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SETTING UP A SMART RECOVERY GROUP St Vincent’s Hospital Alcohol & Drug Service Handbook for S.M.A.R.T Facilitators Compiled by Renee Slym & Josette Freeman 1 Table of Contents About S.M.A.R.T Recovery..............................................................................2 2 The Role of the Professional Advisor........................................................4 2.1 Reasons for contacting your Professional Advisor (examples)..........4 3 Setting up (What you need to know to get started)...................................4 3:1 Finding a Meeting Location ...................................................................6 3:2 Advertising..............................................................................................7 4 What Works (Our experiences in setting up a group)...............................8 4.1 Suitable Meeting times ......................................................................8 4.2 Using Flip Charts as Prompts in the first Group.................................9 4.3 Regular SMART Spiels at the start of every meeting ........................9 4.4 Pre-preparing a SMART Tool for the week......................................10 4.5 Encouraging others to chair the meetings .......................................10 4.6 Being in regular touch with other SMART facilitators.......................10 5 What doesn’t work (our blunders in setting up a group!).........................11 5.1 Putting other self help groups down ................................................11 5.2 Telling War Stories ..........................................................................11 5.3 Not sticking to the SMART Structure...............................................12 6 Frequently Asked Questions...................................................................13 7 Handling Intoxicated Clients ...................................................................16 7.1 How should I address an intoxicated person?.................................17 8 Handling resistant members...................................................................18 9 Handling late comers..............................................................................19 10 Resources and Information.................................................................19 About S.M.A.R.T Recovery S.M.A.R.T Recovery (Self Management and Recovery Training) was developed in the United States to provide more options for alcohol and drug dependent people who would like to pursue self- help approaches to their recovery but prefer not to embrace Alcoholics Anonymous or Narcotics Anonymous. SMART provides 2 a more flexible approach although many might prefer the more traditional style of AA or NA. SMART, based on cognitive behavioural strategies, has become increasingly popular in the United States over the last 15 years. SMART self-help groups are run by volunteers in the US, where they are now providing an alternative to the AA or NA model. One major attraction of SMART is that participants generally find that they have to attend groups only for a relatively short period – usually 12 - 18 months - rather than accepting the burden of attending AA or NA groups for the rest of their lives. SMART has become an increasingly popular and useful program in a large number of prisons throughout the US. Long Bay Gaol, Sydney, has now commenced the program and other Correctional Centres are in the process of taking it on. The Alcohol and Drug Service at St Vincent' s Hospital began facilitating these groups in 2002. Since then, groups have grown in numbers and facilitation has been mostly taken over by skilled peers. Currently in Sydney there are six different SMART groups running and more are set to start in the near future. SMART is based on a four point program which covers 1. Problem Solving skills 2. Enhancing Motivation 3. Coping with urges 4. Developing a lifestyle Balance Groups are ‘open’ so people can attend for as long or as little as they would like. They are designed for people from all walks of life who are looking for strategies to assist them manage their dependence. Participants are given the opportunity to discuss difficulties, challenges, accomplishments and successes while focusing on goals. Individuals with marked cognitive difficulties may not have the skills to apply some of the strategies, and so are not encouraged to attend the group. A structured agenda is an important feature of meetings. Some special attention is paid to: - Disputing Irrational beliefs - Coping with High Risk Situations - Resisting Urges 3 - Refusal skills - ABC theory of Cognitive restructuring - Anger reducing beliefs 2 The Role of the Professional Advisor The professional Advisor is available to assist you, the SMART facilitator, with any difficulties you may be having running a SMART meeting in your area. The professional advisor can also offer support, education and information about network meetings for facilitators. The professional advisors all currently work out of St Vincent’s Hospital Alcohol and Drug Service. Professional Advisors may come from a range of backgrounds including psychology, nursing, health education and welfare. All have specific alcohol and other drug skills and have a vested interest in the success of the SMART Recovery program in Australia. 