12 step programs for eating disorders and smart recovery

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12 step programs for eating disorders and smart recovery

SMART* Recovery and 12-Step Programs

In the world of Treatment there are several choices one has in the way of utilizing and attending a community based support group. Should one look more closely at what is offered to those with an eating disorder the choices are somewhat more limited but non-the-less do exist. This article takes a look at two diverse, yet complimentary approaches, 12 Step oriented programs and the SMART Recovery program.

A detailed description of both may be beyond the scope of this article. However, suffice it to say both “philosophies” or “beliefs” have inherent similarities as well as differences. To that end I hope to distinguish what each brings to the table that is unique and what they share in common.

SMART Recovery Basics

Let’s begin with what SMART (SR). In a nutshell, SR offers a 4-Point Program [not to be confused as “steps”] that amount to 1- Building and Maintaining Motivation, 2- Coping with Urges, 3- Managing Thoughts, Feelings, and Behaviors, and 4- Living a Balanced Life. SR can serve as a stand-alone approach or compliment another program such as a 12-step group or professional eating disorder treatment. SR does not necessarily adhere to the premise that one need attend meetings as part of a life long process as there is a beginning, middle, and end to treatment for dependency in this case eating disorders. Another, what I believe to be very important distinction, is SR to intended to be open to support any individual struggling and does not hold separate groups for compulsive overeaters, substance use disorders, compulsive gamblers, and affected family members. Virtually anyone with a compulsive behavior[s] and a desire for abstinence from these may benefit from attendance and are welcomed.

Having the benefit of experiencing both a 12-Step Program for many years and, more recently becoming a trained facilitator for a SMART Recovery group, I would say SR represents a more updated approach. Although there are no bona fide studies to support the efficacy of one support group over another, there is ample research to support the effectiveness of the “tools” and techniques taught in the groups. These include motivational interviewing techniques, cognitive behavioral approaches to confronting urges and destructive behaviors, and developing alternate healthy lifestyles to replace compulsive behaviors. SR encourages participants to take an active role in the group process, and unlike the format of a 12-Step meeting, talking between group members is encouraged. In effect, each participant serves as a therapeutic agent in the meeting. Last, but certainly not least much of the literature offered by SR incorporated a “how to” compilation of the tools and techniques discussed at the meetings. Rather than “steps” to be completed, the SR Handbook, as an example, provides an ample supply of worksheets and structured assignments that correlate with the four point program outlined from the beginning – Motivation, Coping with Urges, Managing emotions, thoughts, behaviors, and lifestyle change. Although not dissimilar from the 12-step notion of “into action”, SR is a program of “doing is believing” rather than an intellectual exercise. In passing, it’s worth noting SR holds no formal belief of the necessity of a spiritual belief system or philosophy being a pre-requisite for benefiting from their program. SR does not discourage or encourage individuals from bringing their religious or spiritual beliefs into their “personal” program of recovery. SR is quick to point out it is not a spiritual based program and as such, steers clear of incorporating such principles in their approach to recovery.

Comparison with 12-Step Programs

First, I would begin by stating both programs are careful not claim superiority with the belief “one size fits all” when it comes to recovery. As such, the “bashing” of one program versus the other is discouraged and both programs encourage a philosophy of open mindedness and seeing what works best for someone seeking recovery* from their substance or behavior[s] for example, eating disorders. *Both programs discourage “moderation” with regard to the substance or behavior and clearly state the goal of successful recovery is total avoidance.

While on the topic of similarities, it’s also important to note both programs encourage the use of medical and relevant professionals when appropriate as an integral part the process. Inherent with that policy is the notion SMART Recovery and 12-Step programs are there to serve as a support network and not a substitute for medically necessary treatment when called for. Indeed, one may argue there is a practical difference between a support group and a treatment program. For someone in the throws of an eating disorder, medical stabilization and a structured setting may be necessary to gain a foothold in the beginning stage of the journey. Yet for others, the frequently associated mental health issues such as depression may require the use of a suitable medication, and so on. Indeed, some people will choose one program over the other while still others will see each group as offering something unique and worthwhile – opting to attending both on an on-going basis.

To someone with no prior experience in a 12-step program, I would suggest it is, at least for me, difficult to put an aggregate of experiences into words to adequately describe them. Although not a religious program there is a strong current of encouraging ones’ own brand of spirituality without defining what that should be for the individual. To be sure, there are members who have succeeded in these fellowships who are agnostic or atheists and there are no “musts” in the program as outlined in their literature. The steps represent a series of actions or a progressive formula participants are encouraged to complete over time – with the inherent belief that doing so will not only result in continued abstinence from food or other substances, but also lead to a more productive and satisfactory lifestyle. Although much can be said pro or con for 12-step programs, the proliferation of groups and meetings is enormous, with hundreds of meetings taking place on a weekly basis in just about every major city here in the U.S. and throughout the world. Perhaps one of the greatest strengths of 12 step programs is the frequency of meetings and the fellowship opportunities they provide for people to find support and some hope.

Article Originally Published: Self Growth

Marty Lerner, PhD
“I love working with such talented professionals and motivated patients who actively advocate for themselves and the betterment of their futures.” Dr. Lerner is the founder and CEO of the Milestones in Recovery’s Eating Disorder Program which he started in 1999. Dr. Lerner is a graduate of Nova Southeastern University. Dr. Lerner is a licensed and board-certified clinical psychologist who…