.
- Practise on everyday events, not only crises. [source: ABC page tips]
- A sign it's working: the client starts catching the B in real time.

5.3 Practise problem solving (new in the 4th edition; earlier "Five Steps of Problem Solving")

Purpose: Work through problems rather than around them, e.g. by using. [source: Handbook V4 What's New; Montgomery County Overview]
Steps [synthesis; SMART's own five steps are not drawn on]:
1. Define the problem specifically.
2. Brainstorm options without judging them.
3. Weigh the pros and cons of the best few.
4. Choose one and plan it.
5. Act, then review.
Example language (illustrative): "Let's get every option on paper, even the silly ones, before we judge any."
Watch for: Jumping to the first solution. Problems that are really emotions to process: move those to ABC.

5.4 Planning positive conversations (PIVA)

Purpose: Prepare difficult conversations, e.g. with family or employers, so they go constructively. It is new in the 4th edition. [source: Handbook V4 What's New] The meaning of the PIVA letters is [uncertain].
Steps [synthesis]:
1. Clarify what you want from the conversation.
2. Plan timing and setting.
3. Draft opening lines in "I" statements.
4. Anticipate the other person's reactions and your responses.
5. Role-play it.
6. Review afterwards.
Example language (illustrative): "Let's rehearse it. I'll be your sister. Start with how you feel, not what she did."
Watch for: Conversations where safety is a concern (e.g. domestic abuse): do not encourage confrontation, and safety-plan instead. [synthesis]

5.5 Setting healthy boundaries (new in the 4th edition)

Purpose: Protect time, energy and wellbeing, and reduce stress and resentment, e.g. with using friends or demanding relatives. [source: Participant tools; Handbook V4 What's New]
Steps [synthesis]:
1. Identify where you feel drained, pressured or resentful.
2. Define the limit you need.
3. Script a clear, brief statement of it.
4. Decide what you'll do if the limit is crossed.
5. Practise saying it.
6. Review how it went.
Example language (illustrative): "I'm not coming to the pub nights for now. I'd love to get breakfast instead."
Watch for: Guilt after setting a boundary. Normalise it, and link it to values (3.2).

G. Point 4: Living a balanced life

6.1 Check your lifestyle balance (Lifestyle Balance Wheel; formerly Pie)

Purpose: Review each life area and shift perspective where you feel stuck. [source: Participant tools; Handbook V4 What's New]
Steps [synthesis]:
1. Draw a wheel of life areas, e.g. health, relationships, work or study, leisure, finances, spirituality or meaning, home.
2. Rate current satisfaction in each area, 0–10.
3. Mark the area where a small gain would help most.
4. Set one step, using 6.3.
Example language (illustrative): "Which spoke, if it moved two points, would make the rest easier?"
Watch for: Overwhelm when every area scores low. Choose just one.

6.2 Explore new passions and pursuits (formerly VACI, "Vital Absorbing Creative Interest")

Purpose: Revisit old interests or find new ones that bring enjoyment back and fill the time the behaviour took. [source: Participant tools; Montgomery County Overview]
Steps [synthesis]:
1. List past enjoyments and curiosities.
2. Pick one to sample, with a low-cost, low-stakes first try.
3. Schedule it with 4.4.
4. Review the experience: absorption, enjoyment, mastery.
Example language (illustrative): "What used to make you lose track of time before drinking took over evenings?"
Watch for:
- Anhedonia in early recovery: warn that enjoyment may lag behind action.
- Persistent low mood: screen for depression.

6.3 Set an effective goal (formerly Goal Setting)

Purpose: Build clear goals tied to values, both short- and long-term. [source: Participant tools; Montgomery County Overview]
Steps [synthesis]:
1. Start from a value (3.2).
2. Make the goal specific, measurable, realistic and time-bound.
3. Break it into weekly steps.
4. Name the obstacles and supports.
5. Review progress.
Example language (illustrative): "'Get fit' is a wish. What would you actually do on Tuesday?"
Watch for: All-or-nothing goal-setting that sets up failure. Use self-compassion after a miss.

6.4 Meditation practice, 6.5 Progressive muscle relaxation, 6.6 Visualise a relaxing space

Purpose: Stress and urge management through mindfulness and relaxation. These are new in the 4th edition. PMR and visualisation are discussion-only, with no handout. [source: Handbook V4 What's New; 4-Point facilitator guides page; OCA 2025]
Steps [synthesis]:
- Meditation: 3–10 minutes of attention on the breath. Notice when the mind wanders and return to the breath. Practise noticing urges as body sensations that rise and fall.
- PMR: tense each muscle group for about 5 seconds, then release for about 15 seconds, noticing the contrast. Work from feet to face.
- Visualisation: imagine a safe, calm place in all senses, and pair it with slow breathing.
Example language (illustrative): "Just notice where the urge sits in your body. You don't have to do anything about it."
Watch for: Trauma survivors may find eyes-closed or body-focused work destabilising. Offer eyes-open, brief versions and an opt-out. [synthesis]

H. Other tools named in older SMART materials

These still appear in some meetings, handbooks or national versions (UK, Australia). Each is listed with its purpose only. Steps are [uncertain].

