An abstinence-based approach means that clients must completely abstain from drugs and alcohol.
Whilst Harm Reduction models will reduce harm, Total Abstinence goes beyond this to support the prevention of harm.
Abstinence Based Practitioners believe that people with substance use disorders may not successfully moderate their use in a way that does not lead to addiction and negative consequences.
This has some evidence base as highlighted by 12 Step Mutual Aid Fellowships modelled on Alcoholics Anonymous since 1935. The basic texts for these fellowships note that some people are not able to achieve total abstinence in their communities and may require to have specialist input (e.g. – Hospitalisation or Residential Rehabilitation).
However, more recently SMART recovery, has developed as an alternative model for achieving total abstinence.
SMART Recovery (Self-Management and Recovery Training) is a scientifically recognised programme of support for individuals affected by Substance use, whether this is lived, or living experience. It is designed to help you change your behaviours in a way that puts you in charge of your recovery and is solution focused.
SMART has four main points which are the central focus of a person’s recovery journey, which are;
SMART Tools are based on Cognitive Behavioural Therapy (CBT) which is about the connection between your thoughts, feelings, and behaviours, and it is those which determine how a person feel’s overall. When SMART Tools are used, individuals are able to move away from substances and negative behaviours and towards a life of positive self-regard and willingness to change.
Moving On Inverclyde deliver a four phase, SMART Recovery focused, CBT based programme which is accessible and suitable for anyone wanting to learn how to make positive changes and learn new behaviours, whilst also learning how, and why they feel the way they do.
During this programme, you are able to access SMART Recovery Meetings which are facilitated and led by those with lived experience and in long term Recovery. We also have an open meeting in Port Glasgow where any one can attend.
A SMART Meeting is focused on recovery. Those attending check in and share how their last week has been, a SMART Recovery tool is chosen that best supports the challenges faced by the group and the facilitator guides the group through the discussions. Finally, everyone checks out sharing what they have learnt and what they will do differently in the week ahead.
People can attend as many or as few meetings as they wish.
SMART Recovery is a powerful tool which enables people to achieve abstinence without the need for Residential Rehab. The tools which are learnt and behaviours which are adopted, with the support of peer led groups, empower people to live a balanced life, gain connections with like minded people and to give back within their community. People who achieve abstinence through SMART Recovery tools, find purpose to their lives and are encouraged and supported to learn new skills to occupy time and to fulfil goals. This might be though education, going to work, volunteering, accessing local community groups, or learning how to become a SMART facilitator as examples.
Often when people have completed residential rehab, they benefit from additional support to learn how to maintain their abstinence and recovery when living back in the community. Abstinence from substances has been achieved, but when faced with the situation and habits of before, it can be challenging to keep going. By engaging on a SMART Recovery programme, even for a short while, will enable the individual to use the tools and support to maintain long term abstinence and achieving that balanced life approach.
Moving On Inverclyde also offer SMART Family and Friends Meetings, facilitated by our partner Scottish Families affected by Alcohol and Drugs.
The 2020 Cochrane Report reported that, based on analysis of 10, 565 clients, that 12 Step informed rehab is at least 20% more effective than other modalities, with a 42% recovery rate after one year. It further noted that there were outcome variations that existed between rehabs that are skilled with delivering interventions and those that are not
The authors found high certainty evidence that clinically delivered and manualized TSF programs designed to increase AA participation can lead to higher rates of continuous abstinence over months and years, when compared to other active treatment approaches such as cognitive behavioural therapy.
The evidence suggests that 42 % of participants participating in AA would remain completely abstinent one year later, compared to 35% of participants receiving other treatments including CBT. This effect is achieved largely by fostering increased Mutual Aid participation beyond the end of the TSF program.
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