2.1 Reasons for contacting your Professional Advisor (examples) • For resources such as Members Manuals, Facilitators Manual, or access to SMART material • For advice on difficult situations in meetings • For specific alcohol and other drug information • For assistance with setting up a group in your area • For information and links to the SMART Facilitators network, meetings and information sessions 3 Setting up (What you need to know to get started) Congratulations on becoming a SMART facilitator! Hopefully this handbook can assist in making your groups successful and enjoyable. Like any group, you will no doubt experience a few teething problems – be patient, this is normal and there are people just like you who can support you to iron out the difficulties. 4 Although it helps, SMART facilitators do not need to be experts in Rational Emotive Therapy. It is recommended before starting facilitating a group, that you 1. Read the US SMART Recovery Facilitators 2. Manual. It outlines the entire program and also gives a brief overview of Rational Emotive Behavioural Therapy and basic counseling skills. 3. Read any additional literature on SMART recovery. Recommended books and resources are also mentioned in this handbook. 4. Attend a SMART Recovery training Session held by Staff at St Vincent’s Hospital. Attend a few groups that are already established 5. Become very familiar with the SMART program. Obviously it is expected that you will have attended a number of SMART groups (and preferably facilitated) either as a member or as a professional observer. If you haven’t already done this, it is paramount before going any further!!! Ask if you can facilitate a few of the meetings to increase your confidence and get to know how the agenda flows. 6. Ask yourself some important questions such as…”Why do I want to become a SMART facilitator”, “Do I feel comfortable enough with my personal issues at the moment in order to address other people’s with objectivity?”. “What are the signs and symptoms that I need to work on my own stuff rather than other people’s?” . “Am I comfortable with the fact that some people are not willing to be completely abstinent?” “Am I willing to promote SMART strategies regardless of where people are at with their substance use?”. “Am I aware that SMART Recovery is NOT a 12 step program?”. 7. Make sure you agree to adhere to SMART Recovery Code of Conduct for Coordinators and Professional Advisors. See Chapter 1 (section 1.14) Facilitators Manual. If you disagree with any of the 10 behavioural guidelines, you may not be suitable to facilitate our groups! Be sure to discuss these with a professional advisor. 8. Know the meeting Outline . Read Section 1.2 of the SMART Recovery Facilitators Manual for an outline 5 and tips on how to address the SMART meetings. You might like to take this along with you to the first few groups before feeling completely confident. 9. Know when to consult your SMART Professional Advisor. 10. Find a meeting location 3:1 Finding a Meeting Location The ideal meeting location is convenient to the coordinator, free of charge, convenient for newcomers to find, available indefinitely at the same time each week, comfortable, large enough to accommodate fluctuations in meeting size and in a safe area. Fortunately, less than the ideal location will often be sufficient. Some suggestions: Contact local Halls, community groups and Church groups. Often these facilities are free to the public (if not, relatively cheap). If there is rent to pay for the space, this will need to be paid for through the “Pass the Hat” money obtained from group members. It is also advisable to contact your nearest Alcohol and Drug Service, local Community Health and Welfare Services and G.P’s in the area. If they have not already heard of SMART, they will be likely to be interested in what it involves, and perhaps may be interested in supporting you as a professional advisor. Sometimes Alcohol and Drug Services may have space for groups, and a lot of referrals can also come from these services. You can call the Alcohol and Drug Information Service (ADIS) 9361-8000 and ask what services are currently operating in your area. The SMART Facilitators Manual (Section 2.3) includes some ideas as to how to approach organizations to explain SMART and request a location. Often finding a location is a long process that involves a number of phone calls and at times, 6 many knockbacks. Phone the SMART Recovery Co- ordinator if you need assistance. If all else fails, DO NOT hold meetings in your home! It is likely that you do not wish for all meeting participants to be aware of your address! 3:2 Advertising Once you have established a meeting location, and registered yourself as a meeting facilitator, it is fundamental that you get the word out, and fast! Promotional material can be collected from St Vincent’s Hospital Clinical Services Team (9361 8020) – Speak to the SMART Recovery Coordinator. Posters and brochures are available to stick up and hand out. Where should you advertise? Some ideas of where advertisements and fliers might best be placed are: -Alcohol and Drug Services -Community Halls and Centres -Hospitals (eg. Emergency Department) -Doctor’s Surgeries in your area (you will need to ask permission to put up any posters) Other Professionals in your area might include doctors, psychologists, psychiatrists, nurses, social workers, marriage counsellors, and other mental health counsellors. The local newspaper in your area is a good way to advertise. If possible, the editor may do a profile on the SMART Recovery program for further promotion. The SMART Co-ordinator can help with this if need be. Our experience was to cold call GP’s and other services to explain the SMART program. Whilst on occasion we received uninterested responses, the majority of people responded with great interest because essentially it was presented as another treatment option that we were offering for their patients/clients. We also offered to visit and distribute pamphlets or to talk to them face to face about what SMART offers. 7 Nowadays, the bulk of our referrals come from GPs in the area, as well as drug and alcohol services, hospitals and community centres. 4 What Works (Our experiences in setting up a group) The main reason for writing this handbook was to guide its readers towards setting up and facilitating a successful SMART group, with help from our good experiences and often our good luck! When the groups first started in Sydney, a small number of people who were familiar with the US SMART Recovery website had called with a keen interest to attend a group such as this in Australia. Most of these people had had AA/NA experiences, and whilst some were still actively attending and benefiting from 12 step groups, others were keen to attend something alternative. People’s expectations of what a SMART group involved were very different, so it was important to bring all participants up to speed, quickly, about what SMART was and what SMART was not! Here are some of the things that we’ve found to have worked for us! Hopefully they are of benefit to you. 4.1 Suitable Meeting times Often after hours meeting times are the best way to get the most numbers of people at any one time. In the beginning, we held groups at 10am in the morning, which was convenient for us, yet inconvenient for very few participants! It was also noted that around lunchtime was a better time as it’s not too early and mothers with school children could attend. Many people who have come to our after hours group (starting at 6pm) have requested that groups be held even later than this due to traffic and other issues at this ‘knock off ‘ time period. It has been suggested that a weekend group may be of benefit to people who have difficulty accessing the groups during the week. It is recommended (if you are flexible) that once you get a few regulars attendees that you consult them on what is the most convenient time for all concerned. That way you will retain attendance and they will also tell their friends about meeting times that are convenient. Remember, this is their group, so ultimately (providing it is a time you are able to make it) this should be their decision. Always let A.D.I.S know if you change the meeting time. 8 4.2 Using Flip Charts as Prompts in the first Group In the beginning, SMART was brand new to Australia and although some newcomers had studied the program and had been online, many had very little knowledge of how the SMART program worked. It is recommended by SMART that Flip charts explaining the SMART philosophy and how it works can be beneficial for both the members and the facilitator to be clear about REBT and other tools. It is important to emphasise that SMART is not a 12 step program and the flipcharts can clearly explain this, as well as highlight what SMART is. When all members have the same and correct understanding, long winded arguments about what the group entails can be avoided! Speak to the SMART Co-ordinator at St Vincent’s Hospital (Josette Freeman 9361-8024) about the Flip charts and how they might be utilized. 4.3 Regular SMART Spiels at the start of every meeting Although you will experience the ‘regulars’ who show up to SMART groups most weeks, from time to time people will drift in and out depending upon whether the program is suited to them or not. Even though the regulars would generally know the philosophies of SMART, frequently people will attend with little knowledge about the program. We have found that it is very useful (as recommended by our colleagues in the US) to read out an opening statement to put newcomers on course and remind others of what SMART is and isn’t. The opening statement is usually read from the member’s manual. It goes like this: “SMART Recovery is an abstinence – based, not for profit organization with a sensible self-help program for people having problems with drinking and using. It includes many ideas and techniques to help you change your life from one that is self – (and other -) destructive and unhappy to one that is constructive and satisfying. SMART Recovery is not a spin-off from Alcoholics Anonymous. No one will label you an alcoholic or an addict. You are neither a diseased person nor powerless and if you do not believe in a religion or spirituality, that’s fine. If you do, that’s fine too. We teach common sense self help procedures designed to empower you to abstain and to develop a more positive lifestyle. When you succeed at following our approach, you may graduate from the program, or you may stay around to help others”. 9 It is also a good idea to tell newcomers how the meeting runs and to let everyone have a moment to discuss their week before jumping in. 4.4 Pre-preparing a SMART Tool for the week It has been effective in the past to download an exercise from the SMART website which demonstrates a SMART tool. During the meeting, the SMART exercise can be read through and participants can learn a new tool to practice during the week. These tools are downloadable from www.smartrecovery.org 4.5 Encouraging others to chair the meetings It is important to share the chairing/facilitating of meetings and allow other members to understand the SMART meeting outline. This enables members to own their own group and to share some of the responsibility of running a group. Delegating people to chair the meeting does not work well. It is more effective if, at the end of a meeting, it is asked if somebody would be willing to volunteer facilitate the meeting next week. By teaching skills to other members within SMART, more people will be capable of starting up their own groups, or becoming a facilitator at a time when you are unable to attend or need to go away. 4.6 Being in regular touch with other SMART facilitators It is important to be able to receive support from other facilitators of SMART Groups. It is also important to consult the SMART Coordinator at St Vincent’s Hospital (or your Professional Advisor) with any queries or concerns, or purely to debrief about a meeting that hasn’t gone so well. Do not isolate yourself from others. The support is there for you! 10 Our facilitators within NSW have regular meetings to get and give support, discuss ideas and new SMART initiatives. Find out more about this by contacting Josette Freeman. 5 What doesn’t work (our blunders in setting up a group!) Whilst a number of things went well for us in setting up SMART groups, generally it was expected that we would also learn from mistakes. Here are some things that we found simply did not work with regard to setting up a successful SMART Group. 5.1 Putting other self help groups down As previously mentioned, it is not a good idea to have long debates about whether 12 step programs or other programs are as effective as SMART. Everyone who attends a group will have a different idea about what is best for them and SMART is not the forum in which to argue about which treatment is best. The whole idea of SMART is to offer another option to those wishing to seek support for their alcohol and drug issues. If people are attending other groups at the same time, this should be supported and respected. Their plan to improve their lifestyle will be an individual one. Just because you succeeded in a certain way, does not mean that others have to follow that exact same path. SMART is about choices, and believe us, no-one will ever agree on the issue of whether 12 step is good, bad or ugly, because everybody is different and everybody gains assistance in their own way! 5.2 Telling War Stories Cognitive Behavioural Therapy and Rational Emotive Therapy specifically address issues occurring in the present. Therefore, SMART topics and content of meetings are focused on the here and now and not on the past. There is limited time for people to talk about how their week has been in recovery, let alone to give a life story. People at SMART know that others in the group have been successful at drinking or using for a good portion of their lives. Nobody learns from hearing the war stories of how this was 11 accomplished!! The SMART belief is that we cannot change the past, however we can manage how we live in the present and future, and this is where we can help each other to achieve change. It is important to have an understanding of your past behaviours and how it was that you came to make the change, however SMART is not the forum in which to explore these matters. As a coordinator, it is important to explain this to participants and to shift the topic of conversation if people begin to dwell on the past. If people want to discuss their deeper issues then it is recommended that they see a counsellor. SMART Recovery is NOT a therapy session. 5.3 Not sticking to the SMART Structure Although every group is varied and has different dynamics, it is important to keep to a structure (the meeting outline) in every group. Of course there will be meetings when this cannot be strictly adhered to, however it is helpful to both members and the facilitator to keep to the structure – Why? • The SMART Philosophy and way of working does not want to fade into the distance. SMART groups do not want to end up taking another turn and become something else • The chairperson of the week can use the meeting outline as a guide and can become more confident with the structure as time goes on, and can thus become a more effective chairperson. Eventually they will not need the manual as a guide. • Members do not go off on tangents and lose the momentum of the group discussion • If the structure is not stuck to, it is easier for certain members of the group to dominate discussion and others not to be able to have a say. • Members can be left at the end of the meeting wondering what the point of the meeting was, and may not return. • Members attend with an expectation that the group will be run according to the SMART program, so therefore we need to deliver this service to our members. 12 6 Frequently Asked Questions Q: Can people be on Methadone, Buprenorphine or other pharmacotherapies still attend SMART? A: Yes! At SMART we encourage people to utilize a range of treatments to assist them in managing their alcohol and other drug problems. Q: How long and how often should members attend? A: You can attend SMART meetings as often as you feel you need. Most participants attend on a weekly basis when they first start the program. You can choose to attend SMART for as long as you need. SMART aims to equip you with strategies to practice outside of meetings, and when you feel you can utilize the strategies without the support of SMART you may exit the program. We do not encourage people to become dependent on SMART for a lifetime! SMART encourages keen participants to become group co-ordinators when they feel they are at a point in their own recovery to assist others. If members leave the group and then feel that they are not doing so well, they are more than welcome to return to the groups. Q: When members attend meetings do they need to speak? A: No. If you do not feel comfortable participating in group discussion, you do not need to speak. You may choose to observe only. Group members are not encouraged to give their life story and no one will label you an ‘addict’ or an ‘alcoholic’. Q: Are members made to feel that their problems are part of their ‘disease’? A: The SMART Recovery program does not believe in the ‘disease’ model. No-one will label you an ‘addict’ or an ‘alcoholic’. SMART encourages members to take responsibility for themselves and to empower people to learn how to manage their dependencies and how to maintain their motivation to abstain. Q: What if members do not want to be abstinent? A: SMART does not exclude participants on the basis of what their goals are regarding their alcohol and other drug use. Participants 13 who do not wish to be abstinent can still benefit from the various SMART tools offered and can develop skills to improve their lifestyle. Q: How does SMART differ from AA/NA? A: SMART is not a spin off from AA or NA. No one will label you an ‘alcoholic’ or an ‘addict’. At SMART, you are not seen as diseased or powerless, and if you do not believe in a religion or spirituality, that’s fine. If you do, that’s fine too. We do not have the 12- step program, rather, we teach common sense self-help procedures designed to empower you to abstain and/or develop a more positive lifestyle. There are no sponsors in the SMART program. When you succeed at following our approach, you may graduate from the program, or you may stay around to help others. In SMART Recovery, we are not much concerned with the past, except to learn from it. We focus on present-day events and the causes of self-destructive behaviours. We concentrate on what to do about them in order to achieve a positive lifestyle change, especially in the areas of our lives that are related to alcohol and drug taking. Q: Can members go to AA/NA and still attend SMART A: Yes! As an individual, SMART encourages its participants to seek a range of treatment options and utilize those options that work for them. Many people who attend SMART also benefit from attending AA and NA and so are happy to attend both. Though our philosophy is different to a 12- step philosophy, members can choose to attend whatever self- help programs they desire! It is recommended that you go with what works for you. Q: What is REBT? A: REBT stands for Rational Emotive Behaviour Therapy. It was pioneered by the psychologist, Albert Ellis in the 1950’s. According to REBT, thinking creates your feelings and leads you to act. By managing the beliefs and emotions that lead you to drink or use, you can empower yourself to quit. Then you can work on problems you have with abstaining. The REBT approach is a form of Cognitive Behavioural Therapy. CBT is a thinking/doing approach. It gets the client to challenge their irrational thoughts. Q: What is the evidence that SMART works? 14 A: There is empirical evidence for the effectiveness of Cognitive Behavioural Strategies (such as those used in SMART) for alcohol and other drug problems. (see next) Q: What works best – AA or SMART? A: There have been few studies into the effectiveness of AA/NA programs due to methodological complexities and the nature of an anonymous program. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) in the US funded ‘Project Match’ (1997) which tested the assumption that different types of “alcoholics” would fare better in some treatments and not in others. Participants were randomly assigned to one of three treatments 1) AA participation, 2) CBT or 3) Motivational Enhancement therapy (MET). Findings showed that apart from patients with low psychiatric severity, all types of participants in all three treatments fared just as well. SMART incorporates CBT and MET, so these results suggest SMART participation could be as effective as 12 step participation for a wide range of individuals. For more information on this study, go to http://www.smartrecovery.org/library/Newsletters/PresidentLetters/ apr97.pdf Q: Where can I go to get additional information on SMART and CBT/REBT A: The American SMART Recovery Website provides a vast amount of information on the SMART program, its origins, effective strategies, online discussions and meetings and general information. Go to www.smartrecovery.org The following publications illustrate the effectiveness of CBT programs: Copeland, J., Swift, W., Roffman, R., and Stephens, R., (2001) A Randomised controlled trial of brief cognitive-behavioural interventions for cannabis use disorder Journal of Substance Abuse Treatment, Vol 21 (2), p55-64. Edelstein, M.R (1997) Three Minute Therapy: Change your thinking, change your life: CO, Glenbridge Publishing, Ltd. 15 Fletcher, A.M (2002) Sober for Good: New Solutions for Drinking Problems – Advice from those who have succeeded.Houghton Mifflin, USA. Horvath, T., (1998) Sex, Drugs, Gambling & Chocolate: A Workbook for Overcoming Addictions: CA, Impact Publishers, Inc. Where do I get the members manuals from? SMART Recovery Members Manuals can be purchased for $25 from St Vincent’s Hospital Drug and Alcohol Service. 9361-8020. The Facilitator’s Manual is $45. Once a group has been established and the membership grows, then members manuals can be purchased directly from the USA. SMART Recovery 7537 Mentor Avenue Suite 306 Mentor. OHIO. 44060 USA or email SRMail1@aol.com 7 Handling Intoxicated Clients It is important as a facilitator to be observant of other member’s appearances and behaviours in the group. For example, signs of intoxication to be aware of are people smelling of alcohol, slurred speech, unbalanced gait, mumbling, pinned pupils, dozing off to sleep during meetings and general inappropriate behaviour. Although confronting the individual might seem nerve racking, it is your job as a facilitator to address these issues as soon as they arise, and ensure the safety and comfort of others in the group. The main reasons for why intoxicated persons are discouraged from attending are: • Intoxicated people can be disruptive and can interrupt the flow of the meeting • Intoxicated people can make others feel uncomfortable or unsafe. (many people who attend meetings do not expect to be confronted with major triggers to drink or use). This jeopardizes other people’s opportunities to continue attending and benefiting from a group, and chairs will 16 empty very quickly if it becomes a place for intoxicated people! • Intoxicated people will most likely not remember what has been discussed in the meeting and therefore it’s a waste of time for them. 7.1 How should I address an intoxicated person? It is never wise (or respectful) to confront a person about their intoxication in front of other group members. It can be humiliating for the member and this can cause defensiveness, and an escalation of aggression. Before the meeting begins, it is wise to observe group members and chat informally as they take a seat. If at this time it is suspected that someone may be intoxicated, it is quite simple to ask someone if you can have a quick chat before the meeting starts outside. It is often a benefit to have another group member chairing the meeting so that if it does not become apparent that someone is intoxicated before the meeting starts, you can politely ask during the meeting if you can have a quick word with someone outside (while the meeting goes on uninterrupted). If you are chairing the meeting, this makes the process difficult. To start with, as a facilitator, you need to use common sense and your own discretion in handling intoxicated members. If a member has had a few drinks prior to the session but is cooperative and providing appropriate and useful discussion, it is not necessary to ask the person to leave. If, on the other hand, the member is disruptive, inappropriate and menacing, it is important that you address the behaviour for the sake of others in the group. Addressing an intoxicated person sometimes takes some practice, however there are some common sense dos and don’t to be mindful of. DO Smile and ask if the person is feeling o.k. DO Say what you are observing. E.g “ Tom, I’ve noticed that you appear to be talking out of turn a little, is it possible that you might have had a couple of drinks before coming to the meeting?”