Vocabulary exchange and coping statements: replace absolute or harsh words with accurate, supportive ones. [source: Montgomery County Overview]
Relapse prevention plan: plans for high-risk situations. [source: Montgomery County Overview]
Five Factor Model: physiology, thinking, feelings, actions and environment all influence one another. [source: OCA 2025]
Role-play and brainstorming: used as group methods in meetings and in facilitator training. [source: OCA 2025 (training role plays); FG DENTS (brainstorming)]

I. Family & Friends programme (refer, don't run unless trained)

Purpose: Support for people affected by a loved one's addictive behaviour. It uses Community Reinforcement and Family Training (CRAFT): reward positive behaviour instead of having emotional confrontations, and respond with compassion instead of hostility or avoidance. [source: Montgomery County Overview] There are separate Family & Friends facilitator training and meetings. [source: Path to become a facilitator]
Clinician steps [synthesis]:
1. Offer it to worried relatives whether or not the user is in treatment.
2. Prepare them: the aim includes their own wellbeing, not only getting the loved one into treatment.
3. Screen for domestic violence before any CRAFT-style communication plan.
Watch for:
- Family members expecting confrontational "intervention" methods. CRAFT is explicitly non-confrontational.
- Detailed CRAFT session content is [uncertain].

5. Handling problems

SMART's published guidance on problems is limited to the items marked [source]. Everything else is my own clinical synthesis, marked [synthesis].

Stuck or ambivalent client ("I don't know if I want to stop").
- Go back to Point 1: CBA with the benefits of using included, values, the change-plan ratings.
- Normalise ambivalence. Do not argue for change. [source: FG CBA]
- Ask what goal the client actually wants. Under the 4th edition, reduction or harm reduction is a valid path. [source: Handbook V4 What's New]
Mandated or pre-contemplative attender. SMART expects people at this stage, often sent by courts or family. [source: The Stages of Change]
- Validate the pressure.
- Invite them to observe.
- Use "what would have to happen for this to be worth your time?"
- Offer attendance verification without making it the focus. [synthesis]
Resistance in the group (debating, "this won't work").
- Reflect the concern and invite other members' experience instead of defending the tool.
- Keep it participant-driven, and redirect gently. [source: FG DENTS tips; synthesis]
Advice-giving, a dominating member, long monologues.
- Use the ground rules: stay on topic, no monologues.
- Summarise, thank, and turn to the group: "what have others tried?" [source: Montgomery County Overview; Opening and Closing; synthesis for wording]
Member arrives intoxicated. Welcome them to observe and ask them to share another time. If they are disruptive or medically at risk, speak privately, check their safety and transport, and stop the meeting if needed. [source: Opening and Closing for the first step; synthesis for the rest]
Lapse or relapse disclosed.
1. Thank the person.
2. Treat it as a setback and a source of learning, not failure.
3. Run an ABC or urge-log review of the lapse.
4. Update the change plan.
5. Revisit the CBA, and screen for complacency in maintenance.
[source: Montgomery County Overview; Opening and Closing; The Stages of Change]
Shame and self-damning after a lapse. Use self-compassion (2.2) and the REBT stance of rating the behaviour, not the person. [source: OCA 2025; Participant tools] The specific dialogue is my own [synthesis]: "You did a harmful thing; that doesn't make you a worthless person."
Overwhelm: too many tools, too much homework. Pick one tool per week. The FG asks for one small DENTS practice. [source: FG DENTS] Use discussion-only versions or a shortened worksheet. [synthesis]
Non-adherence with worksheets or logs. [synthesis]
- Shrink the task to three fields.
- Complete it together in session or on screen (fillable PDFs).
- Use the SMART app.
- Explore what the client gets from not doing it, with a CBA on homework itself.
Rupture with you over SMART vs twelve-step, or over abstinence. [synthesis]
- Apologise for any pressure.
- Restate that SMART is broad-based and compatible with other groups and medication. [source: Montgomery County Overview]
- Let the client choose.
Rupture between a member and the group or facilitator (feeling judged, harassment, unwanted online private messages). Respect, honesty and non-judgemental language are core rules. Unwanted private messages are reported to the facilitator. Harassment is not tolerated. [source: Opening and Closing; Montgomery County Overview] Follow up one-to-one after the meeting, and remove or block harassers per local policy. [synthesis]
Facilitator overreach (doing therapy in the meeting, diagnosing). SMART is not therapy. [source: Opening and Closing] Clinicians who facilitate should keep clinical assessment for individual contact, avoid dual-role confusion with their own caseload, and follow their service's policies when the meeting runs inside a treatment setting. [synthesis] SMART's rules for professional-run meetings were not found. [uncertain]
Risk disclosures (suicidal thoughts, overdose risk, child or adult safeguarding). [synthesis] Do not process these in the group.
1. Acknowledge the disclosure briefly and speak privately after the meeting or at a break.
2. Do a standard risk assessment if you are clinically qualified, or link the person to crisis services if you are a peer facilitator.
3. Follow your professional and local safeguarding duties. Confidentiality in the group does not override a duty to protect.
4. For overdose risk, give naloxone information and lethal-means counselling: secure storage, removal of stockpiled medication.
Withdrawal or medical risk. Alcohol, benzodiazepine or opioid cessation can be medically dangerous. Refer for medical assessment before abrupt stopping, and support prescribed medication. SMART does not discourage it. [source: OCA 2025 (medication not discouraged); synthesis for the rest]
Modality-specific: handbook version confusion. Members may use old names (DEADS, DISARM, DIBS, Pie, VACI). Map old names to new ones using the 4th-edition rename table. [source: Handbook V4 What's New]
Modality-specific: conflict over the meeting's goal (abstinence vs harm reduction). Older scripts centre abstinence, while the 4th edition accepts harm reduction. [source: Opening and Closing; Handbook V4 What's New] State the meeting's stance at the opening, and protect members with either goal from criticism. [synthesis]
Modality-specific: personification or disputing feels invalidating (e.g. trauma-related shame, psychosis). Use plain thought-labelling and compassionate reframes instead of vigorous disputing, and coordinate with the client's treating clinician. [synthesis]
Modality-specific: family members want the loved one "made" to stop. Use Family & Friends' CRAFT principles: positive reinforcement, compassion, no confrontation. Address the family member's own wellbeing and safety. [source: Montgomery County Overview; synthesis]

Sources

Sources: