Rational Recovery and Rational Recovery Systems, Inc. is a commercial vendor of material related to counseling, guidance, and direct instruction for addiction designed as a direct counterpoint to Alcoholics Anonymous (AA) and twelve-step programs. Rational Recovery Systems, Inc. was founded in 1986 by Jack Trimpey, a California-licensed clinical social worker. Trimpey is a recovered alcoholic that works in the field of treatment of alcoholism and other drug addictions. Rational Recovery is a commercial trade mark, along with the Addictive Voice Recognition Technique.
Program
The program is offered on a commercial basis via the Internet and through books, videos, and lectures. The Rational Recovery program is based on the premise that the addict both desires and is capable of permanent, planned abstinence. However, the Rational Recovery program recognizes that, paradoxically, the addict also wants to continue using. This is because of his belief in the power of the substance to quell his anxiety; an anxiety which is itself partially substance-induced, as well as greatly enhanced, by the substance. This ambivalence is the Rational Recovery definition of addiction.
According to this paradigm, the primary force driving an addicts predicament is what Trimpey calls the “addictive voice”, which can physiologically be understood as being related to the parts of the human brain that control our core survival functions such as hunger, sex, and bowel control. Consequently, when the desires of this “voice” are not satiated, the addict experiences anxiety, depression, restlessness, irritability, and anhedonia (inability to feel pleasure). In essence, the RR method is to first make a commitment to planned, permanent abstinence from the undesirable substance or behavior, and then equip oneself with the mental tools to stick to that commitment. Most important to recovering addicts is the recognition of this addictive voice, and determination to remain abstinent by constantly reminding themselves of the rational basis of their decision to quit. As time progresses, the recovering addict begins to see the benefits of separating themselves and their rational minds from a bodily impulse that has no regard for responsibility, success, delayed gratification, or moral obligation.
While nomenclature differs, the methods are similar to those used in Cognitive Therapy of Substance Disorders (Beck, et al.) and other belief-, attitude- and appraisal-challenging and cognitive restructuring schemes.
The RR program is based on recognizing and defeating what the program refers to as the “addictive voice” (internal thoughts that support self-intoxication) and dissociation from addictive impulses. The specific techniques of Addictive Voice Recognition Technique (AVRT) are concerned with demonstrating to the practitioner that the practitioner is in control of the addictive voice, not the other way around.
In his book, Rational Recovery, Trimpey calls the addict’s addictive voice “the Beast”. He proposes that this is the sole reason why addicts continue their self destructive ways. Furthermore, by recognizing any feeling, image, urge, etc. that supports drinking/using as “Beast activity”, the compulsions will fall silent, and the person can eventually regain control over their life and never worry about relapses. Although addiction is a life-long battle, it is much easier to say “no” to the addictive voice, than to give in. Moreover, this separation of the rational self from the relentless “Beast” will, Trimpey says, enable addicts to always remain aware of the repercussions associated with a single relapse.
The notions that internal thoughts support self-intoxication and that the practitioner is in control of the addictive voice have become foundational in “evidence-based” treatment schemes at more progressive substance abuse treatment facilities in the US, Canada, Australia and the UK. These facilities base their programs on the success of Rational emotive behavior therapy, Cognitive behavioral therapy, Cognitive Appraisal Therapy, and Schema Therapy for anxiety and depression, as well as for substance abuse.
While Rational Recovery and AA promote abstinence, the programs use radically different strategies. Rational Recovery repeatedly makes it clear that there is no better time to construct a “big plan” to abstain from drinking/using than now, and that AA’s idea of “one day at a time” is contradictory to never using again. Essentially, it proposes that if you are never going to drink again, then there isn’t a reason to keep track of time.
- Rational Recovery does not regard alcoholism as a disease, but rather a voluntary behavior.
- Rational Recovery discourages adoption of the forever “recovering” drunk persona.
- There are no Rational Recovery recovery groups (although meetings were held throughout the country during the 1990s).
- Great emphasis is placed on self-efficacy (cf. Albert Bandura).
- There are no discrete steps and no consideration of religious matters.
Court-mandated twelve-step program attendance
In the United States, RR encouraged legal action against mandated attendance of twelve-step programs, stating an objection to the courts and other government and tax-supported agencies mandating attendance at meetings run by organizations with spiritual or religious content. They interpret state-mandated twelve-step program attendance as a violation of the Establishment Clause within the First Amendment. This view has been upheld in Griffin v. Coughlin, Grandberg v. Ashland County, Warner v. Orange County Department of Probation, Kerr v. Lind, and O’Connor v. State of California. Recently, these cases have been challenged by Cutter and Wilkinson, which finds no violation of the Establishment Clause.
Critics have accused Rational Recovery of being anti-religious. The Rational Recovery FAQ states:
Rational Recovery has voiced the conscientious objections of tens of thousands of persons who have received unwanted, unconstitutional, religious indoctrinations in the course of addiction treatment. To them and others, we provide a program that is free from religion. By advocating for their religious freedom, and identifying the 12-step program as a religion that competes with established religions, we have been accused by some of being irreligious, sacrilegious, or even anti-religious. Ain’t so.