. “You don’t seem your regular self, is it possible that you’ve used before coming in?” DO Acknowledge that often it is nerve racking coming to a meeting and you can understand why drinking or using might come to mind before attending 17 DO Emphasise rules of no drinking/using before a meeting DO Politely invite the member to come back next week and say that you enjoy their regular contributions when they are not intoxicated (if the person has attended before) DO Emphasise that other people in the group might find their intoxication a little disturbing. DO Use your head and look for signs. Be confident in your decision before speaking to the member DO Be aware of your own body language and make sure that you do not appear aggressive, authoritative or defensive DON’T Instantly accuse somebody of drinking/using. Ask them first. (If the person denies it, depending on how intoxicated they are, there are a number of responses you can give). Firstly if the person is relatively controlled, yet just smells a little of alcohol and appears not to be causing any problems, you can ask them to just observe this week and not verbally contribute. If the person is visibly intoxicated beyond doubt, it is your responsibility to inform the member that although you respect their opinion, it is your opinion that their presence in the group would disrupt others today and could they please come back next week. DON’T Raise your voice or intimidate the intoxicated person DON’T Confront the person in front of others DON’T Accuse the participant of ‘lying’ DON’T Make threats or appear angry DON’T Discuss the conversation with the rest of the group after the person has left the meeting. You may reinforce the fact that it is not advisable to attend a group when intoxicated. 8 Handling resistant members It is common for people to attend SMART groups for a range of reasons that aren’t necessarily their own. For example, many people feel pressured to attend a group due to family pressure or pressure by courts, probation officers or counselors. Not everybody who attends a group is willing to be open to strategies or be willing to provide a meaningful contribution. Some people dread coming along to groups due to past experiences or preconceived notions. Most people are ambivalent about whether to actually change their substance use patterns even after entering treatment. This is all O.K! It is important to roll with resistance and come to manage it effectively. 18 Firstly, when people first attend a group, often they are not wishing to contribute. Do not force people to talk or give a run down of their week. ALWAYS give people an option of remaining silent and just observing for the week. Sometimes people wish to use their presence in the group to criticize other programs (such as NA/AA) or to talk about everything that it going wrong for them! Remember that SMART is solution focused, so give others an opportunity to assist the resistant member with some practical ideas. Remind the resistant person that the point of SMART is not to bad mouth other treatment options. If you don’t, this can often erupt into a heated argument. If people are rude, or uncooperative to the group, you can • Suggest they might like to be an ‘observer’ • Ask to speak to them privately outside and ask whether there is anything you can assist them with if they have any problems with the flow of the meeting. Once again, explain the behaviour you are observing. “You seem a little frustrated by what some people have to say, can I clarify any queries you have about this group?” 9 Handling late comers It is important when new members attend the group to be clear about starting times and the importance of starting on time. This allows everyone a chance to participate. When people are frequently late to groups, it is important to address this with them privately after the meeting and explain that it can be disruptive for others when this occurs. A rule can be made that if participants can not arrive within the first 15 minutes, not to arrive at all. However, lateness is to be discouraged. 10 Resources and Information First and foremost, it is important to purchase a copy of the SMART Recovery Facilitator’s Manual. This can be purchased from the St Vincent’s Hospital SMART Recovery Coordinator for $45. This can then be reimbursed from ‘pass the hat’ money. Members Manuals can also be obtained through St Vincent’s Hospital. Participants are required to buy their own manuals for 19 $25. This money is to be kept in petty cash and participants are to receive a receipt. Members manuals can be supplied by St Vincent’s Hospital SMART Recovery Co-ordinator. Facilitators should keep a book with the numbers of group members attending each week. These figures will need to be either phoned or e-mailed in to the SMART Coordinator every month. USEFUL CONTACT DETAILS: A.D.I.S (Alcohol and Drug Information Service) 9361-8000 St Vincent’s Hospital Drug and Alcohol Service 9361-8020 SMART Recovery Coordinator – Josette Freeman – 9361-8024 email@example.com 20 21
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