Rational Recovery claims to remain neutral on the subject of religion and sobriety. Rational Recovery founder Jack Trimpey explains:
“…Rational Recovery is not interested in having people give up any of their religious beliefs; it’s just none of our business what people believe about gods and saints. The only exception here, of course, is when one is ‘depending’ on a rescuing deity in order to remain sober. If that is one’s preference, then AA is an ideal program.”
Meetings Cancelled
Rational Recovery claims that “AVRT has made recovery groups obsolete.” In 1998, Rational Recovery announced, “The Recovery Group Movement is Over!…Beginning January 1, 1999, all addiction recovery group meetings for Rational Recovery in the United States, Canada, and abroad are hereby canceled and will not be rescheduled ever again, it’s just a waste of time and is completely unproductive.” Despite those remarks, there are still some groups in existence today, although the numbers are dwindling.
In a 1993 research study led by Mark Galanter, former president of both the American Society of Addiction Medicine and the American Association of Addiction Psychiatry, attempted to measure the impact of Rational Recovery on members. The research found that “Rational Recovery succeeded in engaging substance abusers and promoting abstinence among many of them while presenting a cognitive orientation that is different from the spiritual one of AA. Its utility in substance abuse treatment warrants further assessment. The results of the impact on this type of recovery are too few to make an educational assumption” This research was conducted before Rational Recovery disbanded their meetings in favor of self-recovery treatment. SMART Recovery split from Rational Recovery just after this research and continues to offer these same groups.
SMART Recovery
SMART Recovery (Self Management and Recovery Training) is an international non-profit organization which provides assistance to individuals seeking abstinence from addictive behaviors. The approach used is secular and science-based using non-confrontational motivational, behavioral and cognitive methods. Meeting participants learn recovery methods derived from evidence-based addiction treatments.
Methodology
SMART Recovery is based on scientific knowledge, and is intended to evolve as scientific knowledge evolves. The program uses principles of motivational interviewing found in Motivational Enhancement Therapy (MET), and techniques taken from Cognitive Behavior Therapy (CBT), particularly in the version called Rational Emotive Behavior Therapy (REBT), as well as scientifically validated research on treatment.
The organization’s program emphasizes four areas (called the Four Points) in the process of recovery: Building Motivation, Coping with Urges, Problem Solving, and Lifestyle Balance. The “SMART Toolbox” is a collection of various MET, CBT and REBT methods (or “tools”) which address the Four Points.
The program does not use the twelve steps which make up the basis of the various “Anonymous” self-help groups (e.g. AA, NA, etc.) and is generally listed as an “Alternative to AA” or an “Alternative to the Twelve Steps.” Though listed as an “alternative”, it is also suggested as a possible “supplement” to twelve-step programs in SMART Recovery’s main program publication, The SMART Recovery Handbook.
The Stages of Change as a SMART Recovery Tool
In the SMART Recovery program, there are seven stages of change:
- Precontemplation – At this stage, the participant may not realize that they have a problem.
- Contemplation – The participant evaluates the advantages and disadvantages of the addiction by performing a cost/benefit analysis.
- Determination/Preparation – The participant completes a Change Plan Worksheet.
- Action – The participant seeks out new ways of handling their addiction behavior. This can include self-help, the support of addiction help group or professional guidance.
- Maintenance – After a few months, the participant’s behavior has been changed and now seeks to maintain their gains.
- Relapse – Although not inevitable, relapses are a normal part of the change cycle and if handled well, can serve a learning experience in overcoming an addiction.
- Termination – Once a participant has sustained a long period of change, they may choose to move on with their lives and “graduate” from SMART Recovery.
History and Organization
Incorporated in 1992 as the Alcohol and Drug Abuse Self-Help Network (ADASHN), the organization began operating under the SMART Recovery name in 1994.
General operations are overseen by a volunteer Board of Directors. Local groups are run by volunteers known as “Facilitators” with the assistance of volunteer recovery professionals called “Volunteer Advisors.” A central office is currently maintained in Mentor, Ohio.
SMART Recovery offers its services for free although a donation is requested and its publications are sold.
Meetings
The meetings are free for all wishing to attend, and are intended to be informational as well as supportive. Approximately 600 weekly group meetings led by volunteer facilitators are held worldwide. In addition, the organization provides online resources and support to the volunteers and those attending the groups and one or more daily online meetings.
Meetings are also held in correctional facilities in many states including: Arizona, California, Florida, Indiana, Massachusetts, Michigan, Minnesota, New Jersey, New York, Vermont, Virginia, Washington, and Wisconsin.
Family and Friends
Concerned Significant Others (CSO) is an online support group for family and friends of SMART Recovery participants which started in September 2010. Its purpose is to address specific issues encountered when a family member or friend tries to reach out and help a loved one. and it draws from the work of Robert Meyers’ Community reinforcement and family training (CRAFT) approach which differs significantly from Alanon in that it is a behavioral program which advocates that the CSO can have a positive impact on the substance abuser. Further, the CRAFT program has been demonstrated in Meyer’s research to be more effective than the Vernon Johnson type intervention or Alanon, with less negative side-effects and better outcomes whether or not the substance abuser enters treatment.
Recognition
SMART is recognized by the American Academy of Family Physicians, as well as the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). NIDA and NIAAA are agencies